Perceptual learning of dysarthric speech: a review of experimental studies

Children and young adults with profound and multiple learning disabilities: Evidence of intelligible subvocal language

INTRODUCTION

Literature to date describes people with Profound and Multiple Learning Disabilities (PMLD) as pre-linguistic. In contrast, this study explores the existence and use of meaningful sub vocal (SV) language by twenty PMLD participants.

METHOD

The SV utterances of 20 PMLD participants were recorded and amplified. Recordings were investigated for evidence of language content and structure, listener intelligibility, and acoustic and phonetic features relative to normal speech and whisper.

RESULTS

Language content and structure was identified. Listener intelligibility was demonstrated. Acoustic and phonetic features relative to normal speech and whisper were evident.

CONCLUSION

Twenty PMLD participants produced meaningful SV language intelligible to listeners. This study requires further robust research to fully confirm its findings but highlights implications for clinical practice and for understanding of PMLD communication competencies. This paper is accompanied by audio samples and transcriptions of recorded utterances to demonstrate the SV language produced by the participants. The quality of the samples varies due to the difficulties in recording SV utterances and the difficulties for participants in articulating clearly. This is not normal speech, but it is normal language. The listener may need to replay samples where the quality of the recording is poor.

Measuring Articulatory Patterns in Amyotrophic Lateral Sclerosis Using a Data-Driven Articulatory Consonant Distinctiveness Space Approach

PURPOSE

The aim of this study was to leverage data-driven approaches, including a novel articulatory consonant distinctiveness space (ACDS) approach, to better understand speech motor control in amyotrophic lateral sclerosis (ALS).

METHOD

Electromagnetic articulography was used to record tongue and lip movement data during the production of 10 consonants from healthy controls (n = 15) and individuals with ALS (n = 47). To assess phoneme distinctness, speech data were analyzed using two classification algorithms, Procrustes matching (PM) and support vector machine (SVM), and the area/volume of the ACDS. Pearson's correlation coefficient was used to examine the relationship between bulbar impairment and the ACDS. Analysis of variance was used to examine the effects of bulbar impairment on consonant distinctiveness and consonant classification accuracies in clinical subgroups.

RESULTS

There was a significant relationship between the ACDS and intelligible speaking rate (area, p = .003; volume, p = .010), and the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) bulbar subscore (area, p = .009; volume, p = .027). Consonant classification performance followed a consistent pattern with bulbar severity, where consonants produced by speakers with more severe ALS were classified less accurately (SVM = 75.27%; PM = 74.54%) than the healthy, asymptomatic, and mild-moderate groups. In severe ALS, area of the ACDS was significantly condensed compared to both asymptomatic (p = .004) and mild-moderate (p = .013) groups. There was no statistically significant difference in area between the severe ALS group and healthy speakers (p = .292).

CONCLUSIONS

Our comprehensive approach is sensitive to early oromotor changes in response due to disease progression. The preserved articulatory consonant space may capture the use of compensatory adaptations to counteract influences of neurodegeneration.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22044320.

Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech

PURPOSE

The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]).

METHOD

A total of 120 naive listeners (i.e., listeners without experience listening to children with speech and/or language impairments; age range: 18-45 years) orthographically transcribed single-word productions by five children (age range: 2;6-3;11 [years;months]) across three time points over an intervention period (baseline, post-treatment, maintenance). Changes in intelligibility and interrater and intrarater reliability were examined within and across time points.

RESULTS

Speech intelligibility significantly increased in children with CAS over the course of treatment, and these gains were also maintained at 6 weeks posttreatment. There was poor-to-fair consistency between listeners (interrater reliability) and excellent consistency within listeners (intrarater reliability) in ratings of speech intelligibility within and across time points.

CONCLUSIONS

Motor-based intervention increases speech intelligibility following a period of DTTC treatment. Variability among naive listeners of speech intelligibility was also present, with intrarater reliability (within listeners) yielding greater consistency than interrater reliability (between listeners). The implications for including naive listeners as raters of speech intelligibility for research and clinical purposes are discussed.

Oromotor skills in autism spectrum disorder: A scoping review

Oromotor functioning plays a foundational role in spoken communication and feeding, two areas of significant difficulty for many autistic individuals. However, despite years of research and established differences in gross and fine motor skills in this population, there is currently no clear consensus regarding the presence or nature of oral motor control deficits in autistic individuals. In this scoping review, we summarize research published between 1994 and 2022 to answer the following research questions: (1) What methods have been used to investigate oromotor functioning in autistic individuals? (2) Which oromotor behaviors have been investigated in this population? and (3) What conclusions can be drawn regarding oromotor skills in this population? Seven online databases were searched resulting in 107 studies meeting our inclusion criteria. Included studies varied widely in sample characteristics, behaviors analyzed, and research methodology. The large majority (81%) of included studies report a significant oromotor abnormality related to speech production, nonspeech oromotor skills, or feeding within a sample of autistic individuals based on age norms or in comparison to a control group. We examine these findings to identify trends, address methodological aspects hindering cross-study synthesis and generalization, and provide suggestions for future research.

The efficacy of acoustic-based articulatory phenotyping for characterizing and classifying four divergent neurodegenerative diseases using sequential motion rates

Despite the impacts of neurodegeneration on speech function, little is known about how to comprehensively characterize the resulting speech abnormalities using a set of objective measures. Quantitative phenotyping of speech motor impairments may have important implications for identifying clinical syndromes and their underlying etiologies, monitoring disease progression over time, and improving treatment efficacy. The goal of this research was to investigate the validity and classification accuracy of comprehensive acoustic-based articulatory phenotypes in speakers with distinct neurodegenerative diseases. Articulatory phenotypes were characterized based on acoustic features that were selected to represent five components of motor performance: Coordination, Consistency, Speed, Precision, and Rate. The phenotypes were first used to characterize the articulatory abnormalities across four progressive neurologic diseases known to have divergent speech motor deficits: amyotrophic lateral sclerosis (ALS), progressive ataxia (PA), Parkinson's disease (PD), and the nonfluent variant of primary progressive aphasia and progressive apraxia of speech (nfPPA + PAOS). We then examined the efficacy of articulatory phenotyping for disease classification. Acoustic analyses were conducted on audio recordings of 217 participants (i.e., 46 ALS, 52 PA, 60 PD, 20 nfPPA + PAOS, and 39 controls) during a sequential speech task. Results revealed evidence of distinct articulatory phenotypes for the four clinical groups and that the phenotypes demonstrated strong classification accuracy for all groups except ALS. Our results highlight the phenotypic variability present across neurodegenerative diseases, which, in turn, may inform (1) the differential diagnosis of neurological diseases and (2) the development of sensitive outcome measures for monitoring disease progression or assessing treatment efficacy.

