Journal of Speech Language and Hearing Research最新文献

Purpose: This study examines how ultrasound biofeedback and intensive treatment distribution affect speech sound generalization during an evidence-based treatment, Speech Motor Chaining, for children with persisting speech errors associated with childhood apraxia of speech (CAS).

Method: In a 2 × 2 factorial randomized controlled trial, children ages 9-17 years meeting CAS criteria were randomized to receive (a) a distributed treatment (20 sessions twice weekly over 10 weeks) or intensive treatment (20 hr in 5 weeks, with 10 hr in Week 1) and (b) treatment with or without biofeedback. Due to the COVID pandemic, some participants were randomized to distributed/intensive telepractice treatment only. The primary outcome was percent target sounds correct on untreated phrases (i.e., generalization) at the 10-week time point. More than 50,000 narrow phonetic transcriptions were analyzed.

Results: Forty-eight participants completed treatment. Intensive treatment significantly increased generalization at all time points. The effect of biofeedback was significant at 5 weeks from the start of treatment but not significant at the primary 10-week time point. However, when comparing each group immediately after their 20 hr of treatment finished, generalization was significantly greater in intensive over distributed treatment and greater in ultrasound over no-ultrasound treatment (with a significant interaction favoring intensive treatment with ultrasound). Only the advantage of intensive treatment remained significant 5 weeks after groups finished treatment. There was no significant difference between face-to-face and telepractice modalities.

Conclusions: When the number of treatment hours is fixed, an intensive schedule of Speech Motor Chaining facilitated greater improvement than a distributed schedule. Ultrasound biofeedback initially accelerated learning, but the benefits may dissipate as treatment continues or after it ends.

Purpose: The Speech Accessibility Project (SAP) intends to facilitate research and development in automatic speech recognition (ASR) and other machine learning tasks for people with speech disabilities. The purpose of this article is to introduce this project as a resource for researchers, including baseline analysis of the first released data package.

Method: The project aims to facilitate ASR research by collecting, curating, and distributing transcribed U.S. English speech from people with speech and/or language disabilities. Participants record speech from their place of residence by connecting their personal computer, cell phone, and assistive devices, if needed, to the SAP web portal. All samples are manually transcribed, and 30 per participant are annotated using differential diagnostic pattern dimensions. For purposes of ASR experiments, the participants have been randomly assigned to a training set, a development set for controlled testing of a trained ASR, and a test set to evaluate ASR error rate.

Results: The SAP 2023-10-05 Data Package contains the speech of 211 people with dysarthria as a correlate of Parkinson's disease, and the associated test set contains 42 additional speakers. A baseline ASR, with a word error rate of 3.4% for typical speakers, transcribes test speech with a word error rate of 36.3%. Fine-tuning reduces the word error rate to 23.7%.

Conclusions: Preliminary findings suggest that a large corpus of dysarthric and dysphonic speech has the potential to significantly improve speech technology for people with disabilities. By providing these data to researchers, the SAP intends to significantly accelerate research into accessible speech technology.

Supplemental material: https://doi.org/10.23641/asha.27078079.

Purpose: Floating ball voice therapy (FBVT) is a voice-controlled virtual environment based on a common treatment component across multiple evidence-based therapies: improved vocal efficiency (target) via practicing voicing with modified resonance and airflow (ingredient). This study preliminarily tested FBVT's effects on outcomes and the potential for its novel variability metrics to predict individual patient generalization.

Method: Ten patients with nonphonotraumatic vocal hyperfunction (NPVH) practiced FBVT for 10 days. Outcomes were assessed by a vocal efficiency ratio, a validated NPVH index, the patient-reported Voice-Related Quality of Life (V-RQOL), and forced-choice auditory judgments of overall severity. Exploration in early practice (Day 1) was estimated by how the patient's two-dimensional variability (mean airflow and intensity) related to error (difference between the patient-produced and normative vocal efficiency ratio). Generalization from the game to spontaneous speech was evaluated using the validated NPVH index.

Results: Ten days of FBVT were associated with improved vocal efficiency (Cohen's d = 1.3), NPVH index (d = -1.1), V-RQOL total score (d = 0.9), and overall severity (odds ratio = 2.5). Patients who generalized on Day 10 exhibited airflow/intensity exploration that was more aligned with the error gradient on Day 1 (d = 0.6-1.2).

Conclusions: A relatively small dosage of FBVT (i.e., 10 practice sessions) was associated with multiple improved voice therapy outcomes. The FBVT variability metrics on Practice Day 1 demonstrated strong potential to predict which patients generalized to connected speech. Future work can more thoroughly evaluate effects on outcomes and characterizing the quality of vocal exploration with a larger patient population.

Supplemental material: https://doi.org/10.23641/asha.27040873.

Purpose: Greater recognition of the impact of hearing loss on cognitive functions has led speech/hearing clinics to focus more on auditory memory outcomes. Typically evaluated by scoring participants' recall on a list of unrelated words after they have heard the list read out loud, this method implies pitch and timing variations across words. Here, we questioned whether these variations could impact performance differentially in one language or another.

Method: In a series of online studies evaluating auditory short-term memory in normally hearing adults, we examined how pitch patterns (Experiment 1), timing patterns (Experiment 2), and interactions between the two (Experiment 3) affected free recall of words, cued recall of forgotten words, and mental demand. Note that visual memory was never directly tested; written words were only used after auditory encoding in the cued recall part. Studies were administered in both French and English, always conducted with native listeners.

