1
|
Frankford SA, Estrada A, Stepp CE. Contributions of Speech Timing and Articulatory Precision to Listener Perceptions of Intelligibility and Naturalness in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-13. [PMID: 39116309 DOI: 10.1044/2024_jslhr-23-00802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
PURPOSE Parkinson's disease (PD) results in hypokinetic dysarthria in as many as 90% of cases. Among the most distinctive features of hypokinetic dysarthria are atypical timing and articulatory imprecision in speech production. Here, we examined the contributions of perceived speech timing typicality and articulatory precision, both on their own and while controlling for the other, on intelligibility and naturalness in speakers with PD. METHOD Twenty speakers with PD and four healthy older adults read aloud the first paragraph of the Rainbow Passage. Twenty inexperienced listeners with typical hearing listened to these recordings and rated intelligibility, naturalness, timing typicality, and articulatory precision using separate visual analog scales. Ratings were averaged across listeners and entered into linear regression models with intelligibility and naturalness as dependent variables and timing typicality and articulatory precision as independent variables in each. RESULTS Articulatory precision, but not timing typicality, was positively correlated with intelligibility on its own, but neither was associated with intelligibility after accounting for the other. Both timing typicality and articulatory precision were positively correlated with naturalness on their own as well as after controlling for the other variable. CONCLUSION These results contribute to the overall understanding of speech factors associated with intelligibility and naturalness in speakers with PD and indicate that considering the unique contributions of related perceptual constructs may provide more information than bivariate relationships alone.
Collapse
|
2
|
Knowles T, Adams SG, Jog M. Effects of speech rate modifications on phonatory acoustic outcomes in Parkinson's disease. Front Hum Neurosci 2024; 18:1331816. [PMID: 38450224 PMCID: PMC10914948 DOI: 10.3389/fnhum.2024.1331816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
Speech rate reduction is a global speech therapy approach for speech deficits in Parkinson's disease (PD) that has the potential to result in changes across multiple speech subsystems. While the overall goal of rate reduction is usually improvements in speech intelligibility, not all people with PD benefit from this approach. Speech rate is often targeted as a means of improving articulatory precision, though less is known about rate-induced changes in other speech subsystems that could help or hinder communication. The purpose of this study was to quantify phonatory changes associated with speech rate modification across a broad range of speech rates from very slow to very fast in talkers with and without PD. Four speaker groups participated: younger and older healthy controls, and people with PD with and without deep brain stimulation of the subthalamic nucleus (STN-DBS). Talkers read aloud standardized sentences at 7 speech rates elicited using magnitude production: habitual, three slower rates, and three faster rates. Acoustic measures of speech intensity, cepstral peak prominence, and fundamental frequency were measured as a function of speech rate and group. Overall, slower rates of speech were associated with differential effects on phonation across the four groups. While all talkers spoke at a lower pitch in slow speech, younger talkers showed increases in speech intensity and cepstral peak prominence, while talkers with PD and STN-DBS showed the reverse pattern. Talkers with PD without STN-DBS and older healthy controls behaved in between these two extremes. At faster rates, all groups uniformly demonstrated increases in cepstral peak prominence. While speech rate reductions are intended to promote positive changes in articulation to compensate for speech deficits in dysarthria, the present results highlight that undesirable changes may be invoked across other subsystems, such as at the laryngeal level. In particular, talkers with STN-DBS, who often demonstrate speech deterioration following DBS surgery, demonstrated more phonatory detriments at slowed speech rates. Findings have implications for speech rate candidacy considerations and speech motor control processes in PD.