Communication and Social Interaction Experiences of Youths With Congenital Motor Speech Disorders

PURPOSE

The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions.

METHOD

Five male youths (ages 14-18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants' experiences according to the phenomenological tradition that recognizes that participants are experts in their "lived experience."

RESULTS

Participants described the youths' day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help.

CONCLUSIONS

Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders.

Perceptual Classification of Motor Speech Disorders: The Role of Severity, Speech Task, and Listener's Expertise

PURPOSE

The clinical diagnosis of motor speech disorders (MSDs) is mainly based on perceptual approaches. However, studies on perceptual classification of MSDs often indicate low classification accuracy. The aim of this study was to determine in a forced-choice dichotomous decision-making task (a) how accuracy of speech-language pathologists (SLPs) in perceptually classifying apraxia of speech (AoS) and dysarthria is impacted by speech task, severity of MSD, and listener's expertise and (b) which perceptual features they use to classify.

METHOD

Speech samples from 29 neurotypical speakers, 14 with hypokinetic dysarthria associated with Parkinson's disease (HD), 10 with poststroke AoS, and six with mixed dysarthria associated with amyotrophic lateral sclerosis (MD-FlSp [combining flaccid and spastic dysarthria]), were classified by 20 expert SLPs and 20 student SLPs. Speech samples were elicited in spontaneous speech, text reading, oral diadochokinetic (DDK) tasks, and a sample concatenating text reading and DDK. For each recorded speech sample, SLPs answered three dichotomic questions following a diagnostic approach, (a) neurotypical versus pathological speaker, (b) AoS versus dysarthria, and (c) MD-FlSp versus HD, and a multiple-choice question on the features their decision was based on.

RESULTS

Overall classification accuracy was 72% with good interrater reliability, varying with SLP expertise, speech task, and MSD severity. Correct classification of speech samples was higher for speakers with dysarthria than for AoS and higher for HD than for MD-FlSp. Samples elicited with continuous speech reached the best classification rates. An average number of three perceptual features were used for correct classifications, and their type and combination differed between the three MSDs.

CONCLUSIONS

The auditory-perceptual classification of MSDs in a diagnostic approach reaches substantial performance only in expert SLPs with continuous speech samples, albeit with lower accuracy for AoS. Specific training associated with objective classification tools seems necessary to improve recognition of neurotypical speech and distinction between AoS and dysarthria.

Rapid but specific perceptual learning partially explains individual differences in the recognition of challenging speech

Perceptual learning for speech, defined as long-lasting changes in speech recognition following exposure or practice occurs under many challenging listening conditions. However, this learning is also highly specific to the conditions in which it occurred, such that its function in adult speech recognition is not clear. We used a time-compressed speech task to assess learning following either brief exposure (rapid learning) or additional training (training-induced learning). Both types of learning were robust and long-lasting. Individual differences in rapid learning explained unique variance in recognizing natural-fast speech and speech-in-noise with no additional contribution for training-induced learning (Experiment 1). Rapid learning was stimulus specific (Experiment 2), as in previous studies on training-induced learning. We suggest that rapid learning is key for understanding the role of perceptual learning in online speech recognition whereas longer training could provide additional opportunities to consolidate and stabilize learning.

Validation of an Acoustic-Based Framework of Speech Motor Control: Assessing Criterion and Construct Validity Using Kinematic and Perceptual Measures

PURPOSE

This study investigated the criterion (analytical and clinical) and construct (divergent) validity of a novel, acoustic-based framework composed of five key components of motor control: Coordination, Consistency, Speed, Precision, and Rate.

METHOD

Acoustic and kinematic analyses were performed on audio recordings from 22 subjects with amyotrophic lateral sclerosis during a sequential motion rate task. Perceptual analyses were completed by two licensed speech-language pathologists, who rated each subject's speech on the five framework components and their overall severity. Analytical and clinical validity were assessed by comparing performance on the acoustic features to their kinematic correlates and to clinician ratings of the five components, respectively. Divergent validity of the acoustic-based framework was then assessed by comparing performance on each pair of acoustic features to determine whether the features represent distinct articulatory constructs. Bivariate correlations and partial correlations with severity as a covariate were conducted for each comparison.

RESULTS

Results revealed moderate-to-strong analytical validity for every acoustic feature, both with and without controlling for severity, and moderate-to-strong clinical validity for all acoustic features except Coordination, without controlling for severity. When severity was included as a covariate, the strong associations for Speed and Precision became weak. Divergent validity was supported by weak-to-moderate pairwise associations between all acoustic features except Speed (second-formant [F2] slope of consonant transition) and Precision (between-consonant variability in F2 slope).

CONCLUSIONS

This study demonstrated that the acoustic-based framework has potential as an objective, valid, and clinically useful tool for profiling articulatory deficits in individuals with speech motor disorders. The findings also suggest that compared to clinician ratings, instrumental measures are more sensitive to subtle differences in articulatory function. With further research, this framework could provide more accurate and reliable characterizations of articulatory impairment, which may eventually increase clinical confidence in the diagnosis and treatment of patients with different articulatory phenotypes.

Individual Differences in Phonetic Plasticity Across Native and Nonnative Contexts

Purpose Individuals vary in their ability to learn the sound categories of nonnative languages (nonnative phonetic learning) and to adapt to systematic differences, such as accent or talker differences, in the sounds of their native language (native phonetic learning). Difficulties with both native and nonnative learning are well attested in people with speech and language disorders relative to healthy controls, but substantial variability in these skills is also present in the typical population. This study examines whether this individual variability can be organized around a common ability that we label "phonetic plasticity." Method A group of healthy young adult participants (N = 80), who attested they had no history of speech, language, neurological, or hearing deficits, completed two tasks of nonnative phonetic category learning, two tasks of learning to cope with variation in their native language, and seven tasks of other cognitive functions, distributed across two sessions. Performance on these 11 tasks was compared, and exploratory factor analysis was used to assess the extent to which performance on each task was related to the others. Results Performance on both tasks of native learning and an explicit task of nonnative learning patterned together, suggesting that native and nonnative phonetic learning tasks rely on a shared underlying capacity, which is termed "phonetic plasticity." Phonetic plasticity was also associated with vocabulary, comprehension of words in background noise, and, more weakly, working memory. Conclusions Nonnative sound learning and native language speech perception may rely on shared phonetic plasticity. The results suggest that good learners of native language phonetic variation are also good learners of nonnative phonetic contrasts. Supplemental Material https://doi.org/10.23641/asha.16606778.

