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Cloud C, Georgen-Schwartz K, Hilger A. The Contributions of Pitch, Loudness, and Rate Control to Speech Naturalness in Cerebellar Ataxia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:2536-2555. [PMID: 39240811 PMCID: PMC11427746 DOI: 10.1044/2024_ajslp-24-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
PURPOSE The goal of this study was to determine the relationship between the perceptual measure of speech naturalness and objective measures of pitch, loudness, and rate control as a potential tool for assessment of ataxic dysarthria. METHOD Twenty-seven participants with ataxia and 29 age- and sex-matched control participants completed the pitch glide and loudness step tasks drawn from the Frenchay Dysarthria Assessment-Second Edition (FDA-2) in addition to speech diadochokinetic (DDK) tasks. First, group differences were compared for pitch variability in the pitch glide task, loudness variability in the loudness step task, and syllable duration and speech rate in the DDK task. Then, these acoustic measures were compared with previously collected ratings of speech naturalness by speech-language pathology graduate students. RESULTS Robust group differences were measured for pitch variability and both DDK syllable duration and speech rate, indicating that the ataxia group had greater pitch variability, longer DDK syllable duration, and slower DDK speech rate than the control group. No group differences were measured for loudness variability. There were robust relationships between speech naturalness and pitch variability, DDK syllable duration, and DDK speech rate, but not for loudness variability. CONCLUSIONS Objective acoustic measures of pitch variability in the FDA-2 pitch glide task and syllable duration and speech rate in the DDK task can be used to validate perceptual measures of speech naturalness. Overall, speech-language pathologists can incorporate both perceptual measures of speech naturalness and acoustic measures of pitch variability and DDK performance for a comprehensive evaluation of ataxic dysarthria.
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Affiliation(s)
- Caitlin Cloud
- University of Colorado Boulder
- Skagit Regional Health, Mount Vernon, WA
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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; 67:2951-2963. [PMID: 39116309 PMCID: PMC11427422 DOI: 10.1044/2024_jslhr-23-00802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 06/06/2024] [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.
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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.
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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
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Kenyon KH, Strik M, Noffs G, Morgan A, Kolbe S, Harding IH, Vogel AP, Boonstra FMC, van der Walt A. Volumetric and diffusion MRI abnormalities associated with dysarthria in multiple sclerosis. Brain Commun 2024; 6:fcae177. [PMID: 38846538 PMCID: PMC11154149 DOI: 10.1093/braincomms/fcae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/16/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Up to half of all people with multiple sclerosis experience communication difficulties due to dysarthria, a disorder that impacts the motor aspects of speech production. Dysarthria in multiple sclerosis is linked to cerebellar dysfunction, disease severity and lesion load, but the neuroanatomical substrates of these symptoms remain unclear. In this study, 52 participants with multiple sclerosis and 14 age- and sex-matched healthy controls underwent structural and diffusion MRI, clinical assessment of disease severity and cerebellar dysfunction and a battery of motor speech tasks. Assessments of regional brain volume and white matter integrity, and their relationships with clinical and speech measures, were undertaken. White matter tracts of interest included the interhemispheric sensorimotor tract, cerebello-thalamo-cortical tract and arcuate fasciculus, based on their roles in motor and speech behaviours. Volumetric analyses were targeted to Broca's area, Wernicke's area, the corpus callosum, thalamus and cerebellum. Our results indicated that multiple sclerosis participants scored worse on all motor speech tasks. Fixel-based diffusion MRI analyses showed significant evidence of white matter tract atrophy in each tract of interest. Correlational analyses further indicated that higher speech naturalness-a perceptual measure of dysarthria-and lower reading rate were associated with axonal damage in the interhemispheric sensorimotor tract and left arcuate fasciculus in people with multiple sclerosis. Axonal damage in all tracts of interest also correlated with clinical scales sensitive to cerebellar dysfunction. Participants with multiple sclerosis had lower volumes of the thalamus and corpus callosum compared with controls, although no brain volumetrics correlated with measures of dysarthria. These findings indicate that axonal damage, particularly when measured using diffusion metrics, underpin dysarthria in multiple sclerosis.