Collapse
Affiliation(s)
- Thea Knowles
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Scott G. Adams
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
- Department of Clinical Neurological Sciences, University Hospital, London, ON, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, University Hospital, London, ON, Canada
| |
Collapse
|
3
|
Ge S, Wan Q, Wang Y, Yin M, Huang Z. The combination of accent method and phonemic contrast: an innovative strategy to improve speech production on post-stroke dysarthria. Front Hum Neurosci 2024; 17:1298974. [PMID: 38259334 PMCID: PMC10800473 DOI: 10.3389/fnhum.2023.1298974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Speech production includes segmental and suprasegmental features, which interact and cooperate with each other. Impaired speech production is common in individuals with post-stroke dysarthria. The commonly used phonemic contrast therapy and Accent Method in clinical practice can improve the segmental and suprasegmental aspects, respectively. This study aimed to explore the feasibility and immediate effectiveness of the combination of specific rhythm patterns of the Accent Method and phonemic contrast on speech production. Methods Fifteen poststroke dysarthria patients (12 males and three females) first received accentuation task of three rhythm patterns (Largo-slow, Andante-medium, Allegro-fast) and later received speech task in appropriate rhythm patterns combined with phonemic contrast materials and non-phonemic contrast materials. Speech parameters were analyzed by considering speech clarity and prosody. Results The results showed that the number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly, and the average length of pauses and abnormal pause times decreased significantly in Andante (medium) compared to other rhythms. The number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly compared with those in the non-phonemic contrast in Andante (medium). Conclusion The combination of phonemic contrast and Accent Method was verified to have an immediate effect on speech production in Mandarin speakers with post-stroke dysarthria and could be further validated in other diseases with impaired speech production in the clinic in the future.
Collapse
Affiliation(s)
- Shengnan Ge
- School of Life Sciences, East China Normal University, Shanghai, China
| | - Qin Wan
- Department of Rehabilitation Sciences, Faculty of Education, East China Normal University, Shanghai, China
| | - Yongli Wang
- Department of Rehabilitation Sciences, Faculty of Education, East China Normal University, Shanghai, China
| | - Minmin Yin
- Department of Special Education, Faculty of Education, Hangzhou Normal University, Hangzhou, China
| | - Zhaoming Huang
- Department of Rehabilitation Sciences, Faculty of Education, East China Normal University, Shanghai, China
| |
Collapse
|
4
|
Lehner K, Pfab J, Ziegler W. Web-based assessment of communication-related parameters in dysarthria: development and implementation of the KommPaS web app. CLINICAL LINGUISTICS & PHONETICS 2022; 36:1093-1111. [PMID: 34699281 DOI: 10.1080/02699206.2021.1989490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/23/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
This article describes the design of KommPaS, a web-based tool for the clinical assessment of communication impairment in persons with dysarthria. KommPaS (the German acronym for Communication-related Parameters in Speech Disorders) allows clinicians to recruit laypersons via crowdsourcing for the evaluation of samples of dysarthric speech with regard to communication relevant parameters, that is, intelligibility, naturalness, perceived listener effort, and efficiency (intelligible speech units per unit time). Moreover, a communication total score describing the KommPaS profile elevation, i.e., the arithmetic mean of the normalized KommPaS scores, is provided. Based on considerations regarding the theoretical underpinnings and methodological constraints of a clinical tool for the assessment of these parameters, the article describes how each theoretically and methodologically motivated feature is translated into design principles and how these principles are implemented in a web application. The paper reports efficiency data and details the data privacy and data security provisions that are essential in such an approach.
Collapse
Affiliation(s)
- Katharina Lehner
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| | - Jakob Pfab
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|
5
|
Hirsch ME, Thompson A, Kim Y, Lansford KL. The Reliability and Validity of Speech-Language Pathologists’ Estimations of Intelligibility in Dysarthria. Brain Sci 2022; 12:brainsci12081011. [PMID: 36009074 PMCID: PMC9406197 DOI: 10.3390/brainsci12081011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023] Open
Abstract
This study examined the reliability and validity of speech-language pathologists’ (SLP) estimations of speech intelligibility in dysarthria, including a visual analog scale (VAS) method and a percent estimation method commonly used in clinical settings. Speech samples from 20 speakers with dysarthria of varying etiologies were used to collect orthographic transcriptions from naïve listeners n=70 and VAS ratings and percent estimations of intelligibility from SLPs n=21. Intra- and interrater reliability for the two SLP intelligibility measures were evaluated, and the relationship between these measures was assessed. Finally, linear regression was used to evaluate the relationship between the naïve listeners’ orthographic transcription scores and the two SLP intelligibility measures. The results indicated that the intrarater reliability for both SLP intelligibility measures was strong, and the interrater reliability between the SLP ratings was moderate to excellent. A moderate positive relationship between SLPs’ VAS ratings and percent estimations was also observed. Finally, both SLPs’ percent estimations and VAS ratings were predictive of naïve listeners’ orthographic transcription scores, with SLPs’ percent estimations being the strongest predictor. In conclusion, the average SLP percent estimations and VAS ratings are valid and reliable intelligibility measures. However, the validity and reliability of these measures vary between SLPs.