A Perceptual Learning Approach for Dysarthria Remediation: An Updated Review

Purpose Early studies of perceptual learning of dysarthric speech, those summarized in Borrie, McAuliffe, and Liss (2012), yielded preliminary evidence that listeners could learn to better understand the speech of a person with dysarthria, revealing a potentially promising avenue for future intelligibility interventions. Since then, a programmatic body of research grounded in models of perceptual processing has unfolded. The current review provides an updated account of the state of the evidence in this area and offers direction for moving this work toward clinical implementation. Method The studies that have investigated perceptual learning of dysarthric speech (N = 24) are summarized and synthesized first according to the proposed learning source and then by highlighting the parameters that appear to mediate learning, culminating with additional learning outcomes. Results The recent literature has established strong empirical evidence of intelligibility improvements following familiarization with dysarthric speech and a theoretical account of the mechanisms that facilitate improved processing of the neurologically degraded acoustic signal. Conclusions There are no existing intelligibility interventions for individuals with dysarthria who cannot behaviorally modify their speech. However, there is now robust support for the development of an approach that shifts the weight of behavioral change from speaker to listener, exploiting perceptual learning to ease the intelligibility burden of dysarthria. To move this work from bench to bedside, recommendations for translational studies that establish best practices and candidacy for listener-targeted dysarthria remediation, perceptual training, are provided.

Effect of Noise on Speech Intelligibility and Perceived Listening Effort in Head and Neck Cancer

Purpose This study (a) examined the effect of different levels of background noise on speech intelligibility and perceived listening effort in speakers with impaired and intact speech following treatment for head and neck cancer (HNC) and (b) determined the relative contribution of speech intelligibility, speaker group, and background noise to a measure of perceived listening effort. Method Ten speakers diagnosed with nasal, oral, or oropharyngeal HNC provided audio recordings of six sentences from the Sentence Intelligibility Test. All speakers were 100% intelligible in quiet: Five speakers with HNC exhibited mild speech imprecisions (speech impairment group), and five speakers with HNC demonstrated intact speech (HNC control group). Speech recordings were presented to 30 inexperienced listeners, who transcribed the sentences and rated perceived listening effort in quiet and two levels (+7 and +5 dB SNR) of background noise. Results Significant Group × Noise interactions were found for speech intelligibility and perceived listening effort. While no differences in speech intelligibility were found between the speaker groups in quiet, the results showed that, as the signal-to-noise ratio decreased, speakers with intact speech (HNC control) performed significantly better (greater intelligibility, less perceived listening effort) than those with speech imprecisions in the two noise conditions. Perceived listening effort was also shown to be associated with decreased speech intelligibility, imprecise speech, and increased background noise. Conclusions Speakers with HNC who are 100% intelligible in quiet but who exhibit some degree of imprecise speech are particularly vulnerable to the effects of increased background noise in comparison to those with intact speech. Results have implications for speech evaluations, counseling, and rehabilitation.

Speech Treatment Effects on Narrative Intelligibility in French-Speaking Children With Dysarthria

Purpose This study examined the effects of Speech Intelligibility Treatment (SIT) on intelligibility and naturalness of narrative speech produced by francophone children with dysarthria due to cerebral palsy. Method Ten francophone children with dysarthria were randomized to one of two treatments, SIT or Hand-Arm Bimanual Intensive Therapy Including Lower Extremities, a physical therapy (PT) treatment. Both treatments were conducted in a camp setting and were comparable in dosage. The children were recorded pre- and posttreatment producing a story narrative. Intelligibility was measured by means of 60 blinded listeners' orthographic transcription accuracy (percentage of words transcribed correctly). The listeners also rated the children's naturalness on a visual analogue scale. Results A significant pre- to posttreatment increase in intelligibility was found for the SIT group, but not for the PT group, with great individual variability observed among the children. No significant changes were found for naturalness ratings or sound pressure level in the SIT group or the PT group posttreatment. Articulation rate increased in both treatment groups, although not differentially across treatments. Conclusions Findings from this first treatment study on intelligibility in francophone children with dysarthria suggest that SIT shows promise for increasing narrative intelligibility in this population. Acoustic contributors to the increased intelligibility remain to be explored further. Supplemental Material https://doi.org/10.23641/asha.14161943.

The Influence of the Type of Background Noise on Perceptual Learning of Speech in Noise

Objectives

Auditory perceptual learning studies tend to focus on the nature of the target stimuli. However, features of the background noise can also have a significant impact on the amount of benefit that participants obtain from training. This study explores whether perceptual learning of speech in background babble noise generalizes to other, real-life environmental background noises (car and rain), and if the benefits are sustained over time.

Design

Normal-hearing native English speakers were randomly assigned to a training (n = 12) or control group (n = 12). Both groups completed a pre- and post-test session in which they identified Bamford-Kowal-Bench (BKB) target words in babble, car, or rain noise. The training group completed speech-in-babble noise training on three consecutive days between the pre- and post-tests. A follow up session was conducted between 8 and 18 weeks after the post-test session (training group: n = 9; control group: n = 7).

Results

Participants who received training had significantly higher post-test word identification accuracy than control participants for all three types of noise, although benefits were greatest for the babble noise condition and weaker for the car- and rain-noise conditions. Both training and control groups maintained their pre- to post-test improvement over a period of several weeks for speech in babble noise, but returned to pre-test accuracy for speech in car and rain noise.

Conclusion

The findings show that training benefits can show some generalization from speech-in-babble noise to speech in other types of environmental noise. Both groups sustained their learning over a period of several weeks for speech-in-babble noise. As the control group received equal exposure to all three noise types, the sustained learning with babble noise, but not other noises, implies that a structural feature of babble noise was conducive to the sustained improvement. These findings emphasize the importance of considering the background noise as well as the target stimuli in auditory perceptual learning studies.

