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Moya-Galé G, Hernández JD, Goudarzi A, Walsh SJ. ¿Notas La Diferencia? [Do You Hear the Difference?]: Perceptual Consequences of Intensive Voice Treatment in Spanish Speakers With Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2872-2892. [PMID: 38513128 DOI: 10.1044/2023_jslhr-23-00379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
PURPOSE The primary objective of this study was to explore the effects of intensive voice-focused treatment on speech parameters in Spanish speakers with dysarthria associated with Parkinson's disease (PD) as perceived by naïve listeners. METHOD Fifteen Spanish speakers with dysarthria associated with PD received the Lee Silverman Voice Treatment (LSVT LOUD) for a month. Voice and speech recordings were conducted pretreatment, posttreatment, and at a 1-month follow-up. Thirty naïve adult listeners rated the perceptual dimensions of ease of understanding (EoU), resonance, articulatory precision, prosody, and voice quality from sentences extracted from an emotional monologue on a visual analogue scale. RESULTS EoU, resonance, articulatory precision, and voice quality significantly improved pre- to posttreatment, but gains were not maintained at follow-up. Speech severity was a significant source of variance in mean listener response for all perceptual dimensions, although the interaction between speech severity and time was only significant for resonance and voice quality. CONCLUSIONS LSVT LOUD may be beneficial to improve perceptual speech domains affected by PD in Spanish speakers with dysarthria. Its impact on the different speech subsystems may reflect a universal distribution of effects when directly targeting the glottal source. Language-specific contributions of each perceptual domain to speech intelligibility should be explored in further research to determine linguistically sensitive treatment targets.
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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] [Grants] [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.
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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
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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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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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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.
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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
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Haas E, Ziegler W, Schölderle T. Intelligibility, Speech Rate, and Communication Efficiency in Children With Neurological Conditions: A Longitudinal Study of Childhood Dysarthria. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1817-1835. [PMID: 35763411 DOI: 10.1044/2022_ajslp-21-00354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This study aimed to describe communication-related parameters (i.e., intelligibility, speech rate, and communication efficiency) and their developmental courses in children with neurological conditions against the background of typical development. In addition, interrelations between the developmental courses of communication-related parameters and auditory-perceptual ratings related to speech subsystems were investigated. METHOD Fourteen children with neurological conditions (CNC) and 14 typically developing children (CTD), matched for age and gender (four girls; 5;1-8;4 [years;months] at first examination), were assessed at three points in time over an 18-month period. Speech samples were collected using the Bogenhausener Dysarthrie Skalen-Kindliche Dysarthrien (English: Bogenhausen Dysarthria Scales-Childhood Dysarthria), a German tool for the assessment of childhood dysarthria. To assess intelligibility, naïve listeners transcribed audio samples of sentence repetitions of the children. Speech rate was measured by acoustic analyses, and communication efficiency was determined by multiplying the proportion of correctly transcribed syllables with speech rate. Age normalization was performed following a recently published approach. RESULTS On the group level, CNC had conspicuous raw and normalized scores for the three communication-related parameters and were more variable than the CTD group regarding their developmental courses. These differences were more pronounced for intelligibility than for speech rate. A strong relationship between communication-related and speech subsystems-related auditory-perceptual characteristics was apparent only between intelligibility and articulation/resonance. CONCLUSIONS For the first time, age-normalized scores for communication-related parameters were reported in children with neurological disorders and put into a developmental context within the framework of a longitudinal study. Age-normalized intelligibility was more vulnerable to large developmental changes than speech rate and was best predicted by changes in articulation and resonance. Overall, this study may contribute to a more comprehensive and valid clinical assessment of childhood dysarthria and to a better understanding of its developmental dynamics.
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Affiliation(s)
- Elisabet Haas
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Wolfram Ziegler
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Theresa Schölderle
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität München, Munich, Germany
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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.
