1
|
Connaghan KP, Green JR, Eshghi M, Haenssler AE, Scheier ZA, Clark A, Iyer A, Richburg BD, Rowe HP, Okada J, Johnson SA, Onnela JP, Burke KM, Berry JD. The relationship of rate and pause features to the communicative participation of people living with ALS. Muscle Nerve 2024; 70:217-225. [PMID: 38837773 DOI: 10.1002/mus.28170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION/AIMS Many people living with amyotrophic lateral sclerosis (PALS) report restrictions in their day-to-day communication (communicative participation). However, little is known about which speech features contribute to these restrictions. This study evaluated the effects of common speech symptoms in PALS (reduced overall speaking rate, slowed articulation rate, and increased pausing) on communicative participation restrictions. METHODS Participants completed surveys (the Communicative Participation Item Bank-short form; the self-entry version of the ALS Functional Rating Scale-Revised) and recorded themselves reading the Bamboo Passage aloud using a smartphone app. Rate and pause measures were extracted from the recordings. The association of various demographic, clinical, self-reported, and acoustic speech features with communicative participation was evaluated with bivariate correlations. The contribution of salient rate and pause measures to communicative participation was assessed using multiple linear regression. RESULTS Fifty seven people living with ALS participated in the study (mean age = 61.1 years). Acoustic and self-report measures of speech and bulbar function were moderately to highly associated with communicative participation (Spearman rho coefficients ranged from rs = 0.48 to rs = 0.77). A regression model including participant age, sex, articulation rate, and percent pause time accounted for 57% of the variance of communicative participation ratings. DISCUSSION Even though PALS with slowed articulation rate and increased pausing may convey their message clearly, these speech features predict communicative participation restrictions. The identification of quantitative speech features, such as articulation rate and percent pause time, is critical to facilitating early and targeted intervention and for monitoring bulbar decline in ALS.
Collapse
Affiliation(s)
- Kathryn P Connaghan
- Speech and Social Interaction Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Jordan R Green
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Program in Speech and Hearing Bioscience and Technology, Harvard University, Boston, Massachusetts, USA
| | - Marziye Eshghi
- Speech, Physiology, and Neurobiology of Aging and Dementia Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Athinoula A. Martinos Centre for Biomedical Imaging, Boston, Massachusetts, USA
- Department of Radiology, MGH, Harvard Medical School, Boston, Massachusetts, USA
| | - Abigail E Haenssler
- Speech and Social Interaction Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Zoe A Scheier
- Healey Center for ALS, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alison Clark
- Healey Center for ALS, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amrita Iyer
- Healey Center for ALS, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian D Richburg
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Hannah P Rowe
- Speech Neuroscience Lab, Boston University, Boston, Massachusetts, USA
| | - June Okada
- Speech and Social Interaction Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Stephen A Johnson
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard University, Boston, Massachusetts, USA
| | - Katherine M Burke
- Healey Center for ALS, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James D Berry
- Healey Center for ALS, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, School of Medicine, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Sullivan L, Martin E, Allison KM. Effects of SPEAK OUT! & LOUD Crowd on Functional Speech Measures in Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1930-1951. [PMID: 38838243 DOI: 10.1044/2024_ajslp-23-00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE This study investigated the effects of the SPEAK OUT! & LOUD Crowd therapy program on speaking rate, percent pause time, intelligibility, naturalness, and communicative participation in individuals with Parkinson's disease (PD). METHOD Six adults with PD completed 12 individual SPEAK OUT! sessions across four consecutive weeks followed by group-based LOUD Crowd sessions for five consecutive weeks. Most therapy sessions were conducted via telehealth, with two participants completing the SPEAK OUT! portion in person. Speech samples were recorded at six time points: three baseline time points prior to SPEAK OUT!, two post-SPEAK OUT! time points, and one post-LOUD Crowd time point. Acoustic measures of speaking rate and percent pause time and listener ratings of speech intelligibility and naturalness were obtained for each time point. Participant self-ratings of communicative participation were also collected at pre- and posttreatment time points. RESULTS Results showed significant improvement in communicative participation scores at a group level following completion of the SPEAK OUT! & LOUD Crowd treatment program. Two participants showed a significant decrease in speaking rate and increase in percent pause time following treatment. Changes in intelligibility and naturalness were not statistically significant. CONCLUSIONS These findings provide preliminary support for the effectiveness of the SPEAK OUT! & LOUD Crowd treatment program in improving communicative participation for people with mild-to-moderate hypokinetic dysarthria secondary to PD. This study is also the first to demonstrate positive effects of this treatment program for people receiving the therapy via telehealth.