Generalized Learning of Dysarthric Speech Between Male and Female Talkers

Purpose Perceptual training is a listener-targeted means for improving intelligibility of dysarthric speech. Recent work has shown that training with one talker generalizes to a novel talker of the same sex and that the magnitude of benefit is maximized when the talkers are perceptually similar. The current study expands previous findings by investigating whether perceptual training effects generalize between talkers of different sex. Method Forty new listeners were recruited for this study and completed a pretest, familiarization, and posttest perceptual training paradigm. Historical data collected using the same three-phase protocol were included in the data analysis. All listeners were exposed to the same talker with dysarthria during the pretest and posttest phases. For the familiarization phase, listeners were exposed to one of four talkers with dysarthria, differing in sex and level of perceptual similarity to the test talker or a control talker. During the testing phases, listener transcribed phrases produced by the test talker with dysarthria. Listener transcriptions were then used to calculate a percent words correct intelligibility score. Results Multiple linear regression analysis revealed that intelligibility at posttest was not predicted by sex of the training talker. Consistent with earlier work, the magnitude of intelligibility gain was greater when the familiarization and test talkers were perceptually similar. Additional analyses revealed greater between-listeners variability in the dissimilar conditions as compared to the similar conditions. Conclusions Learning as a result of perceptual training with one talker with dysarthria generalized to another talker regardless of sex. In addition, listeners trained with perceptually similar talkers had greater and more consistent intelligibility improvement. Together, these results add to previous evidence demonstrating that learning generalizes to novel talkers with dysarthria and that perceptual training is suitable for many listeners.

Development of Speech Intelligibility Between 30 and 47 Months in Typically Developing Children: A Cross-Sectional Study of Growth

Purpose We sought to establish normative growth curves for intelligibility development for the speech of typically developing children as revealed by objectively based orthographic transcription of elicited single-word and multiword utterances by naïve listeners. We also examined sex differences, and we compared differences between single-word and multiword intelligibility growth. Method One hundred sixty-four typically developing children (92 girls, 72 boys) contributed speech samples for this study. Children were between the ages of 30 and 47 months, and analyses examined 1-month age increments between these ages. Two different naïve listeners heard each child and made orthographic transcriptions of child-produced words and sentences (n = 328 listeners). Average intelligibility scores for single-word productions and multiword productions were modeled using linear regression, which estimated normal-model quantile age trajectories for single- and multiword utterances. Results We present growth curves showing steady linear change over time in 1-month increments from 30 to 47 months for 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. Results showed that boys did not differ from girls and that, prior to 35 months of age, single words were more intelligible than multiword productions. Starting at 41 months of age, the reverse was true. Multiword intelligibility grew at a faster rate than single-word intelligibility. Conclusions Children make steady progress in intelligibility development through 47 months, and only a small number of children approach 100% intelligibility by this age. Intelligibility continues to develop past the fourth year of life. There is considerable variability among children with regard to intelligibility development. Supplemental Material https://doi.org/10.23641/asha.12330956.

The Role of the Speaker, the Listener, and Their Joint Contributions During Communicative Interactions: A Tripartite View of Intelligibility in Individuals With Dysarthria

Purpose We present a tripartite view of intelligibility in which the contributions of both the speaker and listener, as well as their joint effort during interaction, are considered. While considerable research has examined communicative interactions in situ, there is a critical gap in current knowledge on how speech intelligibility unfolds during such interactions. Here, we argue that research examining speech intelligibility in communicative interactions may provide important groundwork for advancement in clinical interventions for individuals with dysarthria. Method First, we describe the view and argue for its consideration as a powerful way of thinking about speech intelligibility. We then briefly situate the view in the relevant literature on speech intelligibility and existing theoretical frameworks. We then identify suitable methodological paradigms for studying joint contributions to intelligibility and, lastly, discuss the clinical application and potential impact of this tripartite view. Conclusions Speech communication occurs through interaction; however, in the laboratory and clinic, emphasis is usually placed on individual speakers and listeners. We have proposed that it is critical to consider how the joint contributions of speakers and listeners affect speech intelligibility in communicative interaction. This conceptualization is well aligned with the International Classification of Functioning, Disability and Health, and the findings from such an approach will allow us to better understand how to maximize available resources to enhance speech intelligibility.

Regularity Matters: Unpredictable Speech Degradation Inhibits Adaptation to Dysarthric Speech

Purpose Listener-targeted perceptual training paradigms, which leverage the mechanism of perceptual learning, show strong promise for improving intelligibility in dysarthria, offsetting the communicative burden from the speaker onto the listener. Theoretical models of perceptual learning underscore the importance of acoustic regularity (i.e., signal predictability) for listener adaptation to degraded speech. The purpose of the current investigation was to evaluate intelligibility outcomes following perceptual training with hyperkinetic dysarthria, a subtype characterized by reduced signal predictability. Method Forty listeners completed the standard 3-phase perceptual training protocol (pretest, training, and posttest) with 1 of 2 talkers with hyperkinetic dysarthria. Perceptual data were compared to a historical data set for 1 other talker with hyperkinetic dysarthria to examine the effect of perceptual training on intelligibility. Results When controlling for pretest intelligibility, regression results suggest listeners of the 2 novel talkers with hyperkinetic dysarthria performed comparably to the listeners of the original talker on the posttest following training. Furthermore, differences between pretest and posttest intelligibility failed to reach clinical significance for all 3 talkers and statistical significance for 2 of the 3. Conclusion The current findings are consistent with theoretical models of perceptual learning and suggest that listener adaptation to degraded speech may be negligible for talkers with dysarthria whose speech is marked by reduced signal predictability.

Effects of Familiarization on Intelligibility of Dysarthric Speech in Older Adults With and Without Hearing Loss

PURPOSE

Familiarization tasks offer a promising platform for listener-targeted remediation of intelligibility disorders associated with dysarthria. To date, the body of work demonstrating improved understanding of dysarthric speech following a familiarization experience has been carried out on younger adults. The primary purpose of the present study was to examine the intelligibility effects of familiarization in older adults.

