Cognitive–Perceptual Examination of Remediation Approaches to Hypokinetic Dysarthria

Abstract

Increased loudness and reduced rate exhibited differential effects on listeners' perceptual processing of dysarthric speech. The current study highlights the insights that may be gained from a cognitive-perceptual approach.

Effect of Dysarthria Type, Speaking Condition, and Listener Age on Speech Intelligibility

“…Speaker participants attended a single recording session, with digital recordings and signal calibration undertaken using our standard laboratory procedures, full details of which are provided in McAuliffe et al (2014). During the assessment, speakers were recorded reading the Grandfather Passage and a list of 80 experimental phrases.…”

“…Example phrases include "push her equal culture" (trochaic) and "address her meeting time" (iambic). Further details regarding composition, and a full list of phrases, are provided in McAuliffe et al (2014).…”

“…For speakers involved in the same study but with a diagnosis of multiple sclerosis, neither cue resulted in significant changes to intelligibility at group level. Similarly, McAuliffe, Kerr, Gibson, Anderson, and LaShell (2014), with speech samples provided by a group of five speakers with hypokinetic dysarthria, reported that both slow and loud cues resulted in improved intelligibility-although in contrast to Tjaden and Wilding (2004), intelligibility was optimized through the use of a slow speech cue.…”

“…However, whether this approach is optimal relative to a slow speaking cue for those with hypokinetic dysarthria is debatable-and likely dependent on the individual speaker. For example, the cue to speak slowly was recently shown to result in greater intelligibility gains than a cue to speak louder in individuals with hypokinetic dysarthria who exhibited a faster speaking rate (McAuliffe et al, 2014). Thus, although the weight of clinical evidence suggests that a loud speech cue will result in the largest intelligibility gain for those with hypokinetic dysarthria, this remains to be determined.…”

<p>Parkinson’s disease-associated dysarthria: prevalence, impact and management strategies</p>

“…42 A slower-than-normal speaking rate has been hypothesized to increase the precision of consonantal articulation, phoneme duration and vowel working space, as well as to reduce lexical boundary errors, contributing to the reduction of phonemic and lexical ambiguity experienced by listeners. 43 Nonetheless, cueing for slow speech appears to be a less effective strategy for increasing intelligibility in dysarthria than is cueing for loud speech, likely because slowing speech rate limits dynamic formant frequency changes, 44 negatively impacting speech naturalness and, therefore, intelligibility. Not surprisingly, Tjaden and Wilding reported greater intelligibility ratings for speech in their loud condition than in their slow or habitual condition.…”