Characterisation of voice and swallowing in individuals with chronic cough

Please note that this study does not involve an intervention as such. However, because the study protocol (i.e., assessments used) goes beyond a typical medical investigation of patients with chronic cough, it cannot be classed as purely observational. All participants will undergo the following assessment protocol: - Questionnaire completed - Respiratory and respiratory-swallowing measures including a) assessment of breathing at rest (i.e., while seated in a chair, not talking or eating) b) spirometry (lung function testing) - Swallowing measures including a) Timed Water Swallow Test (TWST; drinking 150mL water as quickly as possible) b) Test of Masticating and Swallowing Solids (TOMASS; eating a cracker as quickly as possible) c) Videofluoroscopic Swallowing Study (VFSS), a video x-ray of participants whilst eating/drinking various amounts of water, and a cracker. Water will be mixed with a barium contrast powder to allow visualisation of the bolus on VFSS (69 g to every 150mL water). Barium contrast paste will be spread on cracker to thinly coat. - Voice assessment tasks including a) endoscopic voice imaging (using a flexible camera in the throat to assess gross anatomy) b) stroboscopic voice imaging (using the same flexible camera in the throat to assess vocal fold movement and vibration) c) audio recording of the voice, for offline analysis. Participants will do the following during the voice assessment: 1) humming 2) sustained vowel sounds "eee" and "aaa" 3) pitch glide (i.e., from lowest note to highest note, and back down, like a siren) 4) counting from 1-5 with increasing volume (i.e., from lowest non-whispering volume to shouting) 5) repetition of the sentence "how hard did he hit him" 6) conversation, prompted by asking the participant "tell me about your weekend" - Laryngeal sensitivity measures including: a) Presence or absence of the laryngeal adductor reflex i.e., whether a cough response occurs when the larynx (voice box) is touched with a flexible camera b) cough sensitivity threshold to an inhaled citric acid mist Most participants will undergo the above assessment once. This will be completed during one assessment session which will take up to four hours. A subset of patients will undergo the assessment twice, eight weeks apart, to monitor progress over time with usual treatment. This subset will be comprised of participants in the chronic cough group who are currently undergoing treatment for their coughing. In this subset, the treatment will not be completed as part of the study i.e., the group are being assessed prior to and after eight weeks of treatment; change over time is being assessed rather than a specific therapeutic protocol. The assessments will be conducted by a Speech-Language Therapist (SLT)/PhD student. The individual is trained and competent to conduct all assessments, and is certified to practice First Aid. Assessment will be conducted face-to-face, with a single participant per each session. The study will be completed at the University of Canterbury Rose Centre for Stroke Recovery and Research, a laboratory dedicated to investigation of swallowing and voice.