METHOD

Nineteen older adults, with and without hearing loss, completed a familiarization protocol consisting of three phases: pretest, familiarization, and posttest. The older adults' initial intelligibility and intelligibility improvement scores were compared with previously reported data collected from 50 younger adults (Borrie, Lansford, & Barrett, 2017a).

RESULTS

Relative to younger adults, initial intelligibility scores were significantly lower for older adults, although additional analysis revealed that the difference was limited to older adults with hearing loss. Key, however, is that irrespective of hearing status, the older and younger adults achieved comparable intelligibility improvement following familiarization (gain of roughly 20 percentage points).

CONCLUSION

This study extends previous findings of improved intelligibility of dysarthria following familiarization to a group of listeners who are critical to consider in listener-targeted remediation, namely, aging caregivers and/or spouses of individuals with dysarthria.

Generalized Adaptation to Dysarthric Speech

PURPOSE

Generalization of perceptual learning has received limited attention in listener adaptation studies with dysarthric speech. This study investigated whether adaptation to a talker with dysarthria could be predicted by the nature of the listener's prior familiarization experience, specifically similarity of perceptual features, and level of intelligibility.

METHOD

Following an intelligibility pretest involving a talker with ataxic dysarthria, 160 listeners were familiarized with 1 of 7 talkers with dysarthria-who differed from the test talker in terms of perceptual similarity (same, similar, dissimilar) and level of intelligibility (low, mid, high)-or a talker with no neurological impairment (control). Listeners then completed an intelligibility posttest on the test talker.

RESULTS

All listeners benefited from familiarization with a talker with dysarthria; however, adaptation to the test talker was superior when the familiarization talker had similar perceptual features and reduced when the familiarization talker had low intelligibility.

CONCLUSION

Evidence for both generalization and specificity of learning highlights the differential value of listeners' prior experiences for adaptation to, and improved understanding of, a talker with dysarthria. These findings broaden our theoretical knowledge of adaptation to degraded speech, as well as the clinical application of training paradigms that exploit perceptual processes for therapeutic gain.

Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria

PURPOSE

Reductions in articulatory working space and vocal intensity have been linked to intelligibility deficits in children with dysarthria due to cerebral palsy. However, few studies have examined the outcomes of behavioral treatments aimed at these underlying impairments or investigated which treatment cues might best facilitate improved intelligibility. This study assessed the effects of cues targeting clear speech (i.e., "Speak with your big mouth") and greater vocal intensity (i.e., "Speak with your strong voice") on acoustic measures of speech production and intelligibility.

METHOD

Eight children with spastic dysarthria due to cerebral palsy repeated sentence- and word-level stimuli across habitual, big mouth, and strong voice conditions. Acoustic analyses were conducted, and 48 listeners completed orthographic transcription and scaled intelligibility ratings.

RESULTS

Both cues resulted in significant changes to vocal intensity and speech rate although the degree of change varied by condition. In a similar manner, perceptual analysis revealed significant improvements to intelligibility with both cues; however, at the single-word level, big mouth outperformed strong voice.

CONCLUSION

Children with dysarthria are capable of changing their speech styles differentially in response to cueing. Both the big mouth and strong voice cues hold promise as intervention strategies to improve intelligibility in this population.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.5116843.

Rhythm Perception and Its Role in Perception and Learning of Dysrhythmic Speech

PURPOSE

The perception of rhythm cues plays an important role in recognizing spoken language, especially in adverse listening conditions. Indeed, this has been shown to hold true even when the rhythm cues themselves are dysrhythmic. This study investigates whether expertise in rhythm perception provides a processing advantage for perception (initial intelligibility) and learning (intelligibility improvement) of naturally dysrhythmic speech, dysarthria.

METHOD

Fifty young adults with typical hearing participated in 3 key tests, including a rhythm perception test, a receptive vocabulary test, and a speech perception and learning test, with standard pretest, familiarization, and posttest phases. Initial intelligibility scores were calculated as the proportion of correct pretest words, while intelligibility improvement scores were calculated by subtracting this proportion from the proportion of correct posttest words.

RESULTS

Rhythm perception scores predicted intelligibility improvement scores but not initial intelligibility. On the other hand, receptive vocabulary scores predicted initial intelligibility scores but not intelligibility improvement.

CONCLUSIONS

Expertise in rhythm perception appears to provide an advantage for processing dysrhythmic speech, but a familiarization experience is required for the advantage to be realized. Findings are discussed in relation to the role of rhythm in speech processing and shed light on processing models that consider the consequence of rhythm abnormalities in dysarthria.

Individual differences in the perception of regional, nonnative, and disordered speech varieties

Speech perception abilities vary substantially across listeners, particularly in adverse conditions including those stemming from environmental degradation (e.g., noise) or from talker-related challenges (e.g., nonnative or disordered speech). This study examined adult listeners' recognition of words in phrases produced by six talkers representing three speech varieties: a nonnative accent (Spanish-accented English), a regional dialect (Irish English), and a disordered variety (ataxic dysarthria). Semantically anomalous phrases from these talkers were presented in a transcription task and intelligibility scores, percent words correct, were compared across the three speech varieties. Three cognitive-linguistic areas-receptive vocabulary, cognitive flexibility, and inhibitory control of attention-were assessed as possible predictors of individual word recognition performance. Intelligibility scores for the Spanish accent were significantly correlated with scores for the Irish English and ataxic dysarthria. Scores for the Irish English and dysarthric speech, in contrast, were not correlated. Furthermore, receptive vocabulary was the only cognitive-linguistic assessment that significantly predicted intelligibility scores. These results suggest that, rather than a global skill of perceiving speech that deviates from native dialect norms, listeners may possess specific abilities to overcome particular types of acoustic-phonetic deviation. Furthermore, vocabulary size offers performance benefits for intelligibility of speech that deviates from one's typical dialect norms.

The relationship between perceptual disturbances in dysarthric speech and automatic speech recognition performance

State-of-the-art automatic speech recognition (ASR) engines perform well on healthy speech; however recent studies show that their performance on dysarthric speech is highly variable. This is because of the acoustic variability associated with the different dysarthria subtypes. This paper aims to develop a better understanding of how perceptual disturbances in dysarthric speech relate to ASR performance. Accurate ratings of a representative set of 32 dysarthric speakers along different perceptual dimensions are obtained and the performance of a representative ASR algorithm on the same set of speakers is analyzed. This work explores the relationship between these ratings and ASR performance and reveals that ASR performance can be predicted from perceptual disturbances in dysarthric speech with articulatory precision contributing the most to the prediction followed by prosody.

