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Journal of Speech, Language, and... Jun 2021Purpose This study examined the effects of Speech Intelligibility Treatment (SIT) on intelligibility and naturalness of narrative speech produced by francophone children... (Randomized Controlled Trial)
Randomized Controlled Trial
Purpose This study examined the effects of Speech Intelligibility Treatment (SIT) on intelligibility and naturalness of narrative speech produced by francophone children with dysarthria due to cerebral palsy. Method Ten francophone children with dysarthria were randomized to one of two treatments, SIT or Hand-Arm Bimanual Intensive Therapy Including Lower Extremities, a physical therapy (PT) treatment. Both treatments were conducted in a camp setting and were comparable in dosage. The children were recorded pre- and posttreatment producing a story narrative. Intelligibility was measured by means of 60 blinded listeners' orthographic transcription accuracy (percentage of words transcribed correctly). The listeners also rated the children's naturalness on a visual analogue scale. Results A significant pre- to posttreatment increase in intelligibility was found for the SIT group, but not for the PT group, with great individual variability observed among the children. No significant changes were found for naturalness ratings or sound pressure level in the SIT group or the PT group posttreatment. Articulation rate increased in both treatment groups, although not differentially across treatments. Conclusions Findings from this first treatment study on intelligibility in francophone children with dysarthria suggest that SIT shows promise for increasing narrative intelligibility in this population. Acoustic contributors to the increased intelligibility remain to be explored further. Supplemental Material https://doi.org/10.23641/asha.14161943.
Topics: Cerebral Palsy; Child; Cognition; Dysarthria; Humans; Speech Intelligibility; Speech Production Measurement
PubMed: 33719503
DOI: 10.1044/2020_JSLHR-20-00258 -
The South African Journal of... 2007The Four-Level Framework of speech sensorimotor control (Van der Merwe, 1997) complicates the traditional view of dysarthria as a purely motor execution disorder....
The Four-Level Framework of speech sensorimotor control (Van der Merwe, 1997) complicates the traditional view of dysarthria as a purely motor execution disorder. According to this framework, hypokinetic, hyperkinetic and ataxic dysarthria are programming-execution dysarthrias, while flaccid dysarthria is the only execution dysarthria. This preliminary study aimed to differentiate programming-execution dysarthria from execution dysarthria by examining variability of the temporal control of speech. Six participants and five control participants repeated 15 stimulus words ten times. Voice onset time, vowel duration, vowel steady state duration and vowel formant transition duration were measured acoustically. The coefficient of variation of the temporal parameters, and the correlation coefficient between the durational parameters, were calculated and analysed using descriptive statistics. The coefficient of variation revealed that the speakers with dysarthria were more variable than the control speakers. All participants, except those with flaccid dysarthria, showed similar patterns of intra-subject variability. Those with flaccid dysarthria exhibited greater intra-subject variability of voice onset time. The correlation analysis did not reveal differences between dysarthria type, or between the dysarthric speakers and the controls. Differences found in the patterns of variability may support the hypothesis that individuals with programming-execution dysarthria resort to a different level of control than those with execution dysarthria. Further research in this field is necessary.
Topics: Adult; Age of Onset; Aged; Aged, 80 and over; Dysarthria; Female; Humans; Male; Middle Aged; Psychomotor Disorders
PubMed: 18240662
DOI: No ID Found -
American Journal of Speech-language... Aug 2023Few studies have reported on the vowel space area (VSA) in both acoustic and kinematic domains. This study examined acoustic and kinematic VSAs for speakers with and...
PURPOSE
Few studies have reported on the vowel space area (VSA) in both acoustic and kinematic domains. This study examined acoustic and kinematic VSAs for speakers with and without dysarthria and evaluated effects of normalization on acoustic and kinematic VSAs and the relationship between these measures.
METHOD
Vowel data from 12 speakers with and without dysarthria, presenting with a range of speech abilities, were examined. The speakers included four speakers with Parkinson's disease (PD), four speakers with brain injury (BI), and four neurotypical (NT) speakers. Speech acoustic and kinematic data were acquired simultaneously using electromagnetic articulography during a passage reading task. Raw and normalized VSAs calculated from corner vowels /i/, /æ/, /ɑ/, and /u/ were evaluated. Normalization was achieved through score transformations to the acoustic and kinematic data. The effect of normalization on variability within and across groups was evaluated. Regression analysis was used across speakers to assess the association between acoustic and kinematic VSAs for both raw and normalized data.
RESULTS
When evaluating the speakers as three different groups (i.e., PD, BI, and NT), normalization reduced the standard deviations within each group and changed the relative differences in average magnitude between groups. Regression analysis revealed a significant relationship between normalized, but not raw, acoustic and kinematic VSAs, after the exclusion of an outlier speaker.
CONCLUSIONS
Normalization reduces the variability across speakers, within groups, and changes average magnitudes affecting speaker group comparisons. Normalization also influences the correlation between acoustic and kinematic measures. Further investigation of the impact of normalization techniques upon acoustic and kinematic measures is warranted.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.22669747.
