Objective: The relations between acoustic measures and their articulatory bases have rarely been tested in dysarthria but are important for diagnostic and treatment purposes. We tested the association between acoustic measures of F2 range and F2 slope with kinematic measures of tongue movement displacement and speed in individuals with amyotrophic lateral sclerosis (ALS) and healthy controls speaking at normal and slow rates. Relations between acoustic and kinematic measures and speech intelligibility were examined. Results: As healthy controls reduced their speaking rate, their F2 slopes and movement speeds decreased. In talkers with ALS, acoustic and kinematic variables were associated with changes in speaking rate, characteristic of disease progression. Participants with slow rate had shallower F2 slopes and slower movement speeds than those with normal rate. Relations between F2 range and tongue displacement were weaker. F2 slope, displacement, and duration were correlated with speech intelligibility most consistently. Conclusion: Findings suggested that F2 slope is a useful marker for tracking disease progression in ALS. F2 slope reflects changes in tongue function with disease progression and is linked to speech intelligibility. Changes in movement speed, however, might be the earliest sign of disease in the tongue.

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Tongue Movements and TheirAcoustic Consequences in AmyotrophicLateral Sclerosis

Purpose The purpose of this study was to examine the effects of intensive speech treatment on the conversational intelligibility of Castilian Spanish speakers with Parkinson's disease (PD), as well...

/pdf/the-effects-of-intensive-speech-treatment-on-conversational-5eue9kadr4.pdf

The Effects of Intensive Speech Treatment on Conversational Intelligibility in Spanish Speakers With Parkinson's Disease

Birth characteristics and developmental milestones were evaluated as early predictors/correlates of communication in children with cerebral palsy. The hypothesis was that maternal report of child’s age for vocal play and first words would predict current functional communication. A case series of 215 children, 2 to 17 years (mean age = 8.2 years, SD = 3.9) with cerebral palsy was recruited from medical practices in 3 Michigan cities. Early developmental data were collected by maternal interview. The child’s Communication Function Classification System (CFCS) level was obtained from parent. Predictors of less functional communication included gestational age >32 weeks, number of comorbidities, age of first words after age 24 months, and use of communication methods other than speech. Several birth characteristics and developmental language milestones were predictive of later communication performance for children with cerebral palsy. These characteristics and milestones should trigger referrals for communi...

Early Predictors and Correlates of Communication Function in Children With Cerebral Palsy

Purpose The purpose of this longitudinal study was to examine the effect of time and sentence length on speech rate and its characteristics, articulation rate and pauses, within 2 groups of childre...

/pdf/characteristics-of-speech-rate-in-children-with-cerebral-3sn6fyzez7.pdf

Characteristics of Speech Rate in Children With Cerebral Palsy: A Longitudinal Study

Purpose Speech production deficits and reduced intelligibility are frequently noted in individuals with Down syndrome (DS) and are attributed to a combination of several factors. This study reports acoustic data on vowel production in young adults with DS and relates these findings to perceptual analysis of speech intelligibility. Method Participants were eight young adults with DS as well as eight age- and gender-matched typically developing (TD) controls. Several different acoustic measures of vowel centralization and variability were applied to tokens of corner vowels (/ɑ/, /ae/, /i/, /u/) produced in common English words. Intelligibility was assessed for single-word productions of speakers with DS, by means of transcriptions from 14 adult listeners. Results Group differentiation was found for some, but not all, of the acoustic measures. Low vowels were more acoustically centralized and variable in speakers with DS than TD controls. Acoustic findings were associated with overall intelligibility scores. Vowel formant dispersion was the most sensitive measure in distinguishing DS and TD formant data. Conclusion Corner vowels are differentially affected in speakers with DS. The acoustic characterization of vowel production and its association with speech intelligibility scores within the DS group support the conclusion of motor control deficits in the overall speech impairment. Implications are discussed for effective treatment planning.

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Vowel Acoustics and Speech Intelligibility in Young Adults With Down Syndrome.