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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
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Whelan BM, Theodoros D, Cahill L, Vaezipour A, Vogel AP, Finch E, Farrell A, Cardell E. Feasibility of a Telerehabilitation Adaptation of the Be Clear Speech Treatment Program for Non-Progressive Dysarthria. Brain Sci 2022; 12:brainsci12020197. [PMID: 35203960 PMCID: PMC8870717 DOI: 10.3390/brainsci12020197] [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: 12/18/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the feasibility and outcomes of a telerehabilitation adaptation of the Be Clear speech treatment program for adults with non-progressive dysarthria to determine clinical delivery viability and future research directions. Treatment effects on speech clarity, intelligibility, communication effectiveness, and participation, as well as psychosocial outcomes in 15 participants with non-progressive dysarthria, were explored. Intervention involved daily 1-h online sessions (4 days per week for 4 weeks, totalling 16 sessions) and daily home practice. Outcome measures were obtained at baseline (PRE), post-treatment (POST), and 12 weeks following treatment (FUP). Feasibility measures targeting participant satisfaction, treatment adherence and fidelity, and technical viability were also employed. The programme was feasible concerning technical viability and implementation, treatment adherence and fidelity. High levels of participant satisfaction were reported. Increases in overall ratings of communication participation and effectiveness were identified at POST and FUP. Reductions in speech rate were identified at FUP. Improvements in aspects of lingual and laryngeal function were also noted after treatment. Over time, improvements relating to the negative impact of dysarthria were identified. Naïve listeners perceived negligible changes in speech clarity following treatment. Online delivery of the Be Clear speech treatment program was feasible, and some positive speech benefits were observed. Due to the small sample size included in this research, statistically significant findings related to speech outcomes must be interpreted with caution. An adequately powered randomised controlled trial of Be Clear online is warranted to evaluate treatment efficacy.
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Affiliation(s)
- Brooke-Mai Whelan
- Recover Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane 4072, Australia; (D.T.); (L.C.); (A.V.)
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
- Correspondence:
| | - Deborah Theodoros
- Recover Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane 4072, Australia; (D.T.); (L.C.); (A.V.)
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Louise Cahill
- Recover Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane 4072, Australia; (D.T.); (L.C.); (A.V.)
| | - Atiyeh Vaezipour
- Recover Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane 4072, Australia; (D.T.); (L.C.); (A.V.)
| | - Adam P. Vogel
- Centre for the Neuroscience of Speech, Department of Audiology and Speech Pathology, Melbourne School of Health Sciences, The University of Melbourne, Melbourne 3010, Australia;
- Redenlab Inc., Melbourne 3000, Australia
| | - Emma Finch
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Queensland Health, Brisbane 4102, Australia
- The Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland Health, Brisbane 4102, Australia;
| | - Anna Farrell
- The Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland Health, Brisbane 4102, Australia;
- The Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Queensland Health, Brisbane 4029, Australia
| | - Elizabeth Cardell
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia;
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Johansson IL, Samuelsson C, Müller N. Picture description in the assessment of connected speech intelligibility in Parkinson's disease: A pilot study. Folia Phoniatr Logop 2022; 74:320-334. [PMID: 35021169 PMCID: PMC9677862 DOI: 10.1159/000521906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a client's natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson's disease. Methods Speech samples from eleven speakers with Parkinson's disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples. Results Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at the group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson's disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions. Conclusion Within-speaker variability supports literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences and to inform the planning of interventions.
