Journal of medical speech-language pathology最新文献

People use speech in a variety of ways to fulfill life roles and responsibilities. Documenting speech usage is critical in clinical work to plan relevant intervention goals for individual clients, and in clinical research to better describe participant characteristics. A few voice-use classification scales exist; however, they are limited in scope (e.g., focus almost exclusively on occupation) and in applicability beyond voice-disordered populations. The Levels of Speech Usage is a self-report categorical rating scale intended for use with adults across a wide range of communication disorders and life situations. This article presents data from the initial analysis of this scale in a sample of 200 people with spasmodic dysphonia (SD). Speech usage was significantly associated with age, education level, and work status (full time, part time, no paid work). Speech usage was not significantly associated with gender, SD duration, self-rating of voice, treatment status, presence of other medical conditions, Voice Handicap Index, or a measure of communicative participation. Further research is needed to explore the function of this scale in other populations.

Differences in the clinical and ecological manifestations of reduced intelligibility for individuals with dysarthria related to Parkinson disease (PD) have been reported in the literature. The current study explored whether a dual-task paradigm could be used during intelligibility testing to collect speech samples that were representative of functional performance. Intelligibility was calculated for four speakers with PD and four age-matched controls (CG) based on single-word, sentences, and monologue tasks recorded in single-and dual-task conditions and a spontaneous speech sample. In the dual-task condition, speakers produced the target speech sample and performed a simultaneous motor task, turning a nut on a bolt. No significant differences in intelligibility were found for the CG. For speakers with PD, differences between conditions were statistically significant for all speech tasks. Intelligibility scores in the dual-task condition were lower, with variability between tasks and speakers noted. There was a significant difference between scores for the monologue in the single-task condition and the spontaneous sample; however, there was no significant difference between the monologue in the dual-task condition and the spontaneous sample. Findings suggest that including a simple motor task during a clinical assessment may help elicit speech samples that are representative of a speaker's typical speech production.

The following report is a summary of the Special Panel Session, entitled, "Driving Critical Initiatives in Motor Speech," that was conducted at the Conference on Motor Speech, March 2008, in Monterey California. Don Finan (Program Chair for Speech Motor Control) and Julie Liss (Program Chair for Motor Speech Disorders) invited four distinguished scientists (Drs. Gary Weismer, Steven Barlow, Anne Smith, and John Caviness) to share, briefly, their opinions and views on selected topics. This was followed by an hour-long general discussion session with conference attendees. This report contains an introductory statement followed by the panel members' own summaries of the opinions and ideas expressed in their talks. We then summarize the major topics that were considered during the discussion session. This summary reflects the biases and opinions of the participants, and is meant to serve as a thought-piece for the readership of JMSLP, rather than as a scientific report.

Changes in speech rate have long been identified as a prominent sign of dysarthria. At the same time, such changes have been reported in the literature on normal ageing. This study aimed to provide information on the speech rate behaviour in the three participant groups, comprising speakers with Parkinson's Disease (PD), healthy age matched control speakers (CON), and an older non-dysarthric group with mild cognitive decline (DEM).The analysis revealed that the CON and PD group performed similarly for articulation rate whereas the DEM speakers spoke significantly more slowly. This relationship was reversed for pausing behaviour, where the DEM and CON groups performed similarly whilst the PD speakers produced a higher degree of pause time. All groups could change their articulation rate significantly from habitual to slow and fast conditions. However, the groups differed in the amount of change, with CON speakers showing the greatest and DEM the smallest amount of differences in articulation rate. The data did not identify clear performance predictors. However, there was a suggestion that the speakers' cognitive skills had an impact on their speech performance.

This study tested the hypothesis that left versus right deep brain stimulation (DBS) of the subthalamic nucleus (STN) would have differential effects on speech. Twenty right-handed individuals with advanced Parkinson's disease (PD) underwent unilateral STN DBS. Ten were operated on the right and 10 on the left hemisphere as indicated by severity of nonspeech motor function. Speech was evaluated before surgery and 3 to 6 months after surgery with stimulator-off and with stimulator-on, with all participants off anti-parkinsonian medication for 12 hours before evaluation. Evaluators and patient speakers were blinded to the stimulator status at the postsurgery evaluations. Motor performance was assessed with UPDRS-III. Each participant produced three samples of diadochokinetic syllables. Syllable rate, syllable and vowel duration, VOT, and F0 were obtained. The diadochokinetic syllables were rated for articulatory accuracy and speaking rate. Twenty graduate clinicians served as judges. The samples were randomly presented via headphones. A mixed ANOVA with repeated measures was used to assess the significance of the changes in UPRS-III scores and speech measures. The results indicated that unilateral STN DBS produced improvement in nonspeech motor function regardless of the side of stimulation. In contrast, the changes in articulatory accuracy and syllable rate associated with the STN DBS were hemisphere specific.