Purpose Reductions in articulatory working space and vocal intensity have been linked to intelligibility deficits in children with dysarthria due to cerebral palsy. However, few studies have examined the outcomes of behavioral treatments aimed at these underlying impairments or investigated which treatment cues might best facilitate improved intelligibility. This study assessed the effects of cues targeting clear speech (i.e., “Speak with your big mouth”) and greater vocal intensity (i.e., “Speak with your strong voice”) on acoustic measures of speech production and intelligibility. Method Eight children with spastic dysarthria due to cerebral palsy repeated sentence- and word-level stimuli across habitual, big mouth, and strong voice conditions. Acoustic analyses were conducted, and 48 listeners completed orthographic transcription and scaled intelligibility ratings. Results Both cues resulted in significant changes to vocal intensity and speech rate although the degree of change varied by condition. In ...

https://pubs.asha.org/doi/pdf/10.1044/2017_JSLHR-S-16-0274

Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria

Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.

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Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria.

Background Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children's intelligibility deficits and negatively affecting their social participation. However, the effects of speech-treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English-speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in French-speaking children are virtually unexplored areas of research. Information gleaned from such research is critical for providing an evidence base on which to provide treatment. Aims To examine acoustic and perceptual changes in the speech of French-speaking children with dysarthria, who are provided with speech cues targeting greater articulatory excursion (French translation of 'speak with your big mouth') and vocal intensity (French translation of 'speak with your strong voice'). This study investigated whether, in response to the cues, the children would make acoustic changes and listeners would perceive the children's speech as more intelligible. Methods & procedures Eleven children with dysarthria due to CP (six girls, five boys; ages 4;11-17;0 years; eight with spastic CP, three with dyskinetic CP) repeated pre-recorded speech stimuli across three speaking conditions (habitual, 'big mouth' and 'strong voice'). Stimuli were sentences and contrastive words in phrases. Acoustic analyses were conducted. A total of 66 Belgian-French listeners transcribed the children's utterances orthographically and rated their ease of understanding on a visual analogue scale at sentence and word levels. Outcomes & results Acoustic analyses revealed significantly longer duration in response to the big mouth cue at sentence level and in response to both the big mouth and strong voice cues at word level. Significantly higher vocal sound-pressure levels were found following both cues at sentence and word levels. Both cues elicited significantly higher first-formant vowel frequencies and listeners' greater ease-of-understanding ratings at word level. Increases in the percentage of words transcribed correctly and in sentence ease-of-understanding ratings, however, did not reach statistical significance. Considerable variability between children was observed. Conclusions & implications Speech cues targeting greater articulatory excursion and vocal intensity yield significant acoustic changes in French-speaking children with dysarthria. However, the changes may only aid listeners' ease of understanding at word level. The significant findings and great inter-speaker variability are generally consistent with studies on English-speaking children with dysarthria, although changes appear more constrained in these French-speaking children. What this paper adds What is already known on the subject According to the only study comparing effects of speech-cueing strategies on English-speaking children with dysarthria, intelligibility increases when the children are provided with cues aimed to increase articulatory excursion and vocal intensity. Little is known about speech characteristics in French-speaking children with dysarthria and no published research has explored effects of cueing strategies in this population. What this paper adds to existing knowledge This paper is the first study to examine the effects of speech cues on the acoustics and intelligibility of French-speaking children with CP. It provides evidence that the children can make use of cues to modify their speech, although the changes may only aid listeners' ease of understanding at word level. What are the potential or actual clinical implications of this work? For clinicians, the findings suggest that speech cues emphasizing increasing articulatory excursion and vocal intensity show promise for improving the ease of understanding of words produced by francophone children with dysarthria, although improvements may be modest. The variability in the responses also suggests that this population may benefit from a combination of such cues to produce words that are easier to understand.

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Effects of Speech Cues in French-Speaking Children with Dysarthria.

A 36-year-old female with severe spastic dysarthria participated in this study. She received 4 weeks of individual intensive voice-focused treatment. Voice recordings were conducted at three baseli...

Younghwa M. Chang

Papers

Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria

Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria.

Effects of Speech Cues in French-Speaking Children with Dysarthria.

LSVT LOUD® Applied to an Adult With Cerebral Palsy: Acoustic Findings