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Affiliation(s)
- Katherine H Kenyon
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
| | - Myrte Strik
- Spinoza Centre for Neuroimaging, Netherlands Institute for Neuroscience, Royal Academy for Arts and Sciences, KNAW, Amsterdam 1105 BK, The Netherlands
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC 3052, Australia
| | - Gustavo Noffs
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC 3052, Australia
- Redenlab Inc, Melbourne, VIC 3000, Australia
| | - Angela Morgan
- Murdoch Children’s Research Institute, Genomic Medicine, Speech and Language Group, Parkville 3052, Australia
- Department of Speech Pathology and Audiology, University of Melbourne, Parkville 3052, Australia
| | - Scott Kolbe
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Ian H Harding
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Adam P Vogel
- Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC 3052, Australia
- Redenlab Inc, Melbourne, VIC 3000, Australia
- Division of Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
- Center for Neurology, University Hospital Tübingen, Tübingen 72076, Germany
- The Bionics Institute, East Melbourne, VIC 3002, Australia
| | - Frederique M C Boonstra
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Anneke van der Walt
- Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC 3004, Australia
- Spinoza Centre for Neuroimaging, Netherlands Institute for Neuroscience, Royal Academy for Arts and Sciences, KNAW, Amsterdam 1105 BK, The Netherlands
- The Bionics Institute, East Melbourne, VIC 3002, Australia
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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.
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Wolfrum V, Lehner K, Heim S, Ziegler W. Clinical Assessment of Communication-Related Speech Parameters in Dysarthria: The Impact of Perceptual Adaptation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-21. [PMID: 37486782 DOI: 10.1044/2023_jslhr-23-00105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
PURPOSE In current clinical practice, intelligibility of dysarthric speech is commonly assessed by speech-language therapists (SLTs), in most cases by the therapist caring for the patient being diagnosed. Since SLTs are familiar with dysarthria in general and with the speech of the individual patient to be assessed in particular, they have an adaptation advantage in understanding the patient's utterances. We examined whether and how listeners' assessments of communication-related speech parameters vary as a function of their familiarity with dysarthria in general and with the diagnosed patients in particular. METHOD Intelligibility, speech naturalness, and perceived listener effort were assessed in 20 persons with dysarthria (PWD). Patients' speech samples were judged by the individual treating therapists, five dysarthria experts who were unfamiliar with the patients, and crowdsourced naïve listeners. Adaptation effects were analyzed using (a) linear mixed models of overall scoring levels, (b) regression models of severity dependence, (c) network analyses of between-listener and between-parameter relationships, and (d) measures of intra- and interobserver consistency. RESULTS Significant advantages of dysarthria experts over laypeople were found in all parameters. An overall advantage of the treating therapists over nonfamiliar experts was only seen in listening effort. Severity-dependent adaptation effects occurred in all parameters. The therapists' responses were heterogeneous and inconsistent with those of the unfamiliar experts and the naïve listeners. CONCLUSIONS The way SLTs evaluate communication-relevant speech parameters of the PWD whom they care for is influenced not only by adaptation benefits but also by therapeutic biases. This finding weakens the validity of assessments of communication-relevant speech parameters by the treating therapists themselves and encourages the development and use of alternative methods.