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Affiliation(s)
- Inga-Lena Johansson
- Department of Biomedical and Clinical Sciences/Speech and Language Pathology, Linköping University, Linköping, Sweden
- *Inga-Lena Johansson,
| | - Christina Samuelsson
- Department of Biomedical and Clinical Sciences/Speech and Language Pathology, Linköping University, Linköping, Sweden
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Solna, Sweden
| | - Nicole Müller
- Department of Biomedical and Clinical Sciences/Speech and Language Pathology, Linköping University, Linköping, Sweden
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
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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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11
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Feng Y, Chen F. Nonintrusive objective measurement of speech intelligibility: A review of methodology. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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12
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Stipancic KL, Palmer KM, Rowe HP, Yunusova Y, Berry JD, Green JR. "You Say Severe, I Say Mild": Toward an Empirical Classification of Dysarthria Severity. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4718-4735. [PMID: 34762814 PMCID: PMC9150682 DOI: 10.1044/2021_jslhr-21-00197] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/07/2021] [Accepted: 08/12/2021] [Indexed: 05/19/2023]
Abstract
PURPOSE The main purpose of this study was to create an empirical classification system for speech severity in patients with dysarthria secondary to amyotrophic lateral sclerosis (ALS) by exploring the reliability and validity of speech-language pathologists' (SLPs') ratings of dysarthric speech. METHOD Ten SLPs listened to speech samples from 52 speakers with ALS and 20 healthy control speakers. SLPs were asked to rate the speech severity of the speakers using five response options: normal, mild, moderate, severe, and profound. Four severity-surrogate measures were also calculated: SLPs transcribed the speech samples for the calculation of speech intelligibility and rated the effort it took to understand the speakers on a visual analog scale. In addition, speaking rate and intelligible speaking rate were calculated for each speaker. Intrarater and interrater reliability were calculated for each measure. We explored the validity of clinician-based severity ratings by comparing them to the severity-surrogate measures. Receiver operating characteristic (ROC) curves were conducted to create optimal cutoff points for defining dysarthria severity categories. RESULTS Intrarater and interrater reliability for the clinician-based severity ratings were excellent and were comparable to reliability for the severity-surrogate measures explored. Clinician severity ratings were strongly associated with all severity-surrogate measures, suggesting strong construct validity. We also provided a range of values for each severity-surrogate measure within each severity category based on the cutoff points obtained from the ROC analyses. CONCLUSIONS Clinician severity ratings of dysarthric speech are reliable and valid. We discuss the underlying challenges that arise when selecting a stratification measure and offer recommendations for a classification scheme when stratifying patients and research participants into speech severity categories.
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Affiliation(s)
- Kaila L. Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Kira M. Palmer
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Hannah P. Rowe
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Yana Yunusova
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
| | - James D. Berry
- Sean M. Healey and AMG Center for ALS, Massachusetts General Hospital, Boston
| | - Jordan R. Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
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On combining acoustic and modulation spectrograms in an attention LSTM-based system for speech intelligibility level classification. Neurocomputing 2021. [DOI: 10.1016/j.neucom.2021.05.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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An Auditory Saliency Pooling-Based LSTM Model for Speech Intelligibility Classification. Symmetry (Basel) 2021. [DOI: 10.3390/sym13091728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Speech intelligibility is a crucial element in oral communication that can be influenced by multiple elements, such as noise, channel characteristics, or speech disorders. In this paper, we address the task of speech intelligibility classification (SIC) in this last circumstance. Taking our previous works, a SIC system based on an attentional long short-term memory (LSTM) network, as a starting point, we deal with the problem of the inadequate learning of the attention weights due to training data scarcity. For overcoming this issue, the main contribution of this paper is a novel type of weighted pooling (WP) mechanism, called saliency pooling where the WP weights are not automatically learned during the training process of the network, but are obtained from an external source of information, the Kalinli’s auditory saliency model. In this way, it is intended to take advantage of the apparent symmetry between the human auditory attention mechanism and the attentional models integrated into deep learning networks. The developed systems are assessed on the UA-speech dataset that comprises speech uttered by subjects with several dysarthria levels. Results show that all the systems with saliency pooling significantly outperform a reference support vector machine (SVM)-based system and LSTM-based systems with mean pooling and attention pooling, suggesting that Kalinli’s saliency can be successfully incorporated into the LSTM architecture as an external cue for the estimation of the speech intelligibility level.
