CHAPTER 1 INTRODUCTION   CRYING IS THE FIRST MEANS of communication of an infant with its surroundings. Immediately after birth the baby takes its first breath and cries out. This is the very first sign of the baby's emergence from the womb into the world. The first cry is the result of a reflex mechanism for expanding and activating the respiratory system, but soon the cry turns into purposeful activity, as the infant seeks contact with the environment. During the early weeks and months of post -- CHAPTER 2 THE SOUND PHENOMENA INVESTIGATED: CRY, STRIDOR, AND COUGH   Cry Cry is a complex neuromuscular and acoustic phenomenon. As a motor function, crying begins in the facial and respiratory muscles and eventually involves nearly all the muscles of the child. The movements of the larynx are the finest, fastest, and most coordinated, whereas those of the mouth and pharynx are less complex and those of the trunk are the least refined. KEY POINT Cry is a neuromuscular and acoustic phenomenon. C -- CHAPTER 3 HISTORICAL BACKGROUND   THE HUMAN INFANT CRY has always been looked on with interest -- however, scientific observations were not made of it until the 19th century. Since then, the cry has been analyzed for type, cause, course, and concurrent activity. Beginning in the 1950s, sound spectrography has also been used for acoustic analysis of infant cry by pediatricians, psychologists, and phoneticians. Given this long history, there is only a modest literature about laryngoscopic examinatio.

CHAPTER 4 PATIENTS   INVESTIGATIONS were carried out on 370 infants and young children referred to us for evaluation of pathologic sound phenomena of respiratory tract origin over a period of 45 years. We identified 540 different pathologic sounds among these patients suffering from more than 40 different diseases or anomalies. They were compared to a control group which consisted of 50 healthy infants whose physiologic cries and intensified physiologic respiratory noises were recorded. Our stud -- CHAPTER 5 METHODS   Conventional Examination Methods, Their Critical Analysis and Sphere of Indication The course of investigation in infants with unusual, pathologic phonatory, or respiratory sound phenomenon depends on the following factors: Whether the patient had been referred for clarification of a peculiar sound phenomenon (pathologic cry, stridor, or coughing sound) or for some other reason and the voice disorder, noisy breathing, or cough only had been an accidental finding. The general -- CHAPTER 6 CHARACTERIZATION AND ACOUSTIC DESCRIPTION OF THE MOST COMMONLY OCCURRING SOUND SIGNALS   THE SEQUENCE of the individual sound types follows the classification contained in Figure 6-1. Cries Clear (pure, regular, normal) Cry (FIGURES 6-2A, B, AND C) A normal cry is (Figure 6-2) understood to be composed of a well-defined, adequately forceful fundamental frequency of about 400 to 500 Hz, and a series of overtones arranged regularly (at about 450 Hz distances) above the fundamental fillin.

CHAPTER 7 AIRWAY AND NERVOUS ANOMALIES ASSOCIATED WITH PATHOLOGIC SOUND PRODUCTION   IN DEALING with the individual diseases the sequence given in the Summary (see Table 9-1)-proceeding from the nose down to the deeper airways-is followed. The neurologic conditions and some chromosomal anomalies accompanied by pathologic cries are discussed in connection with the diseases of the larynx, whereas diseases associated with pharyngeal stridor are dealt with in the sections on nasal, oral, and pharyng -- CHAPTER 8 THE DIAGNOSTIC VALUE OF THE CONVENTIONAL EXAMINATION METHODS AND OF ACOUSTIC ANALYSIS   ACOUSTIC FINDINGS obtained from disorders of the respiratory tract or from some neurologic anomalies, that is, pathologic cry, stridor, and cough, mirror characteristic symptoms. In a number of diseases they may, in fact, furnish the diagnostic clues, or may be so typical as to give the disease its name (e.g., cri du chat syndrome, congenital inspiratory stridor, or whooping cough). Verification of -- CHAPTER 9 SUMMARY   IT HAS BEEN our starting point and is indeed one of the conclusions of our work that various infant vocalizations originating from the air passages are merely symptoms and not entities. However, the systematic study and classification of the various sounds have convinced us that subjective observation and objective analysis of these symptoms may furnish important diagnostic clues. In the course of 45 years of practice in pediatric laryngology, phoniatrics, and bronchology, we.