Cognitive Predictors of Perception and Adaptation to Dysarthric Speech in Young Adult Listeners

Purpose: Although recruitment of cognitive-linguistic resources to support dysarthric speech perception and adaptation is presumed by theoretical accounts of effortful listening and supported by cross-disciplinary empirical findings, prospective relationships have received limited attention in the disordered speech literature. This study aimed to examine the predictive relationships between cognitive-linguistic parameters and intelligibility outcomes associated with familiarization with dysarthric speech in young adult listeners. Method: A cohort of 156 listener participants between the ages of 18 and 50 years completed a three-phase perceptual training protocol (pretest, training, and posttest) with one of three speakers with dysarthria. Additionally, listeners completed the National Institutes of Health Toolbox Cognition Battery to obtain measures of the following cognitive-linguistic constructs: working memory, inhibitory control of attention, cognitive flexibility, processing speed, and vocabulary knowledge. Results: Elastic net regression models revealed that select cognitive-linguistic measures and their two-way interactions predicted both initial intelligibility and intelligibility improvement of dysarthric speech. While some consistency across models was shown, unique constellations of select cognitive factors and their interactions predicted initial intelligibility and intelligibility improvement of the three different speakers with dysarthria. Conclusions: Current findings extend empirical support for theoretical models of speech perception in adverse listening conditions to dysarthric speech signals. Although predictive relationships were complex, vocabulary knowledge, working memory, and cognitive flexibility often emerged as important variables across the models.