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Purpose: Identifying efficacious measures to characterize dysphonia in complex neurodegenerative diseases is key to optimal assessment and intervention. This study evaluates the validity and sensitivity of acoustic features of phonatory disruption in amyotrophic lateral sclerosis (ALS). Method: Forty-nine individuals with ALS (40-79 years old) were audio-recorded while producing a sustained vowel and continuous speech. Perturbation/noisebased (jitter, shimmer, and harmonics-to-noise ratio) and cepstral/spectral (cepstral peak prominence, low-high spectral ratio, and related features) acoustic measures were extracted. The criterion validity of each measure was assessed using correlations with perceptual voice ratings provided by three speech-language pathologists. Diagnostic accuracy of the acoustic features was evaluated using area-under-the-curve analysis. Results: Perturbation/noise-based and cepstral/spectral features extracted from/a/were significantly correlated with listener ratings of roughness, breathiness, strain, and overall dysphonia. Fewer and smaller correlations between cepstral/spectral measures and perceptual ratings were observed for the continuous speech task, although post hoc analyses revealed stronger correlations in speakers with less perceptually impaired speech. Area-under-the-curve analyses revealed that multiple acoustic features, particularly from the sustained vowel task, adequately differentiated between individuals with ALS with and without perceptually dysphonic voices. Conclusions: Our findings support using both perturbation/noise-based and cepstral/spectral measures of sustained/a/to assess phonatory quality in ALS. Results from the continuous speech task suggest that multisubsystem involvement impacts cepstral/spectral analyses in complex motor speech disorders such as ALS. Further investigation of the validity and sensitivity of cepstral/spectral measures during continuous speech in ALS is warranted. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions. Method: Five male youths (ages 14–18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants’ experiences according to the phenomenological tradition that recognizes that participants are experts in their “lived experience.” Results: Participants described the youths’ day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help. Conclusions: Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders. [ABSTRACT FROM AUTHOR]

Purpose: Hypernasality and atypical voice characteristics are common features of dysarthric speech due to amyotrophic lateral sclerosis (ALS). Existing acoustic measures have been developed to primarily target either hypernasality or voice impairment, and the effects of co-occurring hypernasality-voice problems on these measures are unknown. This report explores (a) the extent to which acoustic measures are affected by concurrent perceptually identified hypernasality and voice impairment due to ALS and (b) candidate acoustic measures of early indicators of hypernasality and voice impairment in the presence of multisystem involvement in individuals with ALS. Method: Two expert listeners rated severity of hypernasality and voice impairment in sentences produced by individuals with ALS (n = 27). The samples were stratified based on perceptual ratings: voice/hypernasality asymptomatic, predominantly hypernasal, predominantly voice impairment, and mixed (co-occurring hypernasality and voice impairment). Groups were compared using established acoustic measures of hypernasality (one-third octave analysis) and voice (cepstral/spectral analysis) impairment. Results: The one-third octave analysis differentiated all groups; the cepstral peak prominence differentiated all groups except asymptomatic versus mixed, whereas the low-to-high spectral ratio did not differ among groups. Additionally, one-third octave analyses demonstrated promising speech diagnostic potential. Conclusions: The results highlight the need to consider the validity of measures in the context of multisubsystem involvement. Our preliminary findings further suggest that the one-third octave analysis may be an optimal approach to quantify hypernasality and voice abnormalities in the presence of multisystem speech impairment. Future evaluation of the diagnostic accuracy of the onethird octave analysis is warranted. [ABSTRACT FROM AUTHOR]

To explore the influence of listener profession on impressions of speakers with dysarthria with varying intelligibility using semantic differential scales. Method: Three listener groups (undergraduate students, emergency workers, speech–language pathologists (SLPs); n = 38) rated non-speech attributes of six adults with dysarthria that ranged from low to high speech intelligibility. Participants rated 22 bipolar adjective pairs and listening effort on visual analogue scales. Following factor analysis of the semantic differential scales, listener impression and effort ratings were compared across listening groups and speaker intelligibility. Repeated measures ANOVA revealed that neither impressions nor effort ratings differed across listener groups. However, impressions significantly decreased and listening effort significantly increased with reduced intelligibility. Analysis of the semantic differential scale items revealed two factors (Capability, Personality) that predicted 52% of the variance. Listener impressions were significantly higher for Personality than Capability. Conclusion: Preliminary findings suggest that speakers with dysarthria with reduced intelligibility are at risk to be negatively judged, particularly on their physical and mental capability. This study demonstrates the promise of employing semantic differential scales to investigate listener impressions and therefore the daily communication experiences of speakers with dysarthria. SLPs should consider patient experience of negative impressions when designing treatment. [ABSTRACT FROM AUTHOR]