Collapse
|
6
|
Hsu SC, Jiao Y, Berisha V, McAuliffe MJ, Lin P, Wu RM, Cheng SJ, Levy ES. The Effects of Intensive Voice Treatment in Mandarin Speakers With Parkinson's Disease: Acoustic and Perceptual Findings. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1354-1367. [PMID: 35394803 DOI: 10.1044/2022_ajslp-21-00195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study investigated the effects of intensive voice treatment on subjective and objective measures of speech production in Mandarin speakers with hypokinetic dysarthria. METHOD Nine Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease received 4 weeks of intensive voice treatment (4 × 60 min per week). The speakers were recorded reading a passage before treatment (PRE), immediately after treatment (POST), and at 6-month follow-up (FU). Listeners (n = 15) rated relative ease of understanding (EOU) of paired speech samples on a visual analogue scale. Acoustic analyses were performed. Changes in EOU, vocal intensity, global and local fundamental frequency (f o) variation, speech rate, and acoustic vowel space area (VSA) were examined. RESULTS Increases were found in EOU and vocal intensity from PRE to POST and from PRE to FU, with no change found from POST to FU. Speech rate increased from PRE to POST, with limited evidence of an increase from PRE to FU and no change from POST to FU. No changes in global or local f o variation or in VSA were found. CONCLUSIONS Intensive voice treatment shows promise for improving speech production in Mandarin speakers with hypokinetic dysarthria. Vocal intensity, speech rate, and, crucially, intelligibility, may improve for up to 6 months posttreatment. In contrast, f o variation and VSA may not increase following the treatment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19529017.
Collapse
Affiliation(s)
- Sih-Chiao Hsu
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Yishan Jiao
- College of Health Solutions, Arizona State University, Tempe
| | - Visar Berisha
- College of Health Solutions, Arizona State University, Tempe
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
| | - Megan J McAuliffe
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- New Zealand Institute of Language, Brain & Behaviour, University of Canterbury, Christchurch
| | - Peiyi Lin
- Institute for Learning Technologies, Teachers College, Columbia University, New York, NY
| | - Ruey-Meei Wu
- Centre of Parkinson and Movement Disorders, National Taiwan University Hospital, Taipei
- College of Medicine, National Taiwan University, Taipei
| | - Shih-Jung Cheng
- MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Medical College, New Taipei City, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Erika S Levy
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| |
Collapse
|
7
|
van Brenk F, Stipancic K, Kain A, Tjaden K. Intelligibility Across a Reading Passage: The Effect of Dysarthria and Cued Speaking Styles. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:390-408. [PMID: 34982941 PMCID: PMC9135029 DOI: 10.1044/2021_ajslp-21-00151] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Reading a passage out loud is a commonly used task in the perceptual assessment of dysarthria. The extent to which perceptual characteristics remain unchanged or stable over the time course of a passage is largely unknown. This study investigated crowdsourced visual analogue scale (VAS) judgments of intelligibility across a reading passage as a function of cued speaking styles commonly used in treatment to maximize intelligibility. PATIENTS AND METHOD The Hunter passage was read aloud in habitual, slow, loud, and clear speaking styles by 16 speakers with Parkinson's disease (PD), 30 speakers with multiple sclerosis (MS), and 32 control speakers. VAS judgments of intelligibility from three fragments representing the beginning, middle, and end of the reading passage were obtained from 540 crowdsourced online listeners. RESULTS Overall passage intelligibility was reduced for the two clinical groups relative to the control group. All speaker groups exhibited intelligibility variation across the reading passage, with trends of increased intelligibility toward the end of the reading passage. For control speakers and speakers with PD, patterns of intelligibility variation across passage reading did not differ with speaking style. For the MS group, intelligibility variation across the passage was dependent on speaking style. CONCLUSIONS The presence of intelligibility variation within a reading passage warrants careful selection of speech materials in research and clinical practice. Results further indicate that the crowdsourced VAS rating paradigm is useful to document intelligibility in a reading passage for different cued speaking styles commonly used in treatment for dysarthria.