Collapse
Affiliation(s)
- Lauren Sullivan
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Elizabeth Martin
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Kristen M Allison
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| |
Collapse
|
3
|
Krajewski E, Lee J, Viswanathan N, Olmstead A, Simmons Z. The Effects of Interactive Context on Acoustic Characteristics of Speech in People With Dysarthria: A Preliminary Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1952-1964. [PMID: 38809826 DOI: 10.1044/2024_ajslp-23-00372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE The current study compared temporal and spectral acoustic contrast between vowel segments produced by speakers with dysarthria across three speech tasks-interactive, solo habitual, and solo clear. METHOD Nine speakers with dysarthria secondary to amyotrophic lateral sclerosis participated in the study. Each speaker was paired with a typical interlocutor over videoconferencing software. The speakers produced the vowels /i, ɪ, ɛ, æ/ in /h/-vowel-/d/ words. For the solo tasks, speakers read the stimuli aloud in both their habitual and clear speaking styles. For the interactive task, speakers produced a target stimulus for their interlocutor to select among the four possibilities. We measured the duration difference between long and short vowels, as well as the F1/F2 Euclidean distance between adjacent vowels, and also determined how well the vowels could be classified based on their acoustic characteristics. RESULTS Temporal contrast between long and short vowels was higher in the interactive task than in both solo tasks. Spectral distance between adjacent vowel pairs was also higher for some pairs in the interactive task than the habitual speech task. Finally, vowel classification accuracy was highest in the interactive task. CONCLUSIONS Overall, we found evidence that individuals with dysarthria produced vowels with greater acoustic contrast in structured interactions than they did in solo tasks. Furthermore, the speech adjustments they made to the vowel segments differed from those observed in solo speech.
Collapse
Affiliation(s)
- Elizabeth Krajewski
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Jimin Lee
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Navin Viswanathan
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Anne Olmstead
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Zachary Simmons
- Departments of Neurology and Humanities, The Pennsylvania State University College of Medicine, Hershey
- Penn State Hershey ALS Clinic and Research Center
| |
Collapse
|
4
|
Stegmann G, Krantsevich C, Liss J, Charles S, Bartlett M, Shefner J, Rutkove S, Kawabata K, Talkar T, Berisha V. Automated speech analytics in ALS: higher sensitivity of digital articulatory precision over the ALSFRS-R. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-9. [PMID: 38932502 DOI: 10.1080/21678421.2024.2371986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Objective: Although studies have shown that digital measures of speech detected ALS speech impairment and correlated with the ALSFRS-R speech item, no study has yet compared their performance in detecting speech changes. In this study, we compared the performances of the ALSFRS-R speech item and an algorithmic speech measure in detecting clinically important changes in speech. Importantly, the study was part of a FDA submission which received the breakthrough device designation for monitoring ALS; we provide this paper as a roadmap for validating other speech measures for monitoring disease progression. Methods: We obtained ALSFRS-R speech subscores and speech samples from participants with ALS. We computed the minimum detectable change (MDC) of both measures; using clinician-reported listener effort and a perceptual ratings of severity, we calculated the minimal clinically important difference (MCID) of each measure with respect to both sets of clinical ratings. Results: For articulatory precision, the MDC (.85) was lower than both MCID measures (2.74 and 2.28), and for the ALSFRS-R speech item, MDC (.86) was greater than both MCID measures (.82 and .72), indicating that while the articulatory precision measure detected minimal clinically important differences in speech, the ALSFRS-R speech item did not. Conclusion: The results demonstrate that the digital measure of articulatory precision effectively detects clinically important differences in speech ratings, outperforming the ALSFRS-R speech item. Taken together, the results herein suggest that this speech outcome is a clinically meaningful measure of speech change.
