A Comparative Study of Auditory-Perceptual Speech Measures for the Early Detection of Mild Speech Impairments
19 August 2019 (online)
Background and Purpose The aim of the study was to compare transcription-based speech intelligibility and scaled speech severity for the detection of mild speech impairments, by studying these metrics across talkers with Parkinson's disease (PD), age- and sex-matched older adults, and younger adults. An additional aim was to determine the impact of listener experience on these clinical measures.
Methods Fifteen speakers from each experimental group were asked to read aloud 11 randomly generated sentences from the Speech Intelligibility Test at their typical speaking rate and loudness. Two groups of four listeners each, stratified as experienced or inexperienced listeners based on their clinical experience, judged the sentence samples. To estimate intelligibility, both listener groups were asked to orthographically transcribe exactly what they heard for each sentence. For severity estimates, the listener groups were asked to rate the sentences for overall quality based on voice, resonance, articulation, and prosody, using a visual analog scale.
Results Transcription-based intelligibility and scaled severity scores of the PD group differed significantly from those of the older and younger adults. Between-age group differences in intelligibility and scaled severity were not observed. Listener experience had an impact on scaled speech severity, but not speech intelligibility. Between-group differences in speech severity were driven by the inexperienced group and not the experienced listener group.
Implications Both transcription-based intelligibility and scaled severity estimates appear to be sensitive to relatively mild speech impairments in PD. Obtaining scaled severity is less labor intensive than transcription; therefore, visual analog scaling may be the preferred paradigm for clinical use. However, listener experience and training are important considerations for scaling techniques to be implemented clinically.
KeywordsParkinson's disease - dysarthria - speech intelligibility - speech severity - visual analog scale
M.K-D. has funding from the National Institute on Deafness and Other Communication Disorders as well as the Missouri Spinal Cord Injury/Disease Research Program. G.N. was awarded Phase II and Phase III funding from the Parkinson Voice Project as part of their National SPEAK OUT! and LOUD Crowd Grant Program.
K.T., M.S., and L.H. have no financial relationships to disclose. None of the authors have any nonfinancial relationships to disclose.
- 1 Bunton K, Kent RD, Duffy JR, Rosenbek JC, Kent JF. Listener agreement for auditory-perceptual ratings of dysarthria. J Speech Lang Hear Res 2007; 50 (06) 1481-1495
- 2 Kent RD, Weismer G, Kent JF, Rosenbek JC. Toward phonetic intelligibility testing in dysarthria. J Speech Hear Disord 1989; 54 (04) 482-499
- 3 Yorkston K, Beukelman D, Hakel M, Dorsey M. Speech Intelligibility Test [Computer Software]. Lincoln, NE: Madonna Rehabilitation Hospitals; 2007
- 4 Sussman JE, Tjaden K. Perceptual measures of speech from individuals with Parkinson's disease and multiple sclerosis: intelligibility and beyond. J Speech Lang Hear Res 2012; 55 (04) 1208-1219
- 5 Weismer G, Laures JS. Direct magnitude estimates of speech intelligibility in dysarthria: effects of a chosen standard. J Speech Lang Hear Res 2002; 45 (03) 421-433
- 6 Weismer G. Speech intelligibility. In: Ball MJ, Perkins M, Müller N. , eds. The Handbook of Clinical Linguistics. Oxford, UK: Blackwell Publishing; 2008: 568-582
- 7 DePaul R, Brooks BR. Multiple orofacial indices in amyotrophic lateral sclerosis. J Speech Hear Res 1993; 36 (06) 1158-1167
- 8 Green JR, Yunusova Y, Kuruvilla MS. , et al. Bulbar and speech motor assessment in ALS: challenges and future directions. Amyotroph Lateral Scler Frontotemporal Degener 2013; 14 (7-8): 494-500