Collapse
Affiliation(s)
- Frits van Brenk
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
| | - Kaila Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Alexander Kain
- Department of Pediatrics, Oregon Health & Science University, Portland
| | - Kris Tjaden
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| |
Collapse
|
8
|
Lehner K, Ziegler W. Indicators of Communication Limitation in Dysarthria and Their Relation to Auditory-Perceptual Speech Symptoms: Construct Validity of the KommPaS Web App. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:22-42. [PMID: 34890213 DOI: 10.1044/2021_jslhr-21-00215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Despite extensive research into communication-related parameters in dysarthria, such as intelligibility, naturalness, and perceived listener effort, the existing evidence has not been translated into a clinically applicable, comprehensive, and valid diagnostic tool so far. This study addresses Communication-Related Parameters in Speech Disorders (KommPaS), a new web-based diagnostic instrument for measuring indices of communication limitation in individuals with dysarthria through online crowdsourcing. More specifically, it answers questions about the construct validity of KommPaS. In the first part, the interrelationship of the KommPaS variables intelligibility, naturalness, perceived listener effort, and speech rate were explored in order to draw a comprehensive picture of a patient's limitations and avoid the collection of redundant information. Second, the influences of motor speech symptoms on the KommPaS variables were studied in order to delineate the structural relationships between two complementary diagnostic perspectives. METHOD One hundred persons with dysarthria of different etiologies and varying degrees of severity were examined with KommPaS to obtain layperson-based data on communication-level parameters, and with the Bogenhausen Dysarthria Scale (BoDyS) to obtain expert-based, function-level data on dysarthria symptoms. The internal structure of the KommPaS variables and their dependence on the BoDyS variables were analyzed using structural equation modeling. RESULTS Despite a high multicollinearity, all KommPaS variables were shown to provide complementary diagnostic information and their mutual interconnections were delineated in a path graph model. Regarding the influence of the BoDyS scales on the KommPaS variables, separate linear regression models revealed plausible predictor sets. A complete path model of KommPaS and BoDyS variables was developed to map the complex interplay between variables at the functional and the communication levels of dysarthria assessment. CONCLUSION In validating a new clinical tool for the diagnostics of communication limitations in dysarthria, this study is the first to draw a comprehensive picture of how auditory-perceptual characteristics of dysarthria interact at the levels of expert-based functional and layperson-based communicative assessments.
Collapse
Affiliation(s)
- Katharina Lehner
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University Munich, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University Munich, Germany
| |
Collapse
|
9
|
van Brenk F, Kain A, Tjaden K. Investigating Acoustic Correlates of Intelligibility Gains and Losses During Slowed Speech: A Hybridization Approach. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1343-1360. [PMID: 34048663 PMCID: PMC8702861 DOI: 10.1044/2021_ajslp-20-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose This exploratory study sought to identify acoustic variables explaining rate-related variation in intelligibility for speakers with dysarthria secondary to multiple sclerosis. Method Seven speakers with dysarthria due to multiple sclerosis produced the same set of Harvard sentences at habitual and slow rates. Speakers were selected from a larger corpus on the basis of rate-related intelligibility characteristics. Four speakers demonstrated improved intelligibility and three speakers demonstrated reduced intelligibility when rate was slowed. A speech analysis resynthesis paradigm termed hybridization was used to create stimuli in which segmental (i.e., short-term spectral) and suprasegmental variables (i.e., sentence-level fundamental frequency, energy characteristics, and duration) of sentences produced at the slow rate were donated individually or in combination to habitually produced sentences. Online crowdsourced orthographic transcription was used to quantify intelligibility for six hybridized sentence types and the original habitual and slow productions. Results Sentence duration alone was not a contributing factor to improved intelligibility associated with slowed rate. Speakers whose intelligibility improved with slowed rate showed higher intelligibility scores for duration spectrum hybrids and energy hybrids compared to the original habitual rate sentences, suggesting these acoustic cues contributed to improved intelligibility for sentences produced with a slowed rate. Energy contour characteristics were also found to play a role in intelligibility losses for speakers with decreased intelligibility at slowed rate. The relative contribution of speech acoustic variables to intelligibility gains and losses varied considerably between speakers. Conclusions Hybridization can be used to identify acoustic correlates of intelligibility variation associated with slowed rate. This approach has further elucidated speaker-specific and individualized speech production adjustments when slowing rate.