Collapse
Affiliation(s)
- Gabriela Stegmann
- Arizona State University, Phoenix, AZ, USA
- Aural Analytics, Scottsdale, AZ, USA
| | - Chelsea Krantsevich
- Arizona State University, Phoenix, AZ, USA
- Aural Analytics, Scottsdale, AZ, USA
| | - Julie Liss
- Arizona State University, Phoenix, AZ, USA
- Aural Analytics, Scottsdale, AZ, USA
| | - Sherman Charles
- Aural Analytics, Scottsdale, AZ, USA
- Linus Health, Boston, MA, USA
| | | | | | - Seward Rutkove
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kan Kawabata
- Aural Analytics, Scottsdale, AZ, USA
- Linus Health, Boston, MA, USA
| | - Tanya Talkar
- Aural Analytics, Scottsdale, AZ, USA
- Linus Health, Boston, MA, USA
| | - Visar Berisha
- Arizona State University, Phoenix, AZ, USA
- Aural Analytics, Scottsdale, AZ, USA
| |
Collapse
|
5
|
Liss J, Berisha V. Operationalizing Clinical Speech Analytics: Moving From Features to Measures for Real-World Clinical Impact. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-7. [PMID: 38838248 DOI: 10.1044/2024_jslhr-24-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
OBJECTIVE This research note advocates for a methodological shift in clinical speech analytics, emphasizing the transition from high-dimensional speech feature representations to clinically validated speech measures designed to operationalize clinically relevant constructs of interest. The aim is to enhance model generalizability and clinical applicability in real-world settings. METHOD We outline the challenges of using conventional supervised machine learning models in clinical speech analytics, particularly their limited generalizability and interpretability. We propose a new framework focusing on speech measures that are closely tied to specific speech constructs and have undergone rigorous validation. This research note discusses a case study involving the development of a measure for articulatory precision in amyotrophic lateral sclerosis (ALS), detailing the process from ideation through Food and Drug Administration (FDA) breakthrough status designation. RESULTS The case study demonstrates how the operationalization of the articulatory precision construct into a quantifiable measure yields robust, clinically meaningful results. The measure's validation followed the V3 framework (verification, analytical validation, and clinical validation), showing high correlation with clinical status and speech intelligibility. The practical application of these measures is exemplified in a clinical trial and designation by the FDA as a breakthrough status device, underscoring their real-world impact. CONCLUSIONS Transitioning from speech features to speech measures offers a more targeted approach for developing speech analytics tools in clinical settings. This shift ensures that models are not only technically sound but also clinically relevant and interpretable, thereby bridging the gap between laboratory research and practical health care applications. We encourage further exploration and adoption of this approach for developing interpretable speech representations tailored to specific clinical needs.
Collapse
|
6
|
Wynn CJ, Barrett TS, Borrie SA. Conversational Speech Behaviors Are Context Dependent. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1360-1369. [PMID: 38629972 PMCID: PMC11087085 DOI: 10.1044/2024_jslhr-23-00622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE According to the interpersonal synergy model of spoken dialogue, interlocutors modify their communicative behaviors to meet the contextual demands of a given conversation. Although a growing body of research supports this postulation for linguistic behaviors (e.g., semantics, syntax), little is understood about how this model applies to speech behaviors (e.g., speech rate, pitch). The purpose of this study is to test the hypothesis that interlocutors adjust their speech behaviors across different conversational tasks with different conversational goals. METHOD In this study, 28 participants each engaged in two different types of conversations (i.e., relational and informational) with two partners (i.e., Partner 1 and Partner 2), yielding a total of 112 conversations. We compared six acoustic measures of participant speech behavior across conversational task and partner. RESULTS Linear mixed-effects models demonstrated significant differences between speech feature measures in informational and relational conversations. Furthermore, these findings were generally robust across conversations with different partners. CONCLUSIONS Results suggest that contextual demands influence speech behaviors. These findings provide empirical support for the interpersonal synergy model and highlight important considerations for assessing speech behaviors in individuals with communication disorders.