Use of Crowdsourcing to Assess the Ecological Validity of Perceptual-Training Paradigms in Dysarthria

PURPOSE

It has been documented in laboratory settings that familiarizing listeners with dysarthric speech improves intelligibility of that speech. If these findings can be replicated in real-world settings, the ability to improve communicative function by focusing on communication partners has major implications for extending clinical practice in dysarthria rehabilitation. An important step toward development of a listener-targeted treatment approach requires establishment of its ecological validity. To this end, the present study leveraged the mechanism of crowdsourcing to determine whether perceptual-training benefits achieved by listeners in the laboratory could be elicited in an at-home computer-based scenario.

METHOD

Perceptual-training data (i.e., intelligibility scores from a posttraining transcription task) were collected from listeners in 2 settings-the laboratory and the crowdsourcing website Amazon Mechanical Turk.

RESULTS

Consistent with previous findings, results revealed a main effect of training condition (training vs. control) on intelligibility scores. There was, however, no effect of training setting (Mechanical Turk vs. laboratory). Thus, the perceptual benefit achieved via Mechanical Turk was comparable to that achieved in the laboratory.

CONCLUSION

This study provides evidence regarding the ecological validity of perceptual-training paradigms designed to improve intelligibility of dysarthric speech, thereby supporting their continued advancement as a listener-targeted treatment option.

Familiarization Effects on Consonant Intelligibility in Dysarthric Speech

BACKGROUND/AIMS

This study investigates the effects of familiarization on naïve listeners' ability to identify consonants in dysarthric speech.

METHODS

A total of 120 listeners (30 listeners/speaker) participated in experiments over a 6-week period. Listeners were randomly assigned to one of the three familiarization conditions: a passive condition in which listeners heard audio recordings of words, an active condition in which listeners heard audio recordings of words while viewing the written material of words, and a control condition in which listeners had no exposure to the audio signal prior to identification tasks.

RESULTS

Familiarization improved naïve listeners' ability to identify consonants produced by a speaker with dysarthria. The active familiarization method exhibited an advantage over the other conditions, in terms of the magnitude and rapidness of improvement. One-month delayed test scores were higher than pre-familiarization scores, but the advantage of active familiarization was not present for all speakers.

CONCLUSION

This study supports familiarization benefits in enhancing consonant intelligibility in dysarthria and suggests that perceptual learning mechanisms be harnessed for developing effective listener-oriented intervention techniques in the management of dysarthria. Current findings call for further research on a familiarization protocol that can subserve segmental learning with maximum efficacy.

The Role of Somatosensory Information in Speech Perception: Imitation Improves Recognition of Disordered Speech

PURPOSE

Perceptual learning paradigms involving written feedback appear to be a viable clinical tool to reduce the intelligibility burden of dysarthria. The underlying theoretical assumption is that pairing the degraded acoustics with the intended lexical targets facilitates a remapping of existing mental representations in the lexicon. This study investigated whether ties to mental representations can be strengthened by way of a somatosensory motor trace.

METHOD

Following an intelligibility pretest, 100 participants were assigned to 1 of 5 experimental groups. The control group received no training, but the other 4 groups received training with dysarthric speech under conditions involving a unique combination of auditory targets, written feedback, and/or a vocal imitation task. All participants then completed an intelligibility posttest.

RESULTS

Training improved intelligibility of dysarthric speech, with the largest improvements observed when the auditory targets were accompanied by both written feedback and an imitation task. Further, a significant relationship between intelligibility improvement and imitation accuracy was identified.

CONCLUSIONS

This study suggests that somatosensory information can strengthen the activation of speech sound maps of dysarthric speech. The findings, therefore, implicate a bidirectional relationship between speech perception and speech production as well as advance our understanding of the mechanisms that underlie perceptual learning of degraded speech.

Variability and Diagnostic Accuracy of Speech Intelligibility Scores in Children

PURPOSE

We examined variability of speech intelligibility scores and how well intelligibility scores predicted group membership among 5-year-old children with speech motor impairment (SMI) secondary to cerebral palsy and an age-matched group of typically developing (TD) children.

METHOD

Speech samples varying in length from 1-4 words were elicited from 24 children with cerebral palsy (mean age 60.50 months) and 20 TD children (mean age 60.33 months). Two hundred twenty adult listeners made orthographic transcriptions of speech samples (n = 5 per child).

RESULTS

Variability associated with listeners made a significant contribution to explaining the variance in intelligibility scores for TD and SMI children, but the magnitude was greater for TD children. Intelligibility scores differentiated very well between children who have SMI and TD children when intelligibility was at or below approximately 75% and above approximately 85%.

CONCLUSIONS

Intelligibility seems to be a useful clinical tool for differentiating between TD children and children with SMI at 5 years of age; however, there is considerable variability within and between listeners, highlighting the need for more than one listener per child to ensure validity of an intelligibility measure.

Familiarization effects on word intelligibility in dysarthric speech

BACKGROUND/AIMS

This study investigated the effects of familiarization on naïve listeners' ability to perceive dysarthric speech produced by speakers with cerebral palsy and evaluated the degree of intelligibility improvement, both in the short and long term, as a function of (1) familiarization paradigms and (2) the number of familiarization phases.

METHODS

A total of 120 listeners (30 listeners/speaker) were recruited to complete word transcription tasks over a 6-week period. The listeners were assigned to one of the following familiarization paradigms: passive familiarization with audio signal only, active familiarization with both audio and orthography, and no explicit familiarization. Intelligibility scores were measured as the percentage of words correctly transcribed.

RESULTS

The active familiarization paradigm that provided listeners with both audio and orthography resulted in higher intelligibility scores compared to the passive familiarization and no explicit familiarization conditions. The degree of intelligibility improvement as a function of passive familiarization varied depending on the speaker. Last, the advantage of active familiarization was also found as a long-term effect.

CONCLUSION

Our findings provide evidence for the benefits of familiarization in enhancing the intelligibility of dysarthric speech and support the efficacy of familiarization paradigms as an intervention technique in the management of dysarthria.