Collapse
Affiliation(s)
- Frits van Brenk
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Alexander Kain
- Department of Pediatrics, Oregon Health & Science University, Portland
| | - Kris Tjaden
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| |
Collapse
|
10
|
Knowles T, Adams SG, Jog M. Variation in Speech Intelligibility Ratings as a Function of Speech Rate Modification in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1773-1793. [PMID: 33950711 DOI: 10.1044/2021_jslhr-20-00593] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The aim of this study was to quantify changes in speech intelligibility in two cohorts of people with Parkinson's disease (PD; those with and without deep brain stimulation [DBS]) across a broad range of self-selected speech rate alterations in (a) read sentences and (b) extemporaneous speech (monologues). Method Four speaker groups participated in this study: younger and older controls, people with PD undergoing standard pharmaceutical treatment, and people with PD and DBS. Naïve listeners rated the intelligibility of read sentences and extemporaneous monologues, spoken by participants at seven self-selected speech rates from very slow to very fast. Intelligibility was modeled as a function of group, speech rate condition, and speech task. Results Overall, compared to habitual speech rate, slower speech rate conditions were not associated with changes in speech intelligibility, whereas faster-than-habitual conditions were associated in declines in intelligibility. Results were mediated by group and task effects, such that talkers with PD and DBS were more likely to see intelligibility benefits at slower self-selected speech rates and less likely to see detriments at faster rates, and these differences were amplified in monologues compared to sentences. Conclusion Findings suggest differences in the ways in which slower and faster speech rate adjustments impact speech intelligibility in people with PD with and without DBS, with the latter demonstrating greater magnitudes of change.
Collapse
Affiliation(s)
- Thea Knowles
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Scott G Adams
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
- Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
| |
Collapse
|
11
|
Eijk L, Fletcher A, McAuliffe M, Janse E. The Effects of Word Frequency and Word Probability on Speech Rhythm in Dysarthria. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2833-2845. [PMID: 32783579 DOI: 10.1044/2020_jslhr-19-00389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose In healthy speakers, the more frequent and probable a word is in its context, the shorter the word tends to be. This study investigated whether these probabilistic effects were similarly sized for speakers with dysarthria of different severities. Method Fifty-six speakers of New Zealand English (42 speakers with dysarthria and 14 healthy speakers) were recorded reading the Grandfather Passage. Measurements of word duration, frequency, and transitional word probability were taken. Results As hypothesized, words with a higher frequency and probability tended to be shorter in duration. There was also a significant interaction between word frequency and speech severity. This indicated that the more severe the dysarthria, the smaller the effects of word frequency on speakers' word durations. Transitional word probability also interacted with speech severity, but did not account for significant unique variance in the full model. Conclusions These results suggest that, as the severity of dysarthria increases, the duration of words is less affected by probabilistic variables. These findings may be due to reductions in the control and execution of muscle movement exhibited by speakers with dysarthria.
Collapse
Affiliation(s)
- Lotte Eijk
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
| | - Annalise Fletcher
- Department of Audiology and Speech-Language Pathology, University of North Texas, Denton
| | - Megan McAuliffe
- School of Psychology, Speech and Hearing, New Zealand Institute of Language, Brain, and Behaviour, University of Canterbury
| | - Esther Janse
- Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| |
Collapse
|
12
|
Hustad KC, Sakash A, Natzke PEM, Broman AT, Rathouz PJ. Longitudinal Growth in Single Word Intelligibility Among Children With Cerebral Palsy From 24 to 96 Months of Age: Predicting Later Outcomes From Early Speech Production. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1599-1613. [PMID: 31112444 PMCID: PMC6808366 DOI: 10.1044/2018_jslhr-s-18-0319] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/23/2018] [Accepted: 12/27/2018] [Indexed: 05/19/2023]
Abstract
Purpose Children with cerebral palsy (CP) are at risk for significant communication problems. Reduced speech intelligibility is common, even for those who do not have speech motor deficits. Development of intelligibility has not been comprehensively quantified in children with CP; as a result, we are currently unable to predict later speech outcomes. Such information would advance treatment decision making. We sought to examine growth in speech intelligibility among children with CP using a prospective longitudinal design, with a focus on age of crossing target intelligibility thresholds, age of greatest intelligibility growth, and how well intelligibility at 36 months predicted intelligibility at 96 months. Method Sixty-nine children with CP were followed longitudinally between 24 and 96 months of age. A total of 566 time points were examined across children ( M = 8.2 time points per child, SD = 2.6). We fitted a nonlinear random effects model for longitudinal observations and then used the fitted model trajectories to generate descriptive analyses of growth. We used results of the model to generate a set of simulations, which we analyzed to determine how well 36-month intelligibility data predicted 96-month data. Results Half of children crossed 25% and 50% intelligibility thresholds at 36 and 49 months of age, respectively. Slightly more than half of children did not reach 75% intelligibility by 96 months of age. Age of crossing 25%, 50%, and 75% intelligibility thresholds was highly negatively correlated with intelligibly at 96 months. Children had the steepest intelligibility growth at 36 months, followed by 48 and 60 months. Intelligibility at 36 months was highly predictive of intelligibility at 96 months. Conclusions The developmental window from 3 to 5 years constitutes a time of rapid growth in speech intelligibility in children with CP. Children who cross intelligibility thresholds of 25%, 50%, and 75% at earlier ages have better outcomes when they are older; early performance is highly predictive of later speech intelligibility outcomes. Children with CP as a group have delayed speech intelligibility development but are still growing through 96 months of age.
