scholarly journals Shorter Sentence Length Maximizes Intelligibility and Speech Motor Performance in Persons With Dysarthria Due to Amyotrophic Lateral Sclerosis

2019 ◽  
Vol 28 (1) ◽  
pp. 96-107 ◽  
Author(s):  
Kristen M. Allison ◽  
Yana Yunusova ◽  
Jordan R. Green

Purpose The purpose of this study was to investigate the effect of sentence length on intelligibility and measures of speech motor performance in persons with amyotrophic lateral sclerosis (ALS) and to determine how these effects were influenced by dysarthria severity levels. Method One hundred thirty-one persons with ALS were included in this study, stratified into 4 dysarthria severity groups. All participants produced sentences from 5 to 15 words in length. Intelligibility, speaking rate, and measures of speech pausing behavior (i.e., total speech duration, total pause duration, and mean speech event duration) were measured for each sentence. Linear mixed-effects models were used to determine the effect of sentence length on speech measures for speakers at different dysarthria severity levels. Results Results showed that speech intelligibility significantly declined at longer sentence lengths only for the speakers with ALS who had more advanced dysarthria symptoms; however, speakers with mild-to-severe dysarthria showed significant declines in speaking rate and speech pausing behavior at longer sentence lengths. Conclusions Findings suggest that producing shorter sentences may help maximize intelligibility for speakers with moderate-to-severe dysarthria secondary to ALS and may be a beneficial compensatory strategy for preserving motor effort for all speakers with dysarthria secondary to ALS.

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Panying Rong ◽  
Yana Yunusova ◽  
Jun Wang ◽  
Jordan R. Green

Purpose. To develop a predictive model of speech loss in persons with amyotrophic lateral sclerosis (ALS) based on measures of respiratory, phonatory, articulatory, and resonatory functions that were selected using a data-mining approach.Method. Physiologic speech subsystem (respiratory, phonatory, articulatory, and resonatory) functions were evaluated longitudinally in 66 individuals with ALS using multiple instrumentation approaches including acoustic, aerodynamic, nasometeric, and kinematic. The instrumental measures of the subsystem functions were subjected to a principal component analysis and linear mixed effects models to derive a set of comprehensive predictors of bulbar dysfunction. These subsystem predictors were subjected to a Kaplan-Meier analysis to estimate the time until speech loss.Results. For a majority of participants, speech subsystem decline was detectible prior to declines in speech intelligibility and speaking rate. Among all subsystems, the articulatory and phonatory predictors were most responsive to early bulbar deterioration; and the resonatory and respiratory predictors were as responsive to bulbar decline as was speaking rate.Conclusions. The articulatory and phonatory predictors are sensitive indicators of early bulbar decline due to ALS, which has implications for predicting disease onset and progression and clinical management of ALS.


2018 ◽  
Vol 27 (1) ◽  
pp. 258-269 ◽  
Author(s):  
Jimin Lee ◽  
Michael Bell ◽  
Zachary Simmons

Purpose The current study investigated whether articulatory kinematic patterns can be extrapolated across the spectrum of dysarthria severity in individuals with amyotrophic lateral sclerosis (ALS). Method Temporal and spatial articulatory kinematic data were collected using electromagnetic articulography from 14 individuals with dysarthria secondary to ALS and 6 typically aging speakers. Speech intelligibility and speaking rate were used as indices of severity. Results Temporal measures (duration, speed of articulators) were significantly correlated with both indices of severity. In speakers with dysarthria, spatial measures were not correlated with severity except in 3 measures: tongue movement displacement was more reduced in the anterior–posterior dimension; jaw movement distance was greater in the inferior–superior dimension; jaw convex hull area was larger in speakers with slower speaking rates. Visual inspection of movement trajectories revealed that overall spatial kinematic characteristics in speakers with severe dysarthria differed qualitatively from those in speakers with mild or moderate dysarthria. Unlike speakers with dysarthria, typically aging speakers displayed variable tongue movement and minimal jaw movement. Conclusions The current study revealed that spatial articulatory characteristics, unlike temporal characteristics, showed a complicated pattern across the severity spectrum. The findings suggest that articulatory characteristics in speakers with severe dysarthria cannot simply be extrapolated from those in speakers with mild-to-moderate dysarthria secondary to ALS.