Collapse
Affiliation(s)
- Camille J. Wynn
- Department of Communication Sciences and Disorders, University of Houston, TX
| | - Tyson S. Barrett
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| |
Collapse
|
7
|
Moya-Galé G, Pagano G, Walsh SJ. Perceptual consequences of online group speech treatment for individuals with Parkinson's disease: A pilot study case series. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-16. [PMID: 38692287 DOI: 10.1080/17549507.2024.2330538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
PURPOSE We examined perceptual changes in the domains of ease of understanding, naturalness, and speech severity, as well as changes in self-perceptions of voice disability, following an online group speech treatment program for people with Parkinson's disease (PD) conducted during the COVID-19 pandemic. METHOD Seven speakers with hypokinetic dysarthria associated with PD participated in a university and community-based online group speech program for 10 weeks. Speech recordings occurred remotely 1 week before and 1 week after the online program. Thirty naïve listeners rated ease of understanding, naturalness, and speech severity based on the speech recordings. Speakers' self-perceptions of voice disability were also obtained at both time points. RESULT Individual analysis of the speech data showed that for most speakers with dysarthria, ease of understanding and perceptions of severity were rated the same or better pre- to post-treatment. Naturalness, however, was only perceived to be the same or better post-treatment in three out of seven speakers. Over half of the speakers reported improvements in their self-perception of voice disability. CONCLUSION This pilot study highlighted the individual variability among speakers with dysarthria and the potential of online group speech treatment to maintain and/or improve speech function in this population.
Collapse
|
8
|
Ziegler W, Staiger A, Schölderle T. Profiles of Dysarthria: Clinical Assessment and Treatment. Brain Sci 2023; 14:11. [PMID: 38248226 PMCID: PMC10813547 DOI: 10.3390/brainsci14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
In recent decades, we have witnessed a wealth of theoretical work and proof-of-principle studies on dysarthria, including descriptions and classifications of dysarthric speech patterns, new and refined assessment methods, and innovative experimental intervention trials [...].
Collapse
Affiliation(s)
- Wolfram Ziegler
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany; (A.S.); (T.S.)
| | | | | |
Collapse
|
9
|
Borrie SA, Hepworth TJ, Wynn CJ, Hustad KC, Barrett TS, Lansford KL. Perceptual Learning of Dysarthria in Adolescence. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3791-3803. [PMID: 37616225 PMCID: PMC10713018 DOI: 10.1044/2023_jslhr-23-00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/28/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE As evidenced by perceptual learning studies involving adult listeners and speakers with dysarthria, adaptation to dysarthric speech is driven by signal predictability (speaker property) and a flexible speech perception system (listener property). Here, we extend adaptation investigations to adolescent populations and examine whether adult and adolescent listeners can learn to better understand an adolescent speaker with dysarthria. METHOD Classified by developmental stage, adult (n = 42) and adolescent (n = 40) listeners completed a three-phase perceptual learning protocol (pretest, familiarization, and posttest). During pretest and posttest, all listeners transcribed speech produced by a 13-year-old adolescent with spastic dysarthria associated with cerebral palsy. During familiarization, half of the adult and adolescent listeners engaged in structured familiarization (audio and lexical feedback) with the speech of the adolescent speaker with dysarthria; and the other half, with the speech of a neurotypical adolescent speaker (control). RESULTS Intelligibility scores increased from pretest to posttest for all listeners. However, listeners who received dysarthria familiarization achieved greater intelligibility improvements than those who received control familiarization. Furthermore, there was a significant effect of developmental stage, where the adults achieved greater intelligibility improvements relative to the adolescents. CONCLUSIONS This study provides the first tranche of evidence that adolescent dysarthric speech is learnable-a finding that holds even for adolescent listeners whose speech perception systems are not yet fully developed. Given the formative role that social interactions play during adolescence, these findings of improved intelligibility afford important clinical implications.