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Affiliation(s)
- Vera Wolfrum
- Department of Neurology, Faculty of Medicine, RWTH Aachen University, Germany
| | - Katharina Lehner
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig Maximilian University of Munich, Germany
| | - Stefan Heim
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Germany
- Research Center Jülich, Institute of Neurosciences and Medicine (INM-1), Germany
- JARA - Translational Brain Medicine, Aachen, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig Maximilian University of Munich, Germany
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Schölderle T, Haas E, Ziegler W. Speech Naturalness in the Assessment of Childhood Dysarthria. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-11. [PMID: 37343549 DOI: 10.1044/2023_ajslp-23-00023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
PURPOSE This study investigated perceived speech naturalness estimated by adult listeners in typically developing children and children with dysarthria. We aimed to identify predictors of naturalness among auditory-perceptual parameters and to evaluate the concept of naturalness as a clinical marker of childhood dysarthria. METHOD In a listening experiment, naive adult listeners rated speech naturalness of 144 typically developing children (3-9 years old) and 28 children with neurological conditions (5-9 years old) on a visual analog scale. Speech samples were recorded using the materials of the Bogenhausen Dysarthria Scales-Childhood Dysarthria, which also provides for auditory-perceptual judgments covering all speech subsystems. RESULTS Children with dysarthria obtained significantly lower naturalness ratings compared to typically developing children. However, there was a substantial age effect observable in the typically developing children; that is, younger typically developing children were also perceived as somewhat unnatural. The ratings of the typically developing children were influenced by the occurrence of developmental speech features; for the children with neurological conditions, specific symptoms of dysarthria had an additional effect. In both groups, the perception of naturalness was predominantly determined by the children's articulation and intelligibility. CONCLUSIONS Both symptoms of childhood dysarthria and developmental speech features (e.g., regarding articulation and intelligibility) were associated to some extent with unnatural speech by the listeners. Thus, perceived speech naturalness appears less suitable as a marker of dysarthria in children than in adults.
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Affiliation(s)
- Theresa Schölderle
- Institute for Phonetics and Speech ProcessingLudwig-Maximilians-Universität München, München, Germany
| | - Elisabet Haas
- Institute for Phonetics and Speech ProcessingLudwig-Maximilians-Universität München, München, Germany
| | - Wolfram Ziegler
- Institute for Phonetics and Speech ProcessingLudwig-Maximilians-Universität München, München, Germany
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Nussbaum C, Pöhlmann M, Kreysa H, Schweinberger SR. Perceived naturalness of emotional voice morphs. Cogn Emot 2023; 37:731-747. [PMID: 37104118 DOI: 10.1080/02699931.2023.2200920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Research into voice perception benefits from manipulation software to gain experimental control over acoustic expression of social signals such as vocal emotions. Today, parameter-specific voice morphing allows a precise control of the emotional quality expressed by single vocal parameters, such as fundamental frequency (F0) and timbre. However, potential side effects, in particular reduced naturalness, could limit ecological validity of speech stimuli. To address this for the domain of emotion perception, we collected ratings of perceived naturalness and emotionality on voice morphs expressing different emotions either through F0 or Timbre only. In two experiments, we compared two different morphing approaches, using either neutral voices or emotional averages as emotionally non-informative reference stimuli. As expected, parameter-specific voice morphing reduced perceived naturalness. However, perceived naturalness of F0 and Timbre morphs were comparable with averaged emotions as reference, potentially making this approach more suitable for future research. Crucially, there was no relationship between ratings of emotionality and naturalness, suggesting that the perception of emotion was not substantially affected by a reduction of voice naturalness. We hold that while these findings advocate parameter-specific voice morphing as a suitable tool for research on vocal emotion perception, great care should be taken in producing ecologically valid stimuli.