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Lagerberg TB, Anrep-Nordin E, Emanuelsson H, Strömbergsson S. Parent rating of intelligibility: A discussion of the construct validity of the Intelligibility in Context Scale (ICS) and normative data of the Swedish version of the ICS. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:873-886. [PMID: 34125476 DOI: 10.1111/1460-6984.12634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Intelligibility can be defined as the speakers' ability to convey a message to the listener and it is considered the key functional measure of speech. The Intelligibility in Context Scale (ICS) is a parent rating scale used to assess intelligibility in children. AIMS To describe normative and validation data on the ICS in Swedish and to investigate how these are related to age, gender and multilingualism. METHODS & PROCEDURES Two studies were included. Study 1 included ICS forms from 319 Swedish-speaking children (3:2-9:2 years:months). Study 2 included video recordings and ICS forms from 14 children with speech sound disorder (SSD) and two with typical speech. The video recordings were transcribed in the validation process, resulting in intelligibility reference scores to which ICS scores were correlated. OUTCOMES & RESULTS Study 1: The mean value of the ICS for the 319 children was 4.73. There were no differences in ICS score related to age or gender. The children in the multilingual group were significantly older than the monolingual group and had significantly lower ICS scores than the group of monolinguals. Study 2: There was a moderate correlation between the ICS score and the transcription-based intelligibility score, with the two children with typical speech excluded; however, this correlation was not significant. CONCLUSIONS & IMPLICATIONS We contribute mean scores and percentiles on the ICS for Swedish-speaking children. The finding that the ICS does not provide valid measures of intelligibility for the included children with SSD suggests that the instrument measures a different construct. WHAT THIS PAPER ADDS What is already known on the subject The ICS has been translated to numerous languages and validated against articulation measures in several previous studies. The validity of the Swedish version has been investigated against intelligibility based on transcription of single words. What this paper adds to existing knowledge The study provides normative values of the Swedish version of the ICS for children aged 3-9 years. This is the first study to use a gold standard measure of intelligibility in continuous speech to validate the ICS. The results show a somewhat dubious validity regarding ICS for the group of children with SSD included in the study. What are the potential or actual clinical implications of this work? The ICS's suitability as a measure of intelligibility is questionable; however, it might be of use for speech and language pathologists to give an overview of the parents' view of their child's ability to communicate, in order to make a decision on possible further assessment and intervention. The normative values of the Swedish version of the ICS could be of use in this decision process.
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Affiliation(s)
- Tove B Lagerberg
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elin Anrep-Nordin
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Emanuelsson
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet (KI), Stockholm, Sweden
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Lagerberg TB, Holm K, McAllister A, Strömbergsson S. Measuring intelligibility in spontaneous speech using syllables perceived as understood. JOURNAL OF COMMUNICATION DISORDERS 2021; 92:106108. [PMID: 34077891 DOI: 10.1016/j.jcomdis.2021.106108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/25/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Intelligibility, the ability to convey a message by speech, is one of the most important variables in speech-language pathology. The assessment of intelligibility is a challenge especially when it comes to spontaneous speech. The aim of the study was to investigate validity and reliability of a method for assessment of intelligibility, syllables perceived as understood (SPU); a method that is more time-efficient than previous methods based on transcription, as it does not require a master transcript for reference. METHOD A group of 20 adult listeners transcribed stimuli consisting of spontaneous speech from 16 children (14 with speech sound disorder and two with typical speech and language development, age 4:4 to 8:1, M = 6:0). Intelligibility was calculated based on these orthographic transcripts, as a) proportion of syllables perceived as understood (SPU) and b) proportion of syllables correctly understood (SCU), with reference to a master transcript. Validity was checked through investigation of the correlation and difference between these two measures. Reliability was analysed with inter-listener reliability by intra-class correlation. RESULTS The correlation between SPU and SCU (the gold standard intelligibility score) was strong and statistically significant, with SPU being consistently higher than SCU. Inter-listener reliability for single measures of intra-class correlation of the assessment by syllables perceived as understood was moderate to low, whereas the inter-listener reliability for average measures of intra-class correlation was high. CONCLUSIONS The method based on SPU might be used for assessment of intelligibility if the median from several listeners is used or when comparing results from the same listener over time. The SPU method might therefore be a valuable tool in a clinical and research context as a more valid option than rating scales and a more time-efficient method than the gold standard SCU method. However, it should be noted that the reliability of the SPU is not as high as for the SCU.