Collapse
Affiliation(s)
- Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Taylor J. Hepworth
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Camille J. Wynn
- Department of Communication Science and Disorders, University of Houston
| | - Katherine C. Hustad
- Waisman Center, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | | | - Kaitlin L. Lansford
- Department of Communication Science and Disorders, Florida State University, Tallahassee
| |
Collapse
|
10
|
Stegmann G, Charles S, Liss J, Shefner J, Rutkove S, Berisha V. A speech-based prognostic model for dysarthria progression in ALS. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:1-6. [PMID: 37309077 PMCID: PMC10713856 DOI: 10.1080/21678421.2023.2222144] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
Objective: We demonstrated that it was possible to predict ALS patients' degree of future speech impairment based on past data. We used longitudinal data from two ALS studies where participants recorded their speech on a daily or weekly basis and provided ALSFRS-R speech subscores on a weekly or quarterly basis (quarter-annually). Methods: Using their speech recordings, we measured articulatory precision (a measure of the crispness of pronunciation) using an algorithm that analyzed the acoustic signal of each phoneme in the words produced. First, we established the analytical and clinical validity of the measure of articulatory precision, showing that the measure correlated with perceptual ratings of articulatory precision (r = .9). Second, using articulatory precision from speech samples from each participant collected over a 45-90 day model calibration period, we showed it was possible to predict articulatory precision 30-90 days after the last day of the model calibration period. Finally, we showed that the predicted articulatory precision scores mapped onto ALSFRS-R speech subscores. Results: the mean absolute error was as low as 4% for articulatory precision and 14% for ALSFRS-R speech subscores relative to the total range of their respective scales. Conclusion: Our results demonstrated that a subject-specific prognostic model for speech predicts future articulatory precision and ALSFRS-R speech values accurately.
Collapse
Affiliation(s)
- Gabriela Stegmann
- Arizona State University, Phoenix, AZ
- Aural Analytics, Scottsdale, AZ
| | - Sherman Charles
- Aural Analytics, Scottsdale, AZ
- University of Arizona, Tucson, AZ
| | - Julie Liss
- Arizona State University, Phoenix, AZ
- Aural Analytics, Scottsdale, AZ
| | | | - Seward Rutkove
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Visar Berisha
- Arizona State University, Phoenix, AZ
- Aural Analytics, Scottsdale, AZ
| |
Collapse
|
11
|
Borrie SA, Yoho SE, Healy EW, Barrett TS. The Application of Time-Frequency Masking To Improve Intelligibility of Dysarthric Speech in Background Noise. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1853-1866. [PMID: 36944186 PMCID: PMC10457087 DOI: 10.1044/2023_jslhr-22-00558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Background noise reduces speech intelligibility. Time-frequency (T-F) masking is an established signal processing technique that improves intelligibility of neurotypical speech in background noise. Here, we investigated a novel application of T-F masking, assessing its potential to improve intelligibility of neurologically degraded speech in background noise. METHOD Listener participants (N = 422) completed an intelligibility task either in the laboratory or online, listening to and transcribing audio recordings of neurotypical (control) and neurologically degraded (dysarthria) speech under three different processing types: speech in quiet (quiet), speech mixed with cafeteria noise (noise), and speech mixed with cafeteria noise and then subsequently processed by an ideal quantized mask (IQM) to remove the noise. RESULTS We observed significant reductions in intelligibility of dysarthric speech, even at highly favorable signal-to-noise ratios (+11 to +23 dB) that did not impact neurotypical speech. We also observed significant intelligibility improvements from speech in noise to IQM-processed speech for both control and dysarthric speech across a wide range of noise levels. Furthermore, the overall benefit of IQM processing for dysarthric speech was comparable with that of the control speech in background noise, as was the intelligibility data collected in the laboratory versus online. CONCLUSIONS This study demonstrates proof of concept, validating the application of T-F masks to a neurologically degraded speech signal. Given that intelligibility challenges greatly impact communication, and thus the lives of people with dysarthria and their communication partners, the development of clinical tools to enhance intelligibility in this clinical population is critical.
Collapse
Affiliation(s)
- Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Sarah E. Yoho
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Eric W. Healy
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | | |
Collapse
|
12
|
Fletcher AR, Wisler AA, Gruver ER, Borrie SA. Beyond Speech Intelligibility: Quantifying Behavioral and Perceived Listening Effort in Response to Dysarthric Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4060-4070. [PMID: 36198057 PMCID: PMC9940894 DOI: 10.1044/2022_jslhr-22-00136] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE This study investigated whether listener processing of dysarthric speech requires the recruitment of more cognitive resources (i.e., higher levels of listening effort) than neurotypical speech. We also explored relationships between behavioral listening effort, perceived listening effort, and objective measures of word transcription accuracy. METHOD A word recall paradigm was used to index behavioral listening effort. The primary task involved word transcription, whereas a memory task involved recalling words from previous sentences. Nineteen listeners completed the paradigm twice, once while transcribing dysarthric speech and once while transcribing neurotypical speech. Perceived listening effort was rated using a visual analog scale. RESULTS Results revealed significant effects of dysarthria on the likelihood of correct word recall, indicating that the transcription of dysarthric speech required higher levels of behavioral listening effort relative to neurotypical speech. There was also a significant relationship between transcription accuracy and measures of behavioral listening effort, such that listeners who were more accurate in understanding dysarthric speech exhibited smaller changes in word recall when listening to dysarthria. The subjective measure of perceived listening effort did not have a statistically significant correlation with measures of behavioral listening effort or transcription accuracy. CONCLUSIONS Results suggest that cognitive resources, particularly listeners' working memory capacity, are more taxed when deciphering dysarthric versus neurotypical speech. An increased demand on these resources may affect a listener's ability to remember aspects of their conversations with people with dysarthria, even when the speaker is fully intelligible.