Association between objective measurement of the speech intelligibility of young people with dysarthria and listener ratings of ease of understanding

PURPOSE

This study aimed to investigate the association between listeners' ratings of how much effort it took to understand the speech of young people with cerebral palsy and the percentage of words listeners actually understood.

METHOD

Thirty-one young people with dysarthria and cerebral palsy (16 males, 15 females; mean age = 11 years, SD = 3) were audio recorded repeating single words and producing speech. Objective measures of intelligibility were calculated for multiple familiar and unfamiliar listeners using a forced choice paradigm for single words and verbatim orthographic transcriptions for connected speech. Listeners rated how much effort it took to understand speech in each condition using a 5-point ordinal ease of listening (EOL) scale.

RESULTS

Agreement on EOL within rater groups was high (ICC > 0.71). An effect of listener was observed for familiar listeners, but not for unfamiliar listeners. EOL agreement between familiar and unfamiliar listeners was weak-moderate (ICC = 0.46). EOL predicted the percentage of speech actually understood by familiar and unfamiliar listeners (r > 0.56, p < 0.001 for all predictions). Strongest associations between EOL and intelligibility were observed for speakers with mild and profound impairments.

CONCLUSIONS

The findings of this study demonstrate that listeners can judge how well they have understood dysarthric speech. EOL is associated with listener familiarity, speech task and speech impairment severity. EOL is appropriate for use in clinical practice as a measure of communication activity.

The influence of dialect upon the perception of dysarthic speech

The purpose of this study was to determine the influence of dialect upon the perception of dysarthric speech. Speakers and listeners were self-identifying as either Caucasian American or African American. Three speakers were Caucasian American, three were African American. Four speakers had experienced a CVA and were dysarthric. Listeners were age matched and were equally divided for gender. Readers recorded 14 word sentences from the Assessment of Intelligibility of Dysarthric Speech. Listeners provided ratings of intelligibility, comprehensibility, and acceptability. Own-race biases were found for all measures; however, significant findings were found for intelligibility and comprehensibility in that the Caucasian Americans provided significantly higher scores for Caucasian American speakers. Clinical implications are discussed.

Modeling Pathological Speech Perception From Data With Similarity Labels

The current state of the art in judging pathological speech intelligibility is subjective assessment performed by trained speech pathologists (SLP). These tests, however, are inconsistent, costly and, oftentimes suffer from poor intra- and inter-judge reliability. As such, consistent, reliable, and perceptually-relevant objective evaluations of pathological speech are critical. Here, we propose a data-driven approach to this problem. We propose new cost functions for examining data from a series of experiments, whereby we ask certified SLPs to rate pathological speech along the perceptual dimensions that contribute to decreased intelligibility. We consider qualitative feedback from SLPs in the form of comparisons similar to statements "Is Speaker A's rhythm more similar to Speaker B or Speaker C?" Data of this form is common in behavioral research, but is different from the traditional data structures expected in supervised (data matrix + class labels) or unsupervised (data matrix) machine learning. The proposed method identifies relevant acoustic features that correlate with the ordinal data collected during the experiment. Using these features, we show that we are able to develop objective measures of the speech signal degradation that correlate well with SLP responses.

Measuring up to speech intelligibility

Improvement or maintenance of speech intelligibility is a central aim in a whole range of conditions in speech-language therapy, both developmental and acquired. Best clinical practice and pursuance of the evidence base for interventions would suggest measurement of intelligibility forms a vital role in clinical decision-making and monitoring. However, what should be measured to gauge intelligibility and how this is achieved and relates to clinical planning continues to be a topic of debate. This review considers the strengths and weaknesses of selected clinical approaches to intelligibility assessment, stressing the importance of explanatory, diagnostic testing as both a more sensitive and a clinically informative method. The worth of this, and any approach, is predicated, though, on awareness and control of key design, elicitation, transcription and listening/listener variables to maximize validity and reliability of assessments. These are discussed. A distinction is drawn between signal-dependent and -independent factors in intelligibility evaluation. Discussion broaches how these different perspectives might be reconciled to deliver comprehensive insights into intelligibility levels and their clinical/educational significance. The paper ends with a call for wider implementation of best practice around intelligibility assessment.

Intelligibility of clear speech: effect of instruction

PURPOSE

The authors investigated how clear speech instructions influence sentence intelligibility.

METHOD

Twelve speakers produced sentences in habitual, clear, hearing impaired, and overenunciate conditions. Stimuli were amplitude normalized and mixed with multitalker babble for orthographic transcription by 40 listeners. The main analysis investigated percentage-correct intelligibility scores as a function of the 4 conditions and speaker sex. Additional analyses included listener response variability, individual speaker trends, and an alternate intelligibility measure: proportion of content words correct.

RESULTS

Relative to the habitual condition, the overenunciate condition was associated with the greatest intelligibility benefit, followed by the hearing impaired and clear conditions. Ten speakers followed this trend. The results indicated different patterns of clear speech benefit for male and female speakers. Greater listener variability was observed for speakers with inherently low habitual intelligibility compared to speakers with inherently high habitual intelligibility. Stable proportions of content words were observed across conditions.

CONCLUSIONS

Clear speech instructions affected the magnitude of the intelligibility benefit. The instruction to overenunciate may be most effective in clear speech training programs. The findings may help explain the range of clear speech intelligibility benefit previously reported. Listener variability analyses suggested the importance of obtaining multiple listener judgments of intelligibility, especially for speakers with inherently low habitual intelligibility.

Suppression of the µ rhythm during speech and non-speech discrimination revealed by independent component analysis: implications for sensorimotor integration in speech processing

Background

Constructivist theories propose that articulatory hypotheses about incoming phonetic targets may function to enhance perception by limiting the possibilities for sensory analysis. To provide evidence for this proposal, it is necessary to map ongoing, high-temporal resolution changes in sensorimotor activity (i.e., the sensorimotor μ rhythm) to accurate speech and non-speech discrimination performance (i.e., correct trials.)

Methods

Sixteen participants (15 female and 1 male) were asked to passively listen to or actively identify speech and tone-sweeps in a two-force choice discrimination task while the electroencephalograph (EEG) was recorded from 32 channels. The stimuli were presented at signal-to-noise ratios (SNRs) in which discrimination accuracy was high (i.e., 80–100%) and low SNRs producing discrimination performance at chance. EEG data were decomposed using independent component analysis and clustered across participants using principle component methods in EEGLAB.