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Affiliation(s)
- Tove B Lagerberg
- Institute of Neuroscience and Physiology, Division of Speech and Language Pathology, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden.
| | - Katarina Holm
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Anita McAllister
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Malatesta Haug G, Pérez Herrera D. Inteligibilidad: diferentes perspectivas de su concepto y evaluación. Una revisión sistemática. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2021. [DOI: 10.5209/rlog.72515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Una adecuada inteligibilidad es un indicador del éxito en la comunicación. Su interferencia, a causa de cualquier patología, debe ser abordada en los objetivos primordiales de la terapia. No obstante, los métodos para su evaluación son poco conocidos. Objetivo: desarrollar una revisión sistemática que describa los métodos empleados en la medición de la inteligibilidad y discutir la conceptualización de este constructo. Metodología: se realiza una búsqueda en las bases de datos PubMed, ScieLo y Science Direct para identificar artículos publicados entre 1990 y 2018. Análisis y discusiones: Se seleccionan 50 investigaciones en inglés, español y portugués, que mostraron preferencia por medidas objetivas de evaluación, por sobre las medidas subjetivas de escala. La inteligibilidad se define mejor como un constructo dependiente de la señal acústica, a diferencia del concepto de comprensibilidad. Esta revisión ofrece información actualizada y organizada para optimizar procedimientos clínicos y científicos de medición de la inteligibilidad.
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Eadie TL, Durr H, Sauder C, Nagle K, Kapsner-Smith M, Spencer KA. Effect of Noise on Speech Intelligibility and Perceived Listening Effort in Head and Neck Cancer. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1329-1342. [PMID: 33630664 PMCID: PMC8702834 DOI: 10.1044/2020_ajslp-20-00149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/13/2020] [Accepted: 09/22/2020] [Indexed: 05/19/2023]
Abstract
Purpose This study (a) examined the effect of different levels of background noise on speech intelligibility and perceived listening effort in speakers with impaired and intact speech following treatment for head and neck cancer (HNC) and (b) determined the relative contribution of speech intelligibility, speaker group, and background noise to a measure of perceived listening effort. Method Ten speakers diagnosed with nasal, oral, or oropharyngeal HNC provided audio recordings of six sentences from the Sentence Intelligibility Test. All speakers were 100% intelligible in quiet: Five speakers with HNC exhibited mild speech imprecisions (speech impairment group), and five speakers with HNC demonstrated intact speech (HNC control group). Speech recordings were presented to 30 inexperienced listeners, who transcribed the sentences and rated perceived listening effort in quiet and two levels (+7 and +5 dB SNR) of background noise. Results Significant Group × Noise interactions were found for speech intelligibility and perceived listening effort. While no differences in speech intelligibility were found between the speaker groups in quiet, the results showed that, as the signal-to-noise ratio decreased, speakers with intact speech (HNC control) performed significantly better (greater intelligibility, less perceived listening effort) than those with speech imprecisions in the two noise conditions. Perceived listening effort was also shown to be associated with decreased speech intelligibility, imprecise speech, and increased background noise. Conclusions Speakers with HNC who are 100% intelligible in quiet but who exhibit some degree of imprecise speech are particularly vulnerable to the effects of increased background noise in comparison to those with intact speech. Results have implications for speech evaluations, counseling, and rehabilitation.
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Affiliation(s)
- Tanya L. Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Holly Durr
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Cara Sauder
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kathleen Nagle
- Department of Speech-Language Pathology, Seton Hall University, South Orange, NJ
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie A. Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
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Natzke P, Sakash A, Mahr T, Hustad KC. Measuring Speech Production Development in Children With Cerebral Palsy Between 6 and 8 Years of Age: Relationships Among Measures. Lang Speech Hear Serv Sch 2020; 51:882-896. [PMID: 32574125 DOI: 10.1044/2020_lshss-19-00102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Accurate measurement of speech intelligibility is essential for children with speech production deficits, but wide variability exists in the measures and protocols used. The current study sought to examine relationships among measures of speech intelligibility and the capacity of different measures to capture change over time. Method Forty-five children with cerebral palsy (CP) with and without speech motor impairment were observed at ages 6, 7, and 8 years. The speech performance of each child was rated using four measures at each time point: standardized articulation test scores, multiword intelligibility scores obtained from naïve listeners, parent ratings of intelligibility, and percent intelligible utterances obtained from language transcripts. We analyzed the correlations of measures within each age and within three different severity groups, and we analyzed how these measures changed year over year in each severity group. Results For children with CP who have mild and moderate speech deficits, different measures of speech production were weakly associated, and for children with CP with severe speech impairment, these measures showed stronger associations. The four measures also differed in their ability to capture change over time. Finally, results from standardized assessments of articulation were not found to inform overall speech intelligibility for children with mild and moderate speech deficits. Conclusions Results suggest that speech production is not fully described by any single clinical measure. In order to adequately describe functional speaking abilities and to capture change over time, multiple levels of measurement are required.
