Protocol for Sonospeech Cleft Pilot: A Pilot Randomised Control Trial of Ultrasound Visual Biofeedback Versus Standard Intervention for Children with Cleft Lip and Palate.

Background: Children with cleft lip and palate can continue to have problems producing clear speech after surgery. This can lead to social, emotional, and educational challenges. Typical treatment involves teaching children the correct tongue movements to produce speech sounds. This is known as articulation intervention. However, this intervention is challenging because the tongue is hidden from view and movements are difficult to see and describe. This pilot randomized control trial will try a new treatment, ultrasound visual biofeedback (U-VBF). Methods/Design: The Sonospeech project will enroll up to 40 children with cleft lip and palate aged 4;6 to 16 in a single-centre two-arm parallel group pilot randomized controlled trial with blinded assessors. Children will receive either six sessions of U-VBF or articulation intervention. The primary goals of this pilot are to determine recruitment/attrition rates; to measure pre-post follow up completion; and acceptability of the randomization and interventions to families.Discussion: Larger trials of speech interventions for children with cleft lip and palate are needed. This pilot/feasibility study will determine whether a larger randomized control trial comparing ultrasound and articulation interventions is feasible. Trial registration. ISRCTN, ISRCTN17441953. Registered 22 March 2021, http://isrctn.com/ISRCTN17441953. See Appendix 1 for all items.

Responses in left inferior frontal gyrus are altered for speech-in-noise processing, but not for clear speech in autism

People with an autism spectrum disorder (ASD) often have difficulties with recognising what another person is saying in noisy conditions such as in a crowded classroom or a restaurant. The underlying neural mechanisms of this speech perception difficulty are unclear. In typically developed individuals, three cerebral cortex regions are particularly related to speech-in-noise perception: The left inferior frontal gyrus (IFG), the right insula and the left inferior parietal lobule (IPL) (Alain et al., HBM, 2018). Here we tested whether responses in these cerebral cortex regions are altered in speech-in-noise perception in ASD. 17 adults with ASD and 17 typically developing controls (matched pairwise on age, sex and IQ) performed an auditory-only speech recognition task during functional magnetic resonance imaging (fMRI). Speech was presented either with noise (noise condition) or without noise (no noise condition, i.e., clear speech). In the left IFG, blood-oxygenation-level-dependent (BOLD) responses were higher in the control compared to the ASD group for recognising speech-in-noise in comparison to clear speech. In the right insula and left IPL both groups had similar response magnitudes for the contrast between speech-in-noise and clear speech recognition. Additionally, we replicated previous findings that BOLD responses in speech-related and auditory brain regions (including bilateral superior temporal sulcus and Heschl’s gyrus) for clear speech were similar in both groups. Our findings show that in ASD, the processing of speech is particularly reduced under noisy conditions in the left IFG. Dysfunction of the IFG might be important in explaining restricted speech comprehension in noisy environments in ASD.

The effect of hyperarticulation on speech comprehension under adverse listening conditions

Comprehension assesses a listener’s ability to construe the meaning of an acoustic signal in order to be able to answer questions about its contents, while intelligibility indicates the extent to which a listener can precisely retrieve the acoustic signal. Previous comprehension studies asking listeners for sentence-level information or narrative-level information used native listeners as participants. This is the first study to look at whether clear speech properties (e.g. expanded vowel space) produce a clear speech benefit at the word level for L2 learners for speech produced in naturalistic settings. This study explored whether hyperarticulated speech was more comprehensible than non-hyperarticulated speech for both L1 British English speakers and early and late L2 British English learners in quiet and in noise. Sixteen British English listeners, 16 native Mandarin Chinese listeners as early learners of L2 and 16 native Mandarin Chinese listeners as late learners of L2 rated hyperarticulated samples versus non-hyperarticulated samples in form of words for comprehension under four listening conditions of varying white noise level (quiet or SNR levels of + 16 dB, + 12 dB or + 8 dB) (3 × 2× 4 mixed design). Mean ratings showed all three groups found hyperarticulated speech samples easier to understand than non-hyperarticulated speech at all listening conditions. Results are discussed in terms of other findings (Uther et al., 2012) that suggest that hyperarticulation may generally improve speech processing for all language groups.

Acoustical Conformance with FGI for Tenant Improvements in Outpatient, Medical Office or Clinic Facility Sound Isolation/Privacy Design

Acoustical privacy and noise control design and implementation guidance is needed, regarding Facility Guidelines Institute (FGI) criteria for outpatient medical facilty tenant improvements (TI). TI in existing commercial buildings or medical office buildings may not have capital budgets or expected facility/lease life that hospitals enjoy. Full conformance to FGI criteria and guidelines may be limited; by economic feasibility and by constructability. Design professionals can use "good practice" space planning, demising assembly selection, and electronic sound masking to achieve appropriate acoustical privacy within reasonable capital expense budgets. Consider FGI criteria for demising partition, ceiling, door and window selections plus infrastructure equipment and material selections that can provide cost-effective lightweight, common construction standards. The objectives are to protect the privacy of patient information and provide quiet spaces, free of transient disturbance for clear speech communications. Continuous ambient sound increases speech privacy including speech transmitted from enclosed quiet spaces. Criteria for acoustics, speech privacy,continuous noise and masking exists in FGI. Temporal level changes (on/off, transients) and tonality (spectrum smoothness or balance) should be considered in basis-of-design (BoD). This paper will present design guidelines for selecting demising assemblies and supplemental sound masking for outpatient clinical spaces in commercial or medical office buildings.

The Effect of Clear Speech on Cantonese Alaryngeal Speakers’ Intelligibility

<b><i>Background/Aim:</i></b> The purpose of this study was to provide preliminary data concerning the effect of clear speech (CS) on Cantonese alaryngeal speakers’ intelligibility. <b><i>Methods:</i></b> Voice recordings of 11 sentences randomly selected from the Cantonese Sentence Intelligibility Test (CSIT) were obtained from 31 alaryngeal speakers (9 electrolarynx [EL] users, 10 esophageal speakers and 12 tracheoesophageal [TE] speakers) in habitual speech (HS) and CS. Two naïve listeners orthographically transcribed a total of 1,364 sentences. <b><i>Results:</i></b> Significant effects of speaking condition on speaking rate and CSIT scores were observed, but no significant effect of alaryngeal communication methods was noted. CS was significantly slower than HS by 0.78 syllables/s. Esophageal speakers demonstrated the slowest speech rate when using CS, while EL users demonstrated the largest decrease in speaking rate when using CS compared to HS. TE speakers had the highest CSIT scores in HS (listener 1 = 81.4%; listener 2 = 81.3%), and esophageal speakers had the highest CSIT scores in CS (listener 1 = 87.5%; listener 2 = 89.7%). EL users experienced the largest increase in intelligibility while using CS compared to HS (9.1%) followed by esophageal speakers (8.9%) and TE speakers (1.4%). <b><i>Conclusion:</i></b> Preliminary data indicate that CS may significantly affect Cantonese alaryngeal speakers’ speaking rate and intelligibility. However, intelligibility appeared to vary considerably across speakers. Further research involving larger, heterogeneous groups of speakers and listeners alongside longer and more refined CS training protocols should be conducted to confirm that CS can improve Cantonese alaryngeal speakers’ intelligibility.