1995 ◽  
Vol 38 (5) ◽  
pp. 1001-1013 ◽  
Author(s):  
Greg S. Turner ◽  
Kris Tjaden ◽  
Gary Weismer

The relationship between speaking rate, vowel space area, and speech intelligibility was studied in a group of 9 subjects with amyotrophic lateral sclerosis (ALS) and 9 age- and gender-matched controls. Subjects read a standard passage (the Farm Passage) at three speaking rates, including HABITUAL, FAST, and SLOW. Vowel segment durations and target formant frequencies were measured at each speaking rate from select words containing the vowels /i/, /æ/, /a/, and /u/. To quantify changes in vowel space area across speaking rate, the area of the vowel quadrilateral was calculated for each speaker at each speaking rate. In addition, intelligibility estimates at each speaking rate were obtained for the dysarthric speakers. Results revealed that dysarthric speakers exhibited smaller vowel space areas and less systematic changes in vowel space as a function of speaking rate, when compared to the neurologically intact speakers. In an examination of the relationship between vowel space area and speech intelligibility, vowel space was found to account for 45% of the variance in speech intelligibility. This result suggests that vowel space area is an important component of global estimates of speech intelligibility.


1993 ◽  
Vol 36 (6) ◽  
pp. 1134-1144 ◽  
Author(s):  
Greg S. Turner ◽  
Gary Weismer

The ability to alter speaking rate was studied in a group of 9 subjects with amyotrophic lateral sclerosis (ALS) and 9 age- and gender-matched, neurologically intact controls. Subjects were instructed to speak at three different rates (i.e., habitual, twice as fast as habitual, and one-half as fast as habitual). Speaking rate, articulation rate, and pause duration and frequency were calculated. The proportional increase in speaking rate was similar between the groups; however, the dysarthric speakers slowed rate to a smaller extent. Articulation rate and pause duration and frequency covaried with speaking rate in a similar manner for both groups. There was evidence that dysarthric speakers showed a greater dependence on pause duration and frequency, as compared to articulation rate, especially when increasing rate. In addition, although it was found that the slope of the function relating phrase duration to phrase length in syllables was statistically significant for both normal and dysarthric speakers, the slope of the function was significantly more shallow for the dysarthric speakers. Perceptual judgments of speaking rate indicated that dysarthric speakers spoke faster for a given physical speaking rate. Finally, results suggested that the function relating physical to perceived speaking rate grew more rapidly for dysarthric as compared to normal speakers. Discussion focuses on the importance of these findings to rate manipulation therapies and models of speaking rate in dysarthric speech.