Topics: Humans; Speech Intelligibility; Speech Production Measurement; Speech Acoustics; Dysarthria; Biomechanical Phenomena; Acoustics; Parkinson Disease; Phonetics
PubMed: 37105919
DOI: 10.1044/2023_AJSLP-22-00158 -
The impact of stroke-related dysarthria on social participation and implications for rehabilitation.Disability and Rehabilitation 2011Each year an estimated 30,000-45,000 UK individuals experience stroke-related dysarthria (impairment of movements required to produce speech). Many will experience...
INTRODUCTION
Each year an estimated 30,000-45,000 UK individuals experience stroke-related dysarthria (impairment of movements required to produce speech). Many will experience persistent dysarthria long after discharge from stroke services. Although we have some insight into the impact of other communication impairments, we have very limited information on the impact of dysarthria on social participation.
PURPOSE
To explore the impact of dysarthria on social participation following stroke.
METHODS
We report data from in-depth semi-structured interviews with 24 individuals with stroke-related dysarthria.
RESULTS
Our findings suggest a complex association between the severity of an individual's dysarthria and the impact on their social participation. Participants' descriptions highlighted their experiences of social participation and isolation. We further suggest that, in some cases, the coping strategies adopted by the participants could be seen to further exacerbate this isolation. These results have important implications for the prioritisation, planning and delivery of therapeutic interventions for people with dysarthria.
CONCLUSIONS
The impact of stroke-related dysarthria transcends the physiological impairment to impact upon individuals' social participation, which is key to the process of rehabilitation. The development and evaluation of the effectiveness of an intervention that addresses these impacts is the next challenge for therapists and researchers working in this area.
Topics: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Dysarthria; Female; Humans; Interpersonal Relations; Interviews as Topic; Male; Middle Aged; Quality of Life; Severity of Illness Index; Social Adjustment; Speech Therapy; Stroke; Stroke Rehabilitation
PubMed: 20831375
DOI: 10.3109/09638288.2010.517897 -
American Journal of Speech-language... Mar 2024This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals...
PURPOSE
This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals with dysarthria due to neurodegenerative disease.
METHOD
Multiple electronic database searches and hand searches of prominent speech-language pathology journals were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards.
RESULTS
The search yielded 1,525 articles, from which 88 met inclusion criteria and were reviewed by two blinded co-investigators. A large range of therapeutic approaches have been added to the evidence base since the last review, including expiratory muscle strength training, singing, and computer- and device-driven programs, as well as a variety of treatment modalities, including teletherapy. Evidence for treatment in several different population groups-including cerebellar ataxia, myotonic dystrophy, autosomal recessive spastic ataxia of Charlevoix-Saguenay, Huntington's disease, multiple system atrophy, and Lewy body dementia-were added to the current review. Synthesis of evidence quality provided strong evidence in support of only one behavioral intervention: Lee Silverman Voice Treatment Program (LSVT LOUD) in people with Parkinson's disease. No other treatment approach or population included in this review demonstrated more than limited evidence, reflecting that these approaches/populations require urgent further examination.
CONCLUSION
Suggestions about where future research efforts could be significantly strengthened and how clinicians can apply research findings to their practice are provided.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24964473.
Topics: Humans; Neurodegenerative Diseases; Dysarthria; Speech Therapy; Voice Training; Parkinson Disease
PubMed: 38232176
DOI: 10.1044/2023_AJSLP-23-00274 -
Annals of Neurology Sep 1979A 64-year-old hypertensive man presented with the dysarthria--clumsy hand syndrome, manifested by dysarthria, dysphagia, central facial weakness, deviation of the tongue...
A 64-year-old hypertensive man presented with the dysarthria--clumsy hand syndrome, manifested by dysarthria, dysphagia, central facial weakness, deviation of the tongue on protrusion, incoordination of the affected hand, and mild imbalance on walking. A computed tomograpphic scan demonstrated a resolving acute infarction in the vicinity of the genu of the internal capsule.
Topics: Deglutition Disorders; Dysarthria; Hand; Humans; Male; Middle Aged; Movement; Neuromuscular Diseases; Speech Disorders; Syndrome
PubMed: 534426
DOI: 10.1002/ana.410060315 -
Journal of Communication Disorders 2005Prosodic abnormality is common in the dysarthria associated with traumatic brain injury (TBI), and adjustments of speaking rate and emphatic stress are often used as...
UNLABELLED
Prosodic abnormality is common in the dysarthria associated with traumatic brain injury (TBI), and adjustments of speaking rate and emphatic stress are often used as steps in treating the speech disorder in patients with TBI-induced dysarthria. However, studies to date do not present a clear and detailed picture of how speaking rate and emphatic stress are affected in this speech disorder. This study, based on the acoustic analyses of syllable repetitions and sentence speech samples, reports on speaking rate and emphatic stress for 12 subjects with TBI and 8 healthy controls. For speaking rate, the subjects with TBI had (1) both slow speaking and articulation rates, (2) smaller phonation proportion and larger pause proportion, and (3) larger percentage change in speaking rate and smaller percentage change in articulation rate. For emphatic stress, the subjects with TBI had (1) significant increases in the difference and percentage change between pre-stressed and pre-unstressed pause durations, (2) significantly smaller difference between stressed and unstressed word durations, but not the percentage change between stressed and unstressed word durations, and (3) significantly reduced differences in f(0) movement and f(0) slope between stressed and unstressed words, but not in RMS range. This study demonstrates the multidimensional nature of prosodic deficits in the dysarthria related to TBI and illustrates the ability of acoustic measures to give a picture of the dysprosody related to TBI-induced dysarthria.
