How do I sound to me? Perceived changes in communication in Parkinson's disease

Abstract

Objective: To examine self and carer perceived changes in communication associated with Parkinson's disease and relate these to speech intelligibility, gender, age and other disease measures. Design: Cross-sectional survey of a hospital- and community-based sample of 176 people with Parkinson's disease and their carers using a questionnaire based on semantic differential techniques. Participants: One hundred and four people with Parkinson's disease with no history of communication difficulties prior to onset of their Parkinson's disease and 45 primary carers who returned completed questionnaires. Main outcome measures: Differences in ratings for `before' the onset of Parkinson's disease versus present status. Results: There was a strong perception of negative impact on communication between `before' and `now', irrespective of age and gender and largely independent of disease severity and duration, intelligibility and cognitive status. Activities of daily living (assessed by Unified Parkinson's Disease Rating Scale (UPDRS) II) and depression rating scale scores had the strongest association with change (adjusted R 2 0.27). There was a significant correlation between the rank order of perceived change in features examined in people with Parkinson's disease versus their carers, though in general carers rated change as having less impact. Conclusions: Parkinson's disease exercises a strong influence on communication even before apparent alterations to intelligibility or motor status (UPDRS).

Loudness perception and speech intensity control in Parkinson's disease

“…It is also necessary for the clinician to focus on the feelings of communication (Miller et al, 2008). An inability to effectively communicate with others can lead to social withdrawal and feelings of depression (Burns, 2002).…”

“…It has also been suggested that individuals with PD feel that the listener does not fully comprehend the struggle involved in trying to communicate and it has frequently been reported that the listener will talk over, speak on behalf of, or completely ignore the person with PD (Miller, Noble, Jones, Allcock, & Burn, 2008). Miller et al (2008) examined communication changes in PD and observed that individuals with PD perceived a significant decline in communication (i.e., speech and language) during the years following the initial diagnosis of the disease. This was determined through the use of a two-part semantic differential questionnaire that assessed the participants' perceptions of their communication abilities at present and prior to the PD diagnosis.…”

“…It is not uncommon for individuals with PD to experience frustration during conversation because of complaints from the listener that they are speaking too quietly Duffy, 2005). A study by Miller et al (2008) impacts their ability to perceive loudness aspects of their own speech. Lewis and Byblow (2002) suggest that individuals with PD could have sensori-perceptual deficits that are exhibited in the scaling of motor effort and output, as well as problems judging the amount of effort in self-produced sensory stimuli like speech (Dykstra, 2007).…”

Listener Perception of Monopitch, Naturalness, and Intelligibility for Speakers With Parkinson's Disease

“…Studies examining listener impressions of speech reveal that individuals with PD are often perceived to be significantly unhappy, cold, withdrawn, introverted, and bored compared with controls (Jaywant & Pell, 2010;Pitcairn, Clemie, Gray, & Pentland, 1990). Recent research also suggests that individuals with PD perceive a negative impact on their communication, which is accompanied by feelings of social isolation (Miller, Noble, Jones, Allcock, & Burn, 2008). It is highly likely that such self-perceived and/or listener-perceived changes could be related to naturalness of speech.…”

“…When communication deficits interfere with participation in life roles, negative consequences, such as loss of employment or difficulty pursuing services (for example, health care) may follow. Thus, reduced naturalness can cause loss of independence affecting individuals' participation at the society level and thus their quality of life (Miller et al, 2006(Miller et al, , 2008Pell et al, 2006).…”