2020 ◽  
Vol 63 (1) ◽  
pp. 59-73 ◽  
Author(s):  
Panying Rong

Purpose The purpose of this article was to validate a novel acoustic analysis of oral diadochokinesis (DDK) in assessing bulbar motor involvement in amyotrophic lateral sclerosis (ALS). Method An automated acoustic DDK analysis was developed, which filtered out the voice features and extracted the envelope of the acoustic waveform reflecting the temporal pattern of syllable repetitions during an oral DDK task (i.e., repetitions of /tɑ/ at the maximum rate on 1 breath). Cycle-to-cycle temporal variability (cTV) of envelope fluctuations and syllable repetition rate (sylRate) were derived from the envelope and validated against 2 kinematic measures, which are tongue movement jitter (movJitter) and alternating tongue movement rate (AMR) during the DDK task, in 16 individuals with bulbar ALS and 18 healthy controls. After the validation, cTV, sylRate, movJitter, and AMR, along with an established clinical speech measure, that is, speaking rate (SR), were compared in their ability to (a) differentiate individuals with ALS from healthy controls and (b) detect early-stage bulbar declines in ALS. Results cTV and sylRate were significantly correlated with movJitter and AMR, respectively, across individuals with ALS and healthy controls, confirming the validity of the acoustic DDK analysis in extracting the temporal DDK pattern. Among all the acoustic and kinematic DDK measures, cTV showed the highest diagnostic accuracy (i.e., 0.87) with 80% sensitivity and 94% specificity in differentiating individuals with ALS from healthy controls, which outperformed the SR measure. Moreover, cTV showed a large increase during the early disease stage, which preceded the decline of SR. Conclusions This study provided preliminary validation of a novel automated acoustic DDK analysis in extracting a useful measure, namely, cTV, for early detection of bulbar ALS. This analysis overcame a major barrier in the existing acoustic DDK analysis, which is continuous voicing between syllables that interferes with syllable structures. This approach has potential clinical applications as a novel bulbar assessment.


2018 ◽  
Vol 61 (9) ◽  
pp. 2205-2214 ◽  
Author(s):  
Mili Kuruvilla-Dugdale ◽  
Claire Custer ◽  
Lindsey Heidrick ◽  
Richard Barohn ◽  
Raghav Govindarajan

Purpose This study describes a phonetic complexity-based approach for speech intelligibility and articulatory precision testing using preliminary data from talkers with amyotrophic lateral sclerosis. Method Eight talkers with amyotrophic lateral sclerosis and 8 healthy controls produced a list of 16 low and high complexity words. Sixty-four listeners judged the samples for intelligibility, and 2 trained listeners completed phoneme-level analysis to determine articulatory precision. To estimate percent intelligibility, listeners orthographically transcribed each word, and the transcriptions were scored as being either accurate or inaccurate. Percent articulatory precision was calculated based on the experienced listeners' judgments of phoneme distortions, deletions, additions, and/or substitutions for each word. Articulation errors were weighted based on the perceived impact on intelligibility to determine word-level precision. Results Between-groups differences in word intelligibility and articulatory precision were significant at lower levels of phonetic complexity as dysarthria severity increased. Specifically, more severely impaired talkers showed significant reductions in word intelligibility and precision at both complexity levels, whereas those with milder speech impairments displayed intelligibility reductions only for more complex words. Articulatory precision was less sensitive to mild dysarthria compared to speech intelligibility for the proposed complexity-based approach. Conclusions Considering phonetic complexity for dysarthria tests could result in more sensitive assessments for detecting and monitoring dysarthria progression.


2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Yana Yunusova ◽  
Jamal Ansari ◽  
Joel Ramirez ◽  
Sanjana Shellikeri ◽  
Greg J. Stanisz ◽  
...  

The goal of this study was to identify neurostructural frontal lobe correlates of cognitive and speaking rate changes in amyotrophic lateral sclerosis (ALS). 17 patients diagnosed with ALS and 12 matched controls underwent clinical, bulbar, and neuropsychological assessment and structural neuroimaging. Neuropsychological testing was performed via a novel computerized frontal battery (ALS-CFB), based on a validated theoretical model of frontal lobe functions, and focused on testing energization, executive function, emotion processing, theory of mind, and behavioral inhibition via antisaccades. The measure of speaking rate represented bulbar motor changes. Neuroanatomical assessment was performed using volumetric analyses focused on frontal lobe regions, postcentral gyrus, and occipital lobes as controls. Partial least square regressions (PLS) were used to predict behavioral (cognitive and speech rate) outcomes using volumetric measures. The data supported the overall hypothesis that distinct behavioral changes in cognition and speaking rate in ALS were related to specific regional neurostructural brain changes. These changes did not support a notion of a general dysexecutive syndrome in ALS. The observed specificity of behavior-brain changes can begin to provide a framework for subtyping of ALS. The data also support a more integrative framework for clinical assessment of frontal lobe functioning in ALS, which requires both behavioral testing and neuroimaging.


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