Collapse
Affiliation(s)
- Annalise R. Fletcher
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | - Alan A. Wisler
- Department of Mathematics and Statistics, Utah State University, Logan
| | - Emily R. Gruver
- Department of Audiology and Speech-Language Pathology, University of North Texas, Denton
| | - Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| |
Collapse
|
13
|
Wynn CJ, Josephson ER, Borrie SA. An Examination of Articulatory Precision in Autistic Children and Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1416-1425. [PMID: 35235372 PMCID: PMC9499346 DOI: 10.1044/2021_jslhr-21-00490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/01/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE According to the speech attunement framework, autistic individuals lack the ability and/or motivation to "tune up" their speech to the same level of precision as their neurotypical peers. However, previous studies exploring the articulatory patterns of autistic individuals have yielded disparate findings. One reason contrasting conclusions exist may be because studies have relied on perceptual measures of articulation. Here, we use an objective acoustic measure of articulatory precision to explore the articulatory patterns of autistic children and adults. METHOD This was a retrospective analysis of an existing corpus of 900 recorded speech samples taken from 30 adult and 30 child participants across two different population groups: autistic individuals (autism spectrum disorder [ASD] group) and neurotypical individuals (neurotypical [NT] group). Articulatory precision scores were calculated using an automated metric that compares observed acoustics to the expected acoustics for each phoneme production. Linear mixed-effects models were used to compare the articulatory precision scores across population group (i.e., ASD group vs. NT group) and to see if these differences were moderated by age group (i.e., children vs. adult). RESULTS The speech of autistic individuals was characterized by reduced articulatory precision relative to their neurotypical peers. This pattern was not significantly moderated by age, indicating it occurred in both the children and adult groups. CONCLUSIONS Our preliminary findings indicate that imprecise articulation may be a characteristic of the speech of autistic individuals in both childhood and adulthood. These findings are in line with predictions posited by the speech attunement framework. Given the current lack of speech markers for this clinical population and the importance of speech quality in the social integration of autistic individuals, our results advance articulatory precision as a viable and important target for future research.
Collapse
Affiliation(s)
- Camille J. Wynn
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| | | | - Stephanie A. Borrie
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
| |
Collapse
|
14
|
Page AD, Yorkston KM. Communicative Participation in Dysarthria: Perspectives for Management. Brain Sci 2022; 12:brainsci12040420. [PMID: 35447952 PMCID: PMC9031517 DOI: 10.3390/brainsci12040420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Communicative participation is restricted in many conditions associated with dysarthria. This position paper defines and describes the construct of communicative participation. In it, the emergence of this construct is reviewed, along with the predictors of and variables associated with communicative participation in the dysarthrias. In doing so, the features that make communicative participation unique and distinct from other measures of dysarthria are highlighted, through emphasizing how communicative participation cannot be predicted solely from other components of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), including levels of impairment or activity limitations. Next, the empirical literature related to the measurement of communicative participation and how this research relates to dysarthria management is presented. Finally, the development of robust clinical measures of communicative participation and approaches to management is described from the point of view of the clinician. We argue that communicative participation should be a primary focus of treatment planning and intervention to provide patient-centered, holistic, and value-based clinical interventions which are responsive to the needs of individuals living with dysarthria.
Collapse
Affiliation(s)
- Allyson D. Page
- School of Communication Sciences and Disorders, Western University, London, ON N6G 1H1, Canada
- Correspondence:
| | - Kathryn M. Yorkston
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA 98105-6246, USA;
| |
Collapse
|