Effects of Familiarization on Intelligibility of Dysarthric Speech in Older Adults With and Without Hearing Loss

Purpose The aim of this study was to investigate the characteristics of electrolaryngeal (EL) speech among untrained speakers to aid in its effective introduction and to identify syllables and words that are easy or difficult to pronounce. Method A total of 21 healthy individuals who had never used an EL were included. The participants were briefed, and tests comprising 100 Japanese syllables and 50 single words were conducted to evaluate EL speech intelligibility. A trained speaker was defined as a certified speech-language pathologist who underwent EL training for 3 months. A 5-point electrolarynx effectivity score (EES) was used for the subjective assessment of EL. Results The median (interquartile range) intelligibility scores of the untrained and trained groups were 24.0% (20.0%–34.0%) and 40.0% (36.0%–45.0%) for syllables and 48.0% (38.0%–60.0%) and 88.0% (82.0%–90.0%) for words, respectively. The intelligibility scores for syllables and words were higher in the trained group than those in the untrained group. Only two syllable subgroups (/m/ and /w/) had > 80% correct answers among untrained speakers. A total of 14 syllable subgroups (/k, kʲ, s, ɕ, t, t͡ɕ, ts, ɲ, h, ç, ɸ, p, pʲ, and a/), a number of which contained voiceless consonants, had < 40% correct answers among both speaker groups. A greater number of morae were associated with higher intelligibility scores. An EES of 4, indicating that the EL was effective, was the most frequent score. Conclusions It was difficult for untrained speakers to produce intelligible speech using an EL. Syllables, including voiceless consonants, were difficult to pronounce using an EL. Longer words with a greater number of morae were more intelligible, even for untrained EL speakers. Supplemental Material https://doi.org/10.23641/asha.16632622

Section: Discussionmentioning

confidence: 99%

Characteristics of Japanese Electrolaryngeal Speech Produced by Untrained Speakers: An Observational Study Involving Healthy Volunteers

Sato

Genda

Minabe

et al. 2021

“…This work has collectively enabled us to reach the following overarching conclusion: Familiarization with dysarthric speech facilitates improvements in a listener's ability to understand the neurologically degraded acoustic signal. To date, the line of investigation following the 2012 review article has chiefly targeted theory; however, robust intelligibility (percent words correct) improvements across the studies, sometimes up to 20%, have been observed (Borrie et al, 2017a(Borrie et al, , 2017bBorrie, McAuliffe, Liss, Kirk, et al, 2012;Lansford et al, 2018). Intelligibility improvements of 5%-12% are considered a guideline for clinically significant change in dysarthria management (Stipancic et al, 2016(Stipancic et al, , 2018Van Nuffelen et al, 2010).…”

Section: Perceptual Learning Of Dysarthric Speechmentioning

confidence: 99%

A Perceptual Learning Approach for Dysarthria Remediation: An Updated Review

Borrie

Lansford

2021

Self Cite

Purpose Early studies of perceptual learning of dysarthric speech, those summarized in Borrie, McAuliffe, and Liss (2012), yielded preliminary evidence that listeners could learn to better understand the speech of a person with dysarthria, revealing a potentially promising avenue for future intelligibility interventions. Since then, a programmatic body of research grounded in models of perceptual processing has unfolded. The current review provides an updated account of the state of the evidence in this area and offers direction for moving this work toward clinical implementation. Method The studies that have investigated perceptual learning of dysarthric speech ( N = 24) are summarized and synthesized first according to the proposed learning source and then by highlighting the parameters that appear to mediate learning, culminating with additional learning outcomes. Results The recent literature has established strong empirical evidence of intelligibility improvements following familiarization with dysarthric speech and a theoretical account of the mechanisms that facilitate improved processing of the neurologically degraded acoustic signal. Conclusions There are no existing intelligibility interventions for individuals with dysarthria who cannot behaviorally modify their speech. However, there is now robust support for the development of an approach that shifts the weight of behavioral change from speaker to listener, exploiting perceptual learning to ease the intelligibility burden of dysarthria. To move this work from bench to bedside, recommendations for translational studies that establish best practices and candidacy for listener-targeted dysarthria remediation, perceptual training, are provided.

“…Next, pretest and posttest transcription accuracy scores for each talker were compared to determine if the familiarization experience leads to statistically and clinically Figure 1. Key conclusions from published studies, illustrating significant intelligibility improvements from pretest to posttest for ataxic (Borrie et al, 2017a(Borrie et al, , 2017bLansford et al, 2018), spastic (Borrie & Schäfer, 2015), and hypokinetic dysarthria (Borrie et al, 2018), but not for hyperkinetic dysarthria (Borrie et al, 2018).…”

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confidence: 95%

“…In response to this critical gap in clinical practice, an alternative approach to intervention, one that targets reduced intelligibility by focusing on the listener rather than the speaker, has been advanced (Liss, 2007). Listener-targeted perceptual training paradigms in which listeners are familiarized with dysarthric speech show promise for improving intelligibility and enhancing communication in dysarthria, without requiring speaker change (e.g., Borrie, McAuliffe, & Liss, 2012;Lansford, Luhrsen, Ingvalson, & Borrie, 2018;Liss, Spitzer, Caviness, & Adler, 2002).…”

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confidence: 99%

“…Currently, there exists a solid body of evidence suggesting that listener-targeted perceptual training paradigms may be a viable clinical approach for reducing the intelligibility burden associated with dysarthria. Statistically and clinically significant gains to intelligibility, ranging from 8 to 20 percentage point increase in intelligibility from pretest to posttest, have been demonstrated for hypokinetic, ataxic, and spastic dysarthria (Borrie, Lansford, & Barrett, 2017a, 2017bBorrie & Schäfer, 2015;Lansford et al, 2018). Notably, these dysarthria subtypes are characterized by rhythmic and phonemic degradations that are largely consistent/stable (e.g., slow rate, equal and even stress, reduced stress, monotone, monoloudness, harsh or breathy vocal quality, imprecise articulation, and reduced vowels).…”

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confidence: 99%

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Regularity Matters: Unpredictable Speech Degradation Inhibits Adaptation to Dysarthric Speech

Lansford

Borrie

Barrett

2019

Self Cite

Purpose Listener-targeted perceptual training paradigms, which leverage the mechanism of perceptual learning, show strong promise for improving intelligibility in dysarthria, offsetting the communicative burden from the speaker onto the listener. Theoretical models of perceptual learning underscore the importance of acoustic regularity (i.e., signal predictability) for listener adaptation to degraded speech. The purpose of the current investigation was to evaluate intelligibility outcomes following perceptual training with hyperkinetic dysarthria, a subtype characterized by reduced signal predictability. Method Forty listeners completed the standard 3-phase perceptual training protocol (pretest, training, and posttest) with 1 of 2 talkers with hyperkinetic dysarthria. Perceptual data were compared to a historical data set for 1 other talker with hyperkinetic dysarthria to examine the effect of perceptual training on intelligibility. Results When controlling for pretest intelligibility, regression results suggest listeners of the 2 novel talkers with hyperkinetic dysarthria performed comparably to the listeners of the original talker on the posttest following training. Furthermore, differences between pretest and posttest intelligibility failed to reach clinical significance for all 3 talkers and statistical significance for 2 of the 3. Conclusion The current findings are consistent with theoretical models of perceptual learning and suggest that listener adaptation to degraded speech may be negligible for talkers with dysarthria whose speech is marked by reduced signal predictability.