The purpose of this study was to investigate biographical and medical factors associated with utilization of speech-language pathology and audiology services provided to stroke patients in the hospital setting. Moreover, the study sought to identify possible sub-groups of stroke patients that might be under served by speech-language pathologists and audiologists. Discharge data for over 91,000 stroke patients from the years 1996 to 2000 were examined. Using a relatively new statistical approach - a novel decision tree - the analyses revealed an association between medical diagnostic complexity, hospital setting, hospital location, and increased utilization of rehabilitation services. Biographical factors such as age, race, and gender were not related to the amount of services rendered.

The aim of this study was to evaluate the validity and performance of an algorithm designed to automatically extract pauses and speech timing information from connected speech samples. Speech samples were obtained from 10 people with amyotrophic lateral sclerosis (ALS) and 10 control speakers. Pauses were identified manually and algorithmically from digitally recorded recitations of a speech passage that was developed to improve the precision of pause boundary detection.The manual and algorithmic methods did not yield significantly different results. A stepwise analysis of three different pause detection parameters revealed that estimates of percent pause time were highly dependent on the values specified for the minimum acceptable pause duration and the minimum signal amplitude. Consistent with previous reports of dysarthric speech, pauses were significantly longer and more variable in speakers with ALS than in the control speakers. These results suggest that the algorithm provided an efficient and valid method for extracting pause and speech timing information from the optimally structured speech sample.

Previously, we reported improved speech breathing and intelligibility after behavioral treatment for a man with hypokinetic-spastic dysarthria following traumatic brain injury (TBI) (Solomon, McKee, & Garcia-Barry, 2001). Treatment included the Lee Silverman Voice Treatment^® (LSVT) program followed by 6 weeks of speech-breathing training, physical therapy, and LSVT-type tasks. In this article, we report a new patient with similar speech characteristics post-TBI. Breathing-for-Speech Treatment (BST), custom designed to improve nonspeech- and speech-breathing coordination, was followed by LSVT. After BST, speech breathing approached normal levels; after LSVT, speech breathing improved further and intelligibility improved markedly. Gains generally were maintained up to 4 months, but were limited by the spastic characteristics of his dysarthria and sporadic medical complications.

We report findings from two feasibility studies using automatic speech recognition (ASR) methods in childhood speech sound disorders. The studies evaluated and implemented the automation of two recently proposed diagnostic markers for suspected Apraxia of Speech (AOS) termed the Lexical Stress Ratio (LSR) and the Coefficient of Variation Ratio (CVR). The LSR is a weighted composite of amplitude area, frequency area , and duration in the stressed compared to the unstressed vowel as obtained from a speaker's productions of eight trochaic word forms. Composite weightings for the three stress parameters were determined from a principal components analysis. The CVR expresses the average normalized variability of durations of pause and speech events that were obtained from a conversational speech sample. We describe the automation procedures used to obtain LSR and CVR scores for four children with suspected AOS and report comparative findings. The LSR values obtained with ASR were within 1.2% to 6.7% of the LSR values obtained manually using Computerized Speech Lab (CSL). The CVR values obtained with ASR were within 0.7% to 2.7% of the CVR values obtained manually using Matlab. These results indicate the potential of ASR-based techniques to process these and other diagnostic markers of childhood speech sound disorders.

Delayed auditory feedback (DAF) has been assessed as a rate reduction and intelligibility enhancing tool in patients with Parkinson's Disease (PD) for some time. However, there are contradictory results in the literature regarding the success of this device. Also, little is known about the effects of DAF on speech other than influences on speech rate and intelligibility. Frequency shifted feedback (FSF) is known to produce more natural sounding speech than DAF and to improve the fluency of persons who stutter. However, there are currently no studies reporting how PD speakers perform under FSF.The aim of this study was to investigate the effects of both types of altered feedback on the speech of PD and control participants on a broad range of measures. The performance of 16 PD speakers and 11 control speakers in a reading task under DAF, FSF and no altered feedback (NAF) are reported in this paper.The results showed that all groups responded to altered feedback in a similar way and showed a prominent reduction of speech rate. The conditions evoked changes in pause frequency (increases), loudness levels (increases), pitch variation (increases) and intelligibility and naturalness (decreases) for all or some of the groups. Few effects could be observed on articulation/pause time ratio, pause duration, pitch range, and speech rhythm. Previous reports on differences in susceptibility of PD speaker to altered feedback were confirmed and some speakers benefited from the system despite the negative group results for intelligibility and naturalness. In general, FSF resulted in performance closer to the NAF state than DAF on all variables, and for those PD speakers who benefited from altered feedback, the FSF condition evoked the greatest improvement.