LEARNING OUTCOMES
As a result of this activity, the participant will be able to (1) describe the prosodic disturbances that have been reported in studies of dysarthria associated with TBI; (2) define acoustic measures appropriate to the analysis of changes in speaking rate and emphatic stress; and (3) discuss the importance of prosody to spoken communication.
Topics: Adolescent; Adult; Brain Injuries; Dysarthria; Female; Humans; Male; Middle Aged; Phonetics; Prevalence; Severity of Illness Index; Sound Spectrography; Speech Production Measurement
PubMed: 15748726
DOI: 10.1016/j.jcomdis.2004.12.001 -
Journal of Speech, Language, and... Oct 2010Previous research demonstrated the ability of temporally based rhythm metrics to distinguish among dysarthrias with different prosodic deficit profiles (J. M. Liss et... (Comparative Study)
Comparative Study
PURPOSE
Previous research demonstrated the ability of temporally based rhythm metrics to distinguish among dysarthrias with different prosodic deficit profiles (J. M. Liss et al., 2009). The authors examined whether comparable results could be obtained by an automated analysis of speech envelope modulation spectra (EMS), which quantifies the rhythmicity of speech within specified frequency bands.
METHOD
EMS was conducted on sentences produced by 43 speakers with 1 of 4 types of dysarthria and healthy controls. The EMS consisted of the spectra of the slow-rate (up to 10 Hz) amplitude modulations of the full signal and 7 octave bands ranging in center frequency from 125 to 8000 Hz. Six variables were calculated for each band relating to peak frequency and amplitude and relative energy above, below, and in the region of 4 Hz. Discriminant function analyses (DFA) determined which sets of predictor variables best discriminated between and among groups.
RESULTS
Each of 6 DFAs identified 2-6 of the 48 predictor variables. These variables achieved 84%-100% classification accuracy for group membership.
CONCLUSIONS
Dysarthrias can be characterized by quantifiable temporal patterns in acoustic output. Because EMS analysis is automated and requires no editing or linguistic assumptions, it shows promise as a clinical and research tool.
Topics: Amyotrophic Lateral Sclerosis; Ataxia; Case-Control Studies; Discriminant Analysis; Dysarthria; Female; Humans; Huntington Disease; Male; Parkinson Disease; Periodicity; Phonetics; Reference Values; Signal Processing, Computer-Assisted; Sound Spectrography; Speech Acoustics; Speech Articulation Tests; Speech Intelligibility; Time Factors
PubMed: 20643800
DOI: 10.1044/1092-4388(2010/09-0121) -
Journal of Clinical Neuroscience :... Jun 2010Cortical infarction presenting with pure dysarthria is rarely reported. Previous studies have reported pure dysarthria due to cortical stroke at the precentral gyrus or...
Cortical infarction presenting with pure dysarthria is rarely reported. Previous studies have reported pure dysarthria due to cortical stroke at the precentral gyrus or middle frontal gyrus. We report a 72-year-old man who developed pure dysarthria caused by an acute cortical infarction in the insular cortex. The role of the insula in language has been difficult to assess clinically because of the rarity of pure insular strokes. Our patient showed pure dysarthria without aphasia, indicating that pure dysarthria can be the sole manifestation of insular infarctions.
Topics: Aged; Brain Infarction; Cerebral Cortex; Diffusion Magnetic Resonance Imaging; Dysarthria; Humans; Male
PubMed: 20400317
DOI: 10.1016/j.jocn.2009.10.026 -
The Journal of the Acoustical Society... Jun 2016The current investigation contributes to a perceptual similarity-based approach to dysarthria characterization by utilizing an innovative statistical approach,... (Comparative Study)
Comparative Study
The current investigation contributes to a perceptual similarity-based approach to dysarthria characterization by utilizing an innovative statistical approach, multinomial logistic regression with sparsity constraints, to identify acoustic features underlying each listener's impressions of speaker similarity. The data-driven approach also permitted an examination of the effect of clinical experience on listeners' impressions of similarity. Listeners, irrespective of level of clinical experience, were found to rely on similar acoustic features during the perceptual sorting task, known as free classification. Overall, the results support the continued advancement of a similarity-based approach to characterizing the communication disorders associated with dysarthria.
Topics: Acoustics; Clinical Competence; Cues; Dysarthria; Humans; Judgment; Logistic Models; Multivariate Analysis; Pattern Recognition, Automated; Predictive Value of Tests; Reproducibility of Results; Severity of Illness Index; Signal Processing, Computer-Assisted; Speech Acoustics; Speech Perception; Speech Production Measurement; Speech-Language Pathology; Voice Quality
PubMed: 27369174
DOI: 10.1121/1.4954384