Collapse
Affiliation(s)
- Katherine C. Hustad
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Waisman Center, University of Wisconsin–Madison
| | | | | | - Aimee Teo Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison
| | - Paul J. Rathouz
- Waisman Center, University of Wisconsin–Madison
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison
| |
Collapse
|
13
|
Hsu SC, McAuliffe MJ, Lin P, Wu RM, Levy ES. Acoustic and Perceptual Consequences of Speech Cues for Mandarin Speakers With Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:521-535. [PMID: 31136238 DOI: 10.1044/2018_ajslp-18-0020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose This study investigated the effects of cueing for increased loudness and reduced speech rate on scaled intelligibility and acoustics of speech produced by Mandarin speakers with hypokinetic dysarthria due to Parkinson's disease (PD). Method Eleven speakers with PD read passages in habitual, loud, and slow speaking conditions. Fifteen listeners rated ease of understanding (EOU) of the speech samples on a visual analog scale. Effects of the cues on EOU, vocal loudness, pitch range, pause duration and frequency, articulation rate, and vowel space, as well as relationships between EOU gains and acoustic features, were analyzed. Results EOU increased significantly in the loud condition only. The loud cue resulted in increased intensity, and the slow cue resulted both in reduced articulation rate and increased pause frequency. In the loud condition, EOU increased significantly as intensity increased and vowel centralization decreased. In the slow condition, EOU tended to increase as intensity increased and vowel centralization decreased but did not reach statistical significance. Conclusion Cueing for loud speech may yield greater EOU gains than cueing for slow speech in Mandarin speakers with PD. Theoretical and clinical implications are discussed, although further investigations with more participants and a larger range of dysarthria severity are warranted.
Collapse
Affiliation(s)
- Sih-Chiao Hsu
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Megan J McAuliffe
- Department of Communication Disorders and New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch
| | - Peiyi Lin
- Institute for Learning Technologies, Teachers College, Columbia University, New York, NY
| | - Ruey-Meei Wu
- Centre of Parkinson and Movement Disorders, Department of Neurology, National Taiwan University Hospital, Taipei
- College of Medicine, National Taiwan University, Taipei
| | - Erika S Levy
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| |
Collapse
|
14
|
Allison KM, Hustad KC. Data-Driven Classification of Dysarthria Profiles in Children With Cerebral Palsy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2837-2853. [PMID: 30481827 PMCID: PMC6440310 DOI: 10.1044/2018_jslhr-s-17-0356] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/16/2018] [Accepted: 06/26/2018] [Indexed: 05/13/2023]
Abstract
Purpose The objectives of this study were to examine different speech profiles among children with dysarthria secondary to cerebral palsy (CP) and to characterize the effect of different speech profiles on intelligibility. Method Twenty 5-year-old children with dysarthria secondary to CP and 20 typically developing children were included in this study. Six acoustic and perceptual speech measures were selected to quantify a range of segmental and suprasegmental speech characteristics and were measured from children's sentence productions. Hierarchical cluster analysis was used to identify naturally occurring subgroups of children who had similar profiles of speech features. Results Results revealed 4 naturally occurring speech clusters among children: 1 cluster of children with typical development and 3 clusters of children with dysarthria secondary to CP. Two of the 3 dysarthria clusters had statistically equivalent intelligibility levels but significantly differed in articulation rate and degree of hypernasality. Conclusion This study provides initial evidence that different speech profiles exist among 5-year-old children with dysarthria secondary to CP, even among children with similar intelligibility levels, suggesting the potential for developing a pediatric dysarthria classification system that could be used to stratify children with dysarthria into meaningful subgroups for studying speech motor development and efficacy of interventions.