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Affiliation(s)
- Christine Nussbaum
- Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, Germany
- Voice Research Unit, Friedrich Schiller University, Jena, Germany
| | - Manuel Pöhlmann
- Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, Germany
| | - Helene Kreysa
- Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, Germany
- Voice Research Unit, Friedrich Schiller University, Jena, Germany
| | - Stefan R Schweinberger
- Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, Germany
- Voice Research Unit, Friedrich Schiller University, Jena, Germany
- Swiss Center for Affective Sciences, University of Geneva, Switzerland
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Ziegler W, Schölderle T, Brendel B, Risch V, Felber S, Ott K, Goldenberg G, Vogel M, Bötzel K, Zettl L, Lorenzl S, Lampe R, Strecker K, Synofzik M, Lindig T, Ackermann H, Staiger A. Speech and Nonspeech Parameters in the Clinical Assessment of Dysarthria: A Dimensional Analysis. Brain Sci 2023; 13:brainsci13010113. [PMID: 36672094 PMCID: PMC9856358 DOI: 10.3390/brainsci13010113] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Nonspeech (or paraspeech) parameters are widely used in clinical assessment of speech impairment in persons with dysarthria (PWD). Virtually every standard clinical instrument used in dysarthria diagnostics includes nonspeech parameters, often in considerable numbers. While theoretical considerations have challenged the validity of these measures as markers of speech impairment, only a few studies have directly examined their relationship to speech parameters on a broader scale. This study was designed to investigate how nonspeech parameters commonly used in clinical dysarthria assessment relate to speech characteristics of dysarthria in individuals with movement disorders. Maximum syllable repetition rates, accuracies, and rates of isolated and repetitive nonspeech oral-facial movements and maximum phonation times were compared with auditory-perceptual and acoustic speech parameters. Overall, 23 diagnostic parameters were assessed in a sample of 130 patients with movement disorders of six etiologies. Each variable was standardized for its distribution and for age and sex effects in 130 neurotypical speakers. Exploratory Graph Analysis (EGA) and Confirmatory Factor Analysis (CFA) were used to examine the factor structure underlying the diagnostic parameters. In the first analysis, we tested the hypothesis that nonspeech parameters combine with speech parameters within diagnostic dimensions representing domain-general motor control principles. In a second analysis, we tested the more specific hypotheses that diagnostic parameters split along effector (lip vs. tongue) or functional (speed vs. accuracy) rather than task boundaries. Our findings contradict the view that nonspeech parameters currently used in dysarthria diagnostics are congruent with diagnostic measures of speech characteristics in PWD.
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Affiliation(s)
- Wolfram Ziegler
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany
- Correspondence:
| | - Theresa Schölderle
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany
| | - Bettina Brendel
- Clinic for Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, 72076 Tübingen, Germany
| | - Verena Risch
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany
| | - Stefanie Felber
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany
| | - Katharina Ott
- Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Georg Goldenberg
- Clinic for Neuropsychology, City Hospital Munich Bogenhausen, 81925 Munich, Germany
| | - Mathias Vogel
- Clinic for Neuropsychology, City Hospital Munich Bogenhausen, 81925 Munich, Germany
| | - Kai Bötzel
- Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Lena Zettl
- Medical Clinic and Outpatient Clinic IV, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Stefan Lorenzl
- Clinic for Neurology, Hospital Agatharied, 83734 Hausham, Germany
| | - Renée Lampe
- School of Medicine, Klinikum Rechts der Isar, Orthopedic Department, Research Unit for Pediatric Neuroorthopedics and Cerebral Palsy of the Buhl-Strohmaier Foundation, Technical University of Munich, 81675 Munich, Germany
| | - Katrin Strecker
- Department of Logopedics, Stiftung ICP Munich, Center for Cerebral Palsy, 81377 Munich, Germany
| | - Matthis Synofzik
- Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases (DZNE), and Center for Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Hermann Ackermann
- Department of General Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Anja Staiger
- Clinical Neuropsychology Research Group (EKN), Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, 80799 Munich, Germany
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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.