Result: Confirming prior work, grouping mechanisms facilitated free recall, but not cued recall (the latter being only affected by longer presentation time) or ratings of mental demand. Critically, grouping by pitch provided more benefit for French than for English listeners, while grouping by time was equally beneficial in both languages.

Conclusion: Pitch is more useful to French- than to English-speaking listeners for encoding spoken words in short-term memory, perhaps due to the syllable-based versus stress-based rhythms inherent to each language.

Supplemental material: https://doi.org/10.23641/asha.27048328.

This Letter to the Editor was created in response to the article titled, "Instrumental Assessment of Aero-Resistive Expiratory Muscle Strength Rehabilitation Devices" by Dietsch et al. (2024). The article aims to compare six expiratory muscle strength training (EMST) devices and investigates their minimum trigger pressure, variability across the settings, and stability. The models tested include five positive expiratory pressure (PEP) devices, Acapella, TheraPEP, Threshold PEP, EMST75, and EMST150. It also includes a combined inspiratory and expiratory muscle training device, the Breather. We have several concerns about the integrity of results presented regarding the Breather as presented in the article. These include the heterogeneity of device sample used, as well as inadequate methodology and the experimental setup.

Purpose: Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by worsening of speech and/or language. Script training intervention promotes automatized speech production via repeated practice of scripted content. This study evaluated the acceptability, feasibility, and effects of a modified version of Video-Implemented Script Training for Aphasia (VISTA) in the three PPA variants and compared outcomes by intervention modality (teletherapy vs. in person).

Method: Thirteen bilingual (Spanish-Catalan) participants were included (semantic variant, n = 5; logopenic variant, n = 5; nonfluent/agrammatic variant, n = 3; teletherapy, n = 7). Using a nonrandomized design, intervention was administered in participants' dominant language. Participants were trained on an individualized script twice per week, over 8 weeks. Performance on measures related to script accuracy, content, and subjective ratings of production quality was evaluated at baseline, immediately post, and at 3 and 6 months post-intervention.

Results: No significant differences were observed on the basis of intervention modality. Participants demonstrated significant improvements from pre- to post-intervention in script production, synonym production, keywords, and global quality on the trained script. Maintenance was observed when comparing performance at post-intervention relative to 3- and 6-month follow-up for script and synonym production. Significant improvement in production quality of the untrained topic was observed following intervention. Different patterns of benefit were observed by PPA variant.

Conclusions: Modified VISTA was acceptable and effective across the three PPA variants, as evidenced by improvements on a broader array of outcome measures than those previously reported. Findings also provide further support for provision for teletherapy in individuals with PPA.

Supplemental material: https://doi.org/10.23641/asha.26999326.

Purpose: The aim of the study was to analyze how face masks influence speech perception and time spent looking at the speaker's mouth and eyes by adults with and without hearing loss.

Method: Twenty participants with hearing loss and 20 without were asked to repeat Spanish words presented in various conditions, including different types of face masks (no mask, transparent window mask, and opaque mask FFP2) and presentation modes (audiovisual, video only, and audio only). Recognition accuracy and the percentage of time looking at the speaker's eyes and mouth (dwell time) were measured.

Results: In the audiovisual condition, participants with hearing loss had significantly better word recognition scores when the speaker wore no mask compared to when they wore an opaque face mask. However, there were no differences between the transparent mask and no mask conditions. For those with typical hearing, the type of face mask did not affect speech recognition. Audiovisual presentation consistently improved speech recognition for participants with hearing loss across all face mask conditions, but for those with typical hearing, it only improved compared to video-only mode. These participants demonstrated a ceiling effect in audiovisual and audio-only modes. Regarding eye movement patterns, participants spent less time looking at the speaker's mouth and more time at the eyes when the speaker wore an opaque mask compared to no mask or a transparent mask.

Conclusion: The use of transparent face masks (ClearMask-type model) is recommended in contexts where face masks are still used (hospitals) to prevent the hindering effect of opaque masks (FFP2-type model) in speech perception among people with hearing loss, provided that any fogging of the window of the transparent mask is controlled by wiping it off as needed and the light is in front of the speaker to minimize shadows.

Background: Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context.

Purpose: After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits.

Conclusions: Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target.

Purpose: Typically developing toddlers extract patterns from their input to add words to their spoken lexicons, yet some evidence suggests that late talkers leverage the statistical regularities of the ambient language differently than do peers. Using the extended statistical learning account, we sought to compare lexical-level statistical features of spoken vocabularies between late talkers and two typically developing comparison groups.

Method: MacArthur-Bates Communicative Developmental Inventories American English Words and Sentences (N = 1,636) were extracted from Wordbank, a database of CDIs. Inventories were divided into three groups: (a) a late talker group (n = 202); (b) a typically developing age-matched group (n = 1,238); and (c) a younger, typically developing group (n = 196) matched to the late talkers on expressive language. Neighborhood density and word frequency were calculated for each word produced by each participant and standardized to z scores. Mixed-effects models were used to evaluate group differences.

Results: The late talker and younger, language-matched groups' spoken vocabularies consist, on standardized average, of words from denser phonological neighborhoods and words higher in frequency of occurrence in parent-child speech, compared to older, typically developing toddlers.

Conclusions: These findings provide support for the extended statistical learning account. Late talkers appear to generally be extracting and using similar patterns from their language input as do younger toddlers with similar levels of expressive vocabulary. This suggests that late talkers may be following a delayed, not deviant, trajectory of expressive language growth.