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Affiliation(s)
- Phoebe Natzke
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison
| | - Ashley Sakash
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison
| | - Tristan Mahr
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison
| | - Katherine C Hustad
- Department of Communication Sciences & Disorders, University of Wisconsin-Madison.,Waisman Center, University of Wisconsin-Madison
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Chiu YF, Neel A. Predicting Intelligibility Deficits in Parkinson's Disease With Perceptual Speech Ratings. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:433-443. [PMID: 32097080 DOI: 10.1044/2019_jslhr-19-00134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose This study investigated whether perceptual ratings of speech parameters were predictive of transcription intelligibility in quiet and in noise for speakers with Parkinson's disease (PD). Method Ten speakers with PD and five healthy controls read 56 sentences. One group of 60 listeners orthographically transcribed the sentences in quiet, and another group of 60 listeners transcribed in noise. An additional 23 listeners judged a variety of speech parameters, including articulation, prosody, resonance, voice quality, and ease of understanding on a visual analog scale. Scores of the visual analog scale ratings were regressed against transcription intelligibility in quiet and in noise. Results Perceptual ratings of all the speech parameters were lower for speakers with PD. Global speech understanding, indexed by ease of understanding ratings, was associated with transcription intelligibility in quiet and in noise with a stronger effect in noise. Among the rated speech parameters, ease of understanding and voice quality ratings were significant predictors of speech intelligibility in noise. Conclusions Speech in individuals with PD was more difficult for listeners to understand and was characterized by deficits in articulation, prosody, resonance, and voice quality compared to normal speech produced by healthy older adults. Ease of understanding ratings, even when performed in quiet, predicted intelligibility in noise. Poor voice quality ratings in PD, a sign of phonatory deficit, had a negative impact on intelligibility in noise for speakers with PD.
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Affiliation(s)
- Yi-Fang Chiu
- Department of Communication Sciences and Disorders, Saint Louis University, MO
| | - Amy Neel
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque
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21
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Intelligibility and Listening Effort of Spanish Oesophageal Speech. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9163233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Communication is a huge challenge for oesophageal speakers, be it for interactions with fellow humans or with digital voice assistants. We aim to quantify these communication challenges (both human–human and human–machine interactions) by measuring intelligibility and Listening Effort (LE) of Oesophageal Speech (OS) in comparison to Healthy Laryngeal Speech (HS). We conducted two listening tests (one web-based, the other in laboratory settings) to collect these measurements. Participants performed a sentence recognition and LE rating task in each test. Intelligibility, calculated as Word Error Rate, showed significant correlation with self-reported LE ratings. Speaker type (healthy or oesophageal) had a major effect on intelligibility and effort. More LE was reported for OS compared to HS even when OS intelligibility was close to HS. Listeners familiar with OS reported less effort when listening to OS compared to nonfamiliar listeners. However, such advantage of familiarity was not observed for intelligibility. Automatic speech recognition scores were higher for OS compared to HS.