Although tongue twisters have been widely use to study speech production in healthy speakers, few studies have employed this methodology for individuals with speech impairment. The present study compared tongue twister errors produced by adults with dysarthria and age-matched healthy controls. Eight speakers (four female, four male; mean age = 54.5 years) with spastic (mixed-spastic) dysarthria of varying aetiology (cerebral palsy, multiple sclerosis, multiple system atrophy) and eight controls (four female, four male; mean age = 56.9 years) were audio-recorded producing tongue twisters. One word in each tongue twister was marked for prominence. Speakers with dysarthria produced significantly more errors and spoke slower than healthy controls. The effect of prominence was significant for both groups-words spoken with prosodic prominence were significantly less error prone compared with words without prominence. While both groups produced most errors on words in the third position (of four-word utterances), speakers with dysarthria also produced high rates of errors on the first and fourth words. This preliminary investigation demonstrated the promise of applying the tongue twister paradigm to speakers with dysarthria and contributes to the evidence base for the implementation of prosodic strategies in speech intervention. [ABSTRACT FROM AUTHOR]

Purpose: To compare vowel acoustics and intelligibility in words produced with and without contrastive stress by speakers with spastic (mixed-spastic) dysarthria secondary to cerebral palsy (DYSCP) and healthy controls (HCs). Method: Fifteen participants (9 men, 6 women; age M = 42 years) with DYSCP and 15 HCs (9 men, 6 women; age M = 36 years) produced sentences containing target words with and without contrastive stress. Forty-five healthy listeners (age M = 25 years) completed a vowel identification task of DYSCP productions. Vowel acoustics were compared across stress conditions and groups using 1st (F1) and 2nd (F2) formant measures. Perceptual intelligibility was compared across stress conditions and dysarthria severity. Results: F1 and F2 significantly increased in stressed words for both groups, although the degree of change differed. Mean Euclidian distance between vowels also increased with stress. The relative probability of vowels falling within the target F1 x F2 space was greater for HCs but did not differ with stress. Stress production resulted in greater listener vowel identification accuracy for speakers with mild dysarthria. Conclusions: Contrastive stress affected vowel formants for both groups. Perceptual results suggest that some speakers with dysarthria may benefit from a contrastive stress strategy to improve vowel intelligibility. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a picture description task for eliciting connected speech from children with motor speech disorders. The Park Play scene is a child-friendly picture description task aimed at augmenting current assessment protocols for childhood motor speech disorders. The design process included a literature review to: (1) establish optimal design features for child assessment, (2) identify a set of evidence-based speech targets specifically tailored to tax the motor speech system, and (3) enhance current assessment tools. To establish proof of concept, five children (ages 4;3-11;1) with dysarthria or childhood apraxia of speech were audio-recorded while describing the Park Play scene. Feedback from the feasibility test informed iterative design modifications. Descriptive, segmental, and prosodic analyses revealed the task was effective in eliciting desired targets in a connected speech sample, thereby yielding additional information beyond the syllables, words, and sentences generally elicited through imitation during the traditional motor speech examination. Further discussion includes approaches to adapt the task for a variety of clinical needs. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the authors compared indirect estimates of jaw-muscle tension in children with suspected muscle-tone abnormalities with age- and gender-matched controls. Method: Jaw movement and muscle activation were measured in children (ages 3 years, 11 months, to 10 years) with suspected muscle-tone abnormalities (Down syndrome or spastic cerebral palsy; n = 10) and controls (n = 11). Two measures were used to infer jaw tension: a kinematic index of mass-normalized stiffness and electromechanical delay (EMD). The kinematic index used video-based kinematics to obtain the slope of the peak velocity displacement relationship. The EMD was derived from the interval between the onset of suprahyoid muscle activity and the onset of jaw depression. Results: Neither measure differentiated the groups. The kinematic index revealed differences between stressed and unstressed syllables in 3-syllable productions by the participants with cerebral palsy and controls, but not in 2-syllable productions by the participants with Down syndrome and controls. Conclusion: This preliminary investigation included the novel application of 2 measures to infer the jaw-muscle tension of children with suspected tone abnormalities. Although the results do not support the hypothesis that suspected muscle-tone abnormalities affect jaw movement sufficiently to influence speech production, considerations for interpreting the findings include methodological limitations and possible compensatory muscle coactivation. [ABSTRACT FROM AUTHOR]