Results

ICA revealed left and right sensorimotor µ components for 14/16 and 13/16 participants respectively that were identified on the basis of scalp topography, spectral peaks, and localization to the precentral and postcentral gyri. Time-frequency analysis of left and right lateralized µ component clusters revealed significant (pFDR<.05) suppression in the traditional beta frequency range (13–30 Hz) prior to, during, and following syllable discrimination trials. No significant differences from baseline were found for passive tasks. Tone conditions produced right µ beta suppression following stimulus onset only. For the left µ, significant differences in the magnitude of beta suppression were found for correct speech discrimination trials relative to chance trials following stimulus offset.

Conclusions

Findings are consistent with constructivist, internal model theories proposing that early forward motor models generate predictions about likely phonemic units that are then synthesized with incoming sensory cues during active as opposed to passive processing. Future directions and possible translational value for clinical populations in which sensorimotor integration may play a functional role are discussed.

Selecting Disorder-Specific Features for Speech Pathology Fingerprinting

The general aim of this work is to learn a unique statistical signature for the state of a particular speech pathology. We pose this as a speaker identification problem for dysarthric individuals. To that end, we propose a novel algorithm for feature selection that aims to minimize the effects of speaker-specific features (e.g., fundamental frequency) and maximize the effects of pathology-specific features (e.g., vocal tract distortions and speech rhythm). We derive a cost function for optimizing feature selection that simultaneously trades off between these two competing criteria. Furthermore, we develop an efficient algorithm that optimizes this cost function and test the algorithm on a set of 34 dysarthric and 13 healthy speakers. Results show that the proposed method yields a set of features related to the speech disorder and not an individual's speaking style. When compared to other feature-selection algorithms, the proposed approach results in an improvement in a disorder fingerprinting task by selecting features that are specific to the disorder.

The role of linguistic and indexical information in improved recognition of dysarthric speech

This investigation examined perceptual learning of dysarthric speech. Forty listeners were randomly assigned to one of two identification training tasks, aimed at highlighting either the linguistic (word identification task) or indexical (speaker identification task) properties of the neurologically degraded signal. Twenty additional listeners served as a control group, passively exposed to the training stimuli. Immediately following exposure to dysarthric speech, all three listener groups completed an identical phrase transcription task. Analysis of listener transcripts revealed remarkably similar intelligibility improvements for listeners trained to attend to either the linguistic or the indexical properties of the signal. Perceptual learning effects were also evaluated with regards to underlying error patterns indicative of segmental and suprasegmental processing. The findings of this study suggest that elements within both the linguistic and indexical properties of the dysarthric signal are learnable and interact to promote improved processing of this type and severity of speech degradation. Thus, the current study extends support for the development of a model of perceptual processing in which the learning of indexical properties is encoded and retained in conjunction with linguistic properties of the signal.

Towards A Clinical Tool For Automatic Intelligibility Assessment

An important, yet under-explored, problem in speech processing is the automatic assessment of intelligibility for pathological speech. In practice, intelligibility assessment is often done through subjective tests administered by speech pathologists; however research has shown that these tests are inconsistent, costly, and exhibit poor reliability. Although some automatic methods for intelligibility assessment for telecommunications exist, research specific to pathological speech has been limited. Here, we propose an algorithm that captures important multi-scale perceptual cues shown to correlate well with intelligibility. Nonlinear classifiers are trained at each time scale and a final intelligibility decision is made using ensemble learning methods from machine learning. Preliminary results indicate a marked improvement in intelligibility assessment over published baseline results.

Familiarisation conditions and the mechanisms that underlie improved recognition of dysarthric speech

This investigation evaluated the familiarisation conditions required to promote subsequent and more long-term improvements in perceptual processing of dysarthric speech and examined the cognitive-perceptual processes that may underlie the experience-evoked learning response. Sixty listeners were randomly allocated to one of three experimental groups and were familiarised under the following conditions: (1) neurologically intact speech (control), (2) dysarthric speech (passive familiarisation), and (3) dysarthric speech coupled with written information (explicit familiarisation). All listeners completed an identical phrase transcription task immediately following familiarisation, and listeners familiarised with dysarthric speech also completed a follow-up phrase transcription task 7 days later. Listener transcripts were analysed for a measure of intelligibility (percent words correct), as well as error patterns at a segmental (percent syllable resemblance) and suprasegmental (lexical boundary errors) level of perceptual processing. The study found that intelligibility scores for listeners familiarised with dysarthric speech were significantly greater than those of the control group, with the greatest and most robust gains afforded by the explicit familiarisation condition. Relative perceptual gains in detecting phonetic and prosodic aspects of the signal varied dependent upon the familiarisation conditions, suggesting that passive familiarisation may recruit a different learning mechanism to that of a more explicit familiarisation experience involving supplementary written information. It appears that decisions regarding resource allocation during subsequent processing of dysarthric speech may be informed by the information afforded by the conditions of familiarisation.

Familiarisation conditions and the mechanisms that underlie improved recognition of dysarthric speech

This investigation evaluated the familiarisation conditions required to promote subsequent and more long-term improvements in perceptual processing of dysarthric speech and examined the cognitive-perceptual processes that may underlie the experience-evoked learning response. Sixty listeners were randomly allocated to one of three experimental groups and were familiarised under the following conditions: (1) neurologically intact speech (control), (2) dysarthric speech (passive familiarisation), and (3) dysarthric speech coupled with written information (explicit familiarisation). All listeners completed an identical phrase transcription task immediately following familiarisation, and listeners familiarised with dysarthric speech also completed a follow-up phrase transcription task 7 days later. Listener transcripts were analysed for a measure of intelligibility (percent words correct), as well as error patterns at a segmental (percent syllable resemblance) and suprasegmental (lexical boundary errors) level of perceptual processing. The study found that intelligibility scores for listeners familiarised with dysarthric speech were significantly greater than those of the control group, with the greatest and most robust gains afforded by the explicit familiarisation condition. Relative perceptual gains in detecting phonetic and prosodic aspects of the signal varied dependent upon the familiarisation conditions, suggesting that passive familiarisation may recruit a different learning mechanism to that of a more explicit familiarisation experience involving supplementary written information. It appears that decisions regarding resource allocation during subsequent processing of dysarthric speech may be informed by the information afforded by the conditions of familiarisation.