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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
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Lehner K, Ziegler W. Clinical measures of communication limitations in dysarthria assessed through crowdsourcing: specificity, sensitivity, and retest-reliability. CLINICAL LINGUISTICS & PHONETICS 2022; 36:988-1009. [PMID: 34763588 DOI: 10.1080/02699206.2021.1979658] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/05/2021] [Accepted: 09/05/2021] [Indexed: 06/13/2023]
Abstract
Assessing the impact of dysarthria on a patient's ability to communicate should be an integral part of patient management. However, due to the high demands on reliable quantification of communication limitations, hardly any formal clinical tests with approved psychometric properties have been developed so far. This study investigates a web-based assessment of communication impairment in dysarthria, named KommPaS. The test comprises measures of intelligibility, naturalness, perceived listener effort and communication efficiency, as well as a total score that integrates these parameters. The approach is characterized by a quasi-random access to a large inventory of test materials and to a large group of naïve listeners, recruited via crowdsourcing. As part of a larger research program to establish the clinical applicability of this new approach, the present paper focuses on two psychometric issues, namely specificity and sensitivity (study 1) and retest-reliability (study 2). Study 1: KommPaS was administered to 54 healthy adults and 100 adult persons with dysarthria (PWD). Non-parametric criterion-based norms (specificity: 0.95) were used to derive a standard metric for each of the four component variables, and corresponding sensitivity values for the presence of dysarthria were identified. Overall classification accuracy of the total score was determined using a ROC analysis. The resulting cutscores showed a high accuracy in the separation of PWD from healthy speakers for the naturalness and the total score. Study 2: A sub-group of 20 PWD enrolled in study 1 were administered a second KommPaS examination. ICC analyses revealed good to excellent retest reliabilities for all parameters.
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Affiliation(s)
- Katharina Lehner
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
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Alduais A, Alduais A, Alfadda H, Allegretta S. Clinical Linguistics: Analysis of Mapping Knowledge Domains in Past, Present and Future. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1202. [PMID: 36010092 PMCID: PMC9406678 DOI: 10.3390/children9081202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
Across the world, many infants, children, adults, and elderly people are reported with many types of disorders and disabilities that damage, delay, or impede typical language development and/or use. Speech-language pathologists and other relevant clinicians are responsible for diagnosing, assessing, and rehabilitating these conditions. In nearly all types of disorders or disabilities that affect language, clinical linguistics plays a significant role in their study, diagnosis, and evaluation. This study provides a thorough analysis of the field of clinical linguistics. Data from Scopus, WOS, and Lens were used between 1981 and 2022. The documents included in the analysis were 1685, 1628, and 2677 articles published between 1981 and 2022 in clinical linguistics in Scopus, WOS, and Lens, respectively. For the purpose of assessing the development and impacts of the field of clinical linguistics, we used eight bibliometric and eight scientometric indicators. As part of the study, the results summarized the top contributors to clinical linguistics in terms of production size by year, country, university/research centre, journal, publisher, and author. The impact of the examined evidence on clinical linguistics was visualized and tabulated in the form of visual networks, citation counts, burst, cooccurrence, centrality, and sigma factors that are helpful in identifying the main influencers in clinical linguistics. A few examples of clinical linguistics patterns that are being explored extensively by researchers include cleft palate speech with model theories, visual feedback, motor speech disorders with instrumental analysis, acoustic analysis to understand conversational breakdown, nonlinear phonological theory, aphasic conversation in atypical interaction, and diagnostic markers in functional segments. There are also phonological disorders, William Syndrome, and the use of ultrasound, which may be considered potential clusters of clinical linguistics. A key contribution of this paper is highlighting the importance of clinical linguistics as well as its integration with linguistics, speech-language pathology, neurolinguistics, psycholinguistics, neuroscience, cognitive sciences, psychology, and psychometrics.
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Affiliation(s)
- Ahmed Alduais
- Department of Human Sciences (Psychology), University of Verona, 37129 Verona, Italy
| | - Abdullah Alduais
- English Language Institute, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hind Alfadda
- Department of Curriculum and Instruction, King Saud University, Riyadh 11362, Saudi Arabia
| | - Silvia Allegretta
- Department of General Psychology, University of Padua, 35122 Padua, Italy
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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.
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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
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