Collapse
Affiliation(s)
- Kristen M. Allison
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison
- Waisman Center, University of Wisconsin-Madison
| | - Katherine C. Hustad
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison
- Waisman Center, University of Wisconsin-Madison
| |
Collapse
|
15
|
Kasari C, Sturm A, Shih W. SMARTer Approach to Personalizing Intervention for Children With Autism Spectrum Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2629-2640. [PMID: 30418492 PMCID: PMC6693574 DOI: 10.1044/2018_jslhr-l-rsaut-18-0029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/12/2018] [Accepted: 09/05/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE This review article introduces research methods for personalization of intervention. Our goals are to review evidence-based practices for improving social communication impairment in children with autism spectrum disorder generally and then how these practices can be systematized in ways that personalize intervention, especially for children who respond slowly to an initial evidence-based practice. METHOD The narrative reflects on the current status of modular and targeted interventions on social communication outcomes in the field of autism research. Questions are introduced regarding personalization of interventions that can be addressed through research methods. These research methods include adaptive treatment designs and the Sequential Multiple Assignment Randomized Trial. Examples of empirical studies using research designs are presented to answer questions of personalization. CONCLUSION Bridging the gap between research studies and clinical practice can be advanced by research that attempts to answer questions pertinent to the broad heterogeneity in children with autism spectrum disorder, their response to interventions, and the fact that a single intervention is not effective for all children. PRESENTATION VIDEO https://doi.org/10.23641/asha.7298021.
Collapse
Affiliation(s)
- Connie Kasari
- Graduate School of Education, University of California, Los Angeles
| | - Alexandra Sturm
- Department of Psychiatry, University of California, Los Angeles
| | - Wendy Shih
- Department of Psychiatry, University of California, Los Angeles
| |
Collapse
|
16
|
Fletcher AR, Wisler AA, McAuliffe MJ, Lansford KL, Liss JM. Predicting Intelligibility Gains in Dysarthria Through Automated Speech Feature Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:3058-3068. [PMID: 29075755 PMCID: PMC6195072 DOI: 10.1044/2017_jslhr-s-16-0453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 05/30/2023]
Abstract
PURPOSE Behavioral speech modifications have variable effects on the intelligibility of speakers with dysarthria. In the companion article, a significant relationship was found between measures of speakers' baseline speech and their intelligibility gains following cues to speak louder and reduce rate (Fletcher, McAuliffe, Lansford, Sinex, & Liss, 2017). This study reexamines these features and assesses whether automated acoustic assessments can also be used to predict intelligibility gains. METHOD Fifty speakers (7 older individuals and 43 with dysarthria) read a passage in habitual, loud, and slow speaking modes. Automated measurements of long-term average spectra, envelope modulation spectra, and Mel-frequency cepstral coefficients were extracted from short segments of participants' baseline speech. Intelligibility gains were statistically modeled, and the predictive power of the baseline speech measures was assessed using cross-validation. RESULTS Statistical models could predict the intelligibility gains of speakers they had not been trained on. The automated acoustic features were better able to predict speakers' improvement in the loud condition than the manual measures reported in the companion article. CONCLUSIONS These acoustic analyses present a promising tool for rapidly assessing treatment options. Automated measures of baseline speech patterns may enable more selective inclusion criteria and stronger group outcomes within treatment studies.
Collapse
Affiliation(s)
- Annalise R Fletcher
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand
| | - Alan A Wisler
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
| | - Megan J McAuliffe
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand
| | - Kaitlin L Lansford
- School of Communication Science & Disorders, Florida State University, Tallahassee
| | - Julie M Liss
- Department of Speech and Hearing Science, Arizona State University, Tempe
| |
Collapse
|