Filled Pauses as a Special Case of Automatic Speech Behaviors and the Effect of Parkinson's Disease

Abstract

Purpose In Parkinson's disease (PD), there are significant changes in the basal ganglia, a structure known to be important for controlling automatic responses to cues. Changes to the basal ganglia in PD impair an individual's ability to trigger a behavior in response to cues, but more so in response to internal cue s more than external ones. Filled pauses are considered a subconscious or automatic speech response to an internal cue that there are difficulties with ongoing communication. Typical speakers use filled pauses (such as uh or um ) to mark silent pauses. The purpose of this study was to examine how automatic speech responses are impacted in PD by looking at filled and silent pausing behaviors, extending our understanding of the role of the basal ganglia in automatic behaviors. We hypothesized that individuals with PD would use fewer filled pauses and longer silent pauses. We also hypothesized that longer pauses would be more likely to be marked with filled pauses and that this relationship would be weaker in speakers with PD. Method Speech samples were collected via a story-retelling task from 15 individuals with PD and 18 age-matched controls. Duration and frequency of filled and silent pauses were measured using spectrographic analysis. Number and duration of marked silent pauses (those consecutive with 1 or more filled pauses) were measured. The t tests and analyses of variance were used to test our hypotheses. Results There was no significant difference in the number of silent pauses between groups, but the duration of silent pauses was significantly greater for individuals with PD. Despite this, individuals with PD produced significantly fewer filled pauses and fewer marked silent pauses. For both groups, longer silent pauses were more likely to be marked by filled pauses, but individuals with PD marked a smaller percentage of silent pauses at longer durations than controls. Conclusions Producing fewer marked silent pauses, coupled with longer silent pauses, reduces natural cues to discourse and puts people with PD at greater risk of sounding unnatural and losing their communicative turn. These results suggest that automatic responses regarding speech production difficulties are impaired by PD. This interpretation fits with nonspeech literature where automatic responses have been demonstrated to be impaired in PD.

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“…(Swain et al 2018). Temporal speech behaviors, such as speech rate and pauses, have been investigated in the detection of hesitation, confidence, anxiety (Corley and Stewart 2008) and even neurological disease (Alvar et al 2019). Understanding affect is crucial for developing alliance/empathy and achieving successful therapeutic interactions (Avdi and Evans 2020).…”

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“…The results indicated that the individuals with PD demonstrated a tendency toward slower production. Finally, studies conducted by Huber and Darling [ 21 ] and Alvar, Lee, and Huber [ 19 ] showed that the speaking rates between PD and TD individuals were similar. Huber and Darling [ 21 ] invited 14 individuals with PD and 14 age- and gender-matched TD controls to read a passage.…”

“…Results from the statistical analysis indicated that the two groups of participants produced similar numbers of syllables per second and the authors concluded that there was no difference in speaking rates between these two groups in reading. Alvar et al [ 19 ] measured the duration of utterances and the number of words produced by 15 individuals with PD and 18 age-matched TD controls in a story retelling task. The results demonstrated that the two groups produced similar utterance durations and numbers of words per story retell, indicating that the speaking rates of the two groups were similar.…”

“…In short, the findings pertaining to the speaking rates of individuals with PD were conflicting. Although many studies have reported that the speaking rates between PD and TD individuals were similar [ 19 , 21 ], some studies showed that individuals with PD spoke slower [ 22 ] and with higher speaking rate variability [ 23 ]. As it will be discussed later in the section, the differences in the severity levels of individuals with PD among different studies might be one potential cause for the inconsistencies found in different studies.…”

“…Some studies found that when the task was reading a passage, the PD and TD individuals produced similar numbers of filled pauses [ 21 ]. On the other hand, when the participants were invited to speak spontaneously, the individuals with PD generally produced a higher number of filled pauses than did their TD counterparts [ 19 , 21 ]. Conversely, the unfilled pause patterns from individuals with PD reported in the literature were less consistent.…”