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van Haaften L, Diepeveen S, Terband H, Vermeij B, van den Engel-Hoek L, de Swart B, Maassen B. Profiling Speech Sound Disorders for Clinical Validation of the Computer Articulation Instrument. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:844-856. [PMID: 31306602 DOI: 10.1044/2018_ajslp-msc18-18-0112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The current article presents data from 2 studies on clinical groups of children referred for speech assessment. The aims of these studies are to validate the Computer Articulation Instrument (CAI) with the known-group validation method and to determine the differential diagnostic power of the resulting speech profiles. Method Study 1 examined known-group validity by comparing the scores of 93 children diagnosed with speech-language difficulties on the picture naming (PN) task of the CAI with intelligibility judgments given by speech-language pathologists. In Study 2, the speech profiles of 41 children diagnosed with speech sound disorders (SSDs), consisting of 4-6 factor scores extracted from the 4 tasks of the CAI, namely, PN, nonword imitation (NWI), word and nonword repetition, and maximum repetition rate (MRR), were validated against clinical judgments of severity of the SSD given by speech-language pathologists. Results In Study 1, a repeated-measures analysis of variance revealed a significant effect of intelligibility level on the PN performance of the CAI and there were highly significant correlations between intelligibility and PN performance in the expected direction. Neither intelligibility level nor PN performance was related to nonverbal intelligence and language scores. The analysis of variance and a series of t tests in Study 2 revealed significant differences between the moderate and severe groups for the CAI factors based on PN and NWI and the bisyllabic and trisyllabic sequences of MRR, but not for the factor word and nonword proportion of whole-word variability based on word and nonword repetition, and the monosyllabic sequences of MRR. These results suggest that, especially, the tasks PN, NWI, and the bisyllabic and trisyllabic sequences of MRR are most sensitive for diagnosing SSDs. Conclusions The findings of these 2 studies support the known-group validity of the CAI. Together with the results of a previous study of our group on reliability and validity ( van Haaften et al., 2019 ), we can conclude that the CAI is a reliable and valid tool for assessment of children with SSDs.
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Affiliation(s)
- Leenke van Haaften
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sanne Diepeveen
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Hayo Terband
- Utrecht Institute of Linguistics-OTS, Utrecht University, the Netherlands
| | - Bernadette Vermeij
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
| | - Lenie van den Engel-Hoek
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bert de Swart
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Ben Maassen
- Center for Language and Cognition, Groningen University, the Netherlands
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Crowe K, Marschark M, McLeod S. Measuring intelligibility in signed languages. CLINICAL LINGUISTICS & PHONETICS 2019; 33:991-1008. [PMID: 31017006 DOI: 10.1080/02699206.2019.1600169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/19/2019] [Accepted: 03/24/2019] [Indexed: 06/09/2023]
Abstract
Intelligibility of spoken languages is a widely discussed construct; however, intelligibility, as it pertains to signed languages, has rarely been considered. This study provides an initial investigation of the construct of intelligibility in American Sign Language (ASL) and evaluates potential measures for self-report and expert ratings of sign intelligibility that examined the frequency of understanding, amount of understanding, and ease of understanding. Participants were 66 college students (42 Deaf, 24 hearing) who had self-rated ASL skills ranging from poor to excellent. Participants rated their own intelligibility in ASL and then provided a signed language sample through a picture description task. Language samples were reviewed by an expert rater and measures of intelligibility were completed. Results indicated that expert ratings of sign intelligibility across all measures were significantly and positively correlated. Understanding of the signer was predicted by the amount of understanding, frequency of understanding, and ASL production skills, while understanding the picture being described was predicted by ease of understanding and ASL grammar skills. Self- and expert ratings of sign intelligibility using the ASL version of the Intelligibility in Context Scale were not significantly different. Self-report of sign intelligibility for viewers of different familiarity using the ICS-ASL was found not to be feasible due to many participants not being in contact with ASL users in the relationships defined by the measure. In conclusion, this preliminary investigation suggests that sign intelligibility is a construct worthy of further investigation.
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Affiliation(s)
- Kathryn Crowe
- National Technical Institute for the Deaf, Rochester Institute of Technology , Rochester , USA
- School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Marc Marschark
- National Technical Institute for the Deaf, Rochester Institute of Technology , Rochester , USA
- Department of Psychology, University of Aberdeen , Aberdeen , Scotland, UK
| | - Sharynne McLeod
- School of Teacher Education, Charles Sturt University , Bathurst , Australia
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Keshet J. Automatic speech recognition: A primer for speech-language pathology researchers. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:599-609. [PMID: 31274357 DOI: 10.1080/17549507.2018.1510033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/03/2018] [Accepted: 07/28/2018] [Indexed: 06/09/2023]
Abstract
Automatic speech recognition (ASR) is increasingly becoming an integral component of our daily lives. This trend is in large part due to recent advances in machine learning, and specifically in deep learning, that have led to accurate ASR across numerous tasks. This has led to renewed interest in providing technological support to populations whose speech patterns are atypical, including identifying the presence of a specific pathology and its severity, comparing speech characteristics before and after a surgery and enhancing the quality of life of individuals with speech pathologies. The purpose of this primer is to bring readers with relatively little technical background up to speed on fundamentals and recent advances in ASR. It presents a detailed account of the anatomy of modern ASR, with examples of how it has been used in speech-language pathology research.
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Affiliation(s)
- Joseph Keshet
- a Department of Computer Science , Bar-Ilan University , Ramat Gan , Israel
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Solomon NP, Makashay MJ, Helou LB, Clark HM. Neurogenic Orofacial Weakness and Speech in Adults With Dysarthria. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:951-960. [PMID: 28763804 PMCID: PMC5829797 DOI: 10.1044/2017_ajslp-16-0144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/07/2017] [Indexed: 05/16/2023]
Abstract
PURPOSE This study compared orofacial strength between adults with dysarthria and neurologically normal (NN) matched controls. In addition, orofacial muscle weakness was examined for potential relationships to speech impairments in adults with dysarthria. METHOD Matched groups of 55 adults with dysarthria and 55 NN adults generated maximum pressure (Pmax) against an air-filled bulb during lingual elevation, protrusion and lateralization, and buccodental and labial compressions. These orofacial strength measures were compared with speech intelligibility, perceptual ratings of speech, articulation rate, and fast syllable-repetition rate. RESULTS The dysarthria group demonstrated significantly lower orofacial strength than the NN group on all tasks. Lingual strength correlated moderately and buccal strength correlated weakly with most ratings of speech deficits. Speech intelligibility was not sensitive to dysarthria severity. Individuals with severely reduced anterior lingual elevation Pmax (< 18 kPa) had normal to profoundly impaired sentence intelligibility (99%-6%) and moderately to severely impaired speech (26%-94% articulatory imprecision; 33%-94% overall severity). CONCLUSIONS Results support the presence of orofacial muscle weakness in adults with dysarthrias of varying etiologies but reinforce tenuous links between orofacial strength and speech production disorders. By examining individual data, preliminary evidence emerges to suggest that speech, but not necessarily intelligibility, is likely to be impaired when lingual weakness is severe.
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Affiliation(s)
- Nancy Pearl Solomon
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Matthew J. Makashay
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Leah B. Helou
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Systems Neuroscience Institute, University of Pittsburgh, PA
| | - Heather M. Clark
- Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC
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Hustad KC, Oakes A, Allison K. Variability and Diagnostic Accuracy of Speech Intelligibility Scores in Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:1695-707. [PMID: 26381119 PMCID: PMC4987026 DOI: 10.1044/2015_jslhr-s-14-0365] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 08/17/2015] [Indexed: 05/15/2023]
Abstract
PURPOSE We examined variability of speech intelligibility scores and how well intelligibility scores predicted group membership among 5-year-old children with speech motor impairment (SMI) secondary to cerebral palsy and an age-matched group of typically developing (TD) children. METHOD Speech samples varying in length from 1-4 words were elicited from 24 children with cerebral palsy (mean age 60.50 months) and 20 TD children (mean age 60.33 months). Two hundred twenty adult listeners made orthographic transcriptions of speech samples (n = 5 per child). RESULTS Variability associated with listeners made a significant contribution to explaining the variance in intelligibility scores for TD and SMI children, but the magnitude was greater for TD children. Intelligibility scores differentiated very well between children who have SMI and TD children when intelligibility was at or below approximately 75% and above approximately 85%. CONCLUSIONS Intelligibility seems to be a useful clinical tool for differentiating between TD children and children with SMI at 5 years of age; however, there is considerable variability within and between listeners, highlighting the need for more than one listener per child to ensure validity of an intelligibility measure.
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Affiliation(s)
- Katherine C. Hustad
- University of Wisconsin–Madison
- Waisman Center, University of Wisconsin–Madison
| | | | - Kristen Allison
- University of Wisconsin–Madison
- Waisman Center, University of Wisconsin–Madison
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Morgan AT, Hodge M, Pennington L. Scientific forum topic: translating knowledge to practice in childhood dysarthria. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:335-336. [PMID: 25011398 DOI: 10.3109/17549507.2014.930176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Angela T Morgan
- Language and Literacy Group, Murdoch Childrens Research Institute , Melbourne, Victoria , Australia
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