- 9 Yunusova Y, Green JR, Lindstrom MJ, Ball LJ, Pattee GL, Zinman L. Kinematics of disease progression in bulbar ALS. J Commun Disord 2010; 43 (01) 6-20
- 10 Duffy JR. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. 3rd ed. St. Louis, MO: Elsevier Mosby; 2013
- 11 Stipancic KL, Tjaden K, Wilding G. Comparison of intelligibility measures for adults with Parkinson's disease, adults with Multiple Sclerosis, and healthy controls. J Speech Lang Hear Res 2016; 59 (02) 230-238
- 12 Weismer G, Jeng JY, Laures JS, Kent RD, Kent JF. Acoustic and intelligibility characteristics of sentence production in neurogenic speech disorders. Folia Phoniatr Logop 2001; 53 (01) 1-18
- 13 Laczi E, Sussman JE, Stathopoulos ET, Huber J. Perceptual evaluation of hypernasality compared to HONC measures: the role of experience. Cleft Palate Craniofac J 2005; 42 (02) 202-211
- 14 Miller N. Measuring up to speech intelligibility. Int J Lang Commun Disord 2013; 48 (06) 601-612
- 15 Schiavetti N. Scaling procedures for the measurement of speech intelligibility. In: Kent RD. , ed. Intelligibility in Speech Disorders. Madison, WI: John Benjamins Publishing Company; 1992: 11-34
- 16 Dromey C, Boyce K, Channell R. Effects of age and syntactic complexity on speech motor performance. J Speech Lang Hear Res 2014; 57 (06) 2142-2151
- 17 Bang YI, Min K, Sohn YH, Cho SR. Acoustic characteristics of vowel sounds in patients with Parkinson disease. NeuroRehabilitation 2013; 32 (03) 649-654
- 18 Ho AK, Bradshaw JL, Iansek R. For better or worse: the effect of levodopa on speech in Parkinson's disease. Mov Disord 2008; 23 (04) 574-580
- 19 Sapir S. Multiple factors are involved in the dysarthria associated with Parkinson's disease: a review with implications for clinical practice and research. J Speech Lang Hear Res 2014; 57 (04) 1330-1343
- 20 Kent RD. Hearing and believing. Am J Speech Lang Pathol 1996; 5 (03) 7-23
- 21 Kreiman J, Gerratt BR, Kempster GB, Erman A, Berke GS. Perceptual evaluation of voice quality: review, tutorial, and a framework for future research. J Speech Hear Res 1993; 36 (01) 21-40
- 22 Kreiman J, Gerratt BR, Precoda K. Listener experience and perception of voice quality. J Speech Hear Res 1990; 33 (01) 103-115
- 23 Zyski BJ, Weisiger BE. Identification of dysarthria types based on perceptual analysis. J Commun Disord 1987; 20 (05) 367-378
- 24 Hustad KC. A closer look at transcription intelligibility for speakers with dysarthria: evaluation of scoring paradigms and linguistic errors made by listeners. Am J Speech Lang Pathol 2006; 15 (03) 268-277
- 25 McHenry M. An exploration of listener variability in intelligibility judgments. Am J Speech Lang Pathol 2011; 20 (02) 119-123
- 26 Zeplin J, Kent RD. Reliability of auditory perceptual scaling of dysarthria. In: Robin DA, Yorkston KM, Beukelman DR. , eds. Disorders of Motor Speech: Assessment, Treatment, and Clinical Characterization. Baltimore, MD: Paul H. Brookes Publishing Company; 1996: 145-154
- 27 Nasreddine ZS, Phillips NA, Bédirian V. , et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (04) 695-699
- 28 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (03) 189-198
- 29 Stepp CE, Heaton JT, Rolland RG, Hillman RE. Neck and face surface electromyography for prosthetic voice control after total laryngectomy. IEEE Trans Neural Syst Rehabil Eng 2009; 17 (02) 146-155
- 30 Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, MO: Lawrence Erlbaum Associates; 1988
- 31 Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15 (02) 155-163
- 32 Riper CV. Speech Correction. Englewood Cliffs, NJ: Prentice-Hall; 1963
- 33 Hustad KC. The relationship between listener comprehension and intelligibility scores for speakers with dysarthria. J Speech Lang Hear Res 2008; 51 (03) 562-573
- 34 Tjaden K, Kain A, Lam J. Hybridizing conversational and clear speech to investigate the source of increased intelligibility in speakers with Parkinson's disease. J Speech Lang Hear Res 2014; 57 (04) 1191-1205
- 