Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.
Purpose: This study aimed to (a) relate temporal patterning of articulation to functional speech outcomes in neurologically healthy and impaired speakers, (b) identify changes in temporal patterning of articulation in neurologically impaired speakers, and (c) evaluate how these changes can be modulated by speaking rate manipulation. Method: Thirteen individuals with amyotrophic lateral sclerosis (ALS) and 10 neurologically healthy controls read a sentence 3 times, first at their habitual rate and then at a voluntarily slowed rate. Temporal patterning of articulation was assessed by 24 features characterizing the modulation patterns within (intra) and between (inter) four articulators (tongue tip, tongue body, lower lip, and jaw) at three linguistically relevant, hierarchically nested timescales corresponding to stress, syllable, and onset–rime/phoneme. For Aim 1, the features for the habitual rate condition were factorized and correlated with two functional speech outcomes—speech intelligibility and intelligible speaking rate. For Aims 2 and 3, the features were compared between groups and rate conditions, respectiely. Results: For Aim 1, the modulation features combined were moderately to strongly correlated with intelligibility ( R 2 = .51–.53) and intelligible speaking rate ( R 2 = .63–.73). For Aim 2, intra-articulator modulation was impaired in ALS, manifested by moderate-to-large decreases in modulation depth at all timescales and cross-timescale phase synchronization. Interarticulator modulation was relatively unaffected. For Aim 3, voluntary rate reduction improved several intra-articulator modulation features identified as being susceptible to the disease effect in individuals with ALS. Conclusions: Disrupted temporal patterning of articulation, presumably reflecting impaired articulatory entrainment to linguistic rhythms, may contribute to functional speech declines in ALS. These impairments tend to be improved through voluntary rate reduction, possibly by reshaping the temporal template of motor plans to better accommodate the disease-related neuromechanical constraints in the articulatory system. These findings shed light on a novel perspective toward global timing–based motor speech assessment and rehabilitation.
Purpose This study examined the articulatory control of speech and speechlike tasks in individuals with amyotrophic lateral sclerosis (ALS) and neurologically healthy individuals with the aim to identify the most useful set of articulatory features and tasks for assessing bulbar motor involvement in ALS. Method Tongue and jaw kinematics were recorded in 12 individuals with bulbar ALS and 10 healthy controls during a speech task and two speechlike tasks (i.e., alternating motion rate [AMR], sequential motion rate [SMR]). Eight articulatory features were derived for each participant per task, including the range, maximum speed, and acceleration time of tongue and jaw movements as well as the coupling and timing between tongue and jaw movements. The effects of task (i.e., AMR, SMR, speech) and group (i.e., ALS, control) on these articulatory features were evaluated. For each feature, the task that yielded the largest difference between the ALS and control groups was identified. The diagnostic efficacy of these task-specific features was assessed using the receiver operating characteristic analysis; the relation of these task-specific features to a well-established bulbar severity index—speaking rate—was determined using Spearman's rank correlation. Results Seven task-specific articulatory features were identified, including (a) tongue and jaw acceleration time during the AMR task, (b) tongue–jaw coupling during the SMR task, and (c) range of tongue movement, maximum tongue and jaw speed, and temporal lag between tongue and jaw movements during the speech task. Among these features, tongue and jaw acceleration time and their temporal lag showed relatively high accuracy (i.e., 0.83–0.95) in differentiating individuals with ALS from healthy controls. Range of tongue movement and maximum tongue and jaw speed showed significant correlations with speaking rate. Conclusion Findings provided preliminary evidence for the utility of task-specific articulatory measurements as a novel quantitative assessment to detect and predict bulbar motor involvement in ALS.
Background and Purpose The aim of the study was to compare transcription-based speech intelligibility and scaled speech severity for the detection of mild speech impairments, by studying these metrics across talkers with Parkinson's disease (PD), age- and sex-matched older adults, and younger adults. An additional aim was to determine the impact of listener experience on these clinical measures. Methods Fifteen speakers from each experimental group were asked to read aloud 11 randomly generated sentences from the Speech Intelligibility Test at their typical speaking rate and loudness. Two groups of four listeners each, stratified as experienced or inexperienced listeners based on their clinical experience, judged the sentence samples. To estimate intelligibility, both listener groups were asked to orthographically transcribe exactly what they heard for each sentence. For severity estimates, the listener groups were asked to rate the sentences for overall quality based on voice, resonance, articulation, and prosody, using a visual analog scale. Results Transcription-based intelligibility and scaled severity scores of the PD group differed significantly from those of the older and younger adults. Between-age group differences in intelligibility and scaled severity were not observed. Listener experience had an impact on scaled speech severity, but not speech intelligibility. Between-group differences in speech severity were driven by the inexperienced group and not the experienced listener group. Implications Both transcription-based intelligibility and scaled severity estimates appear to be sensitive to relatively mild speech impairments in PD. Obtaining scaled severity is less labor intensive than transcription; therefore, visual analog scaling may be the preferred paradigm for clinical use. However, listener experience and training are important considerations for scaling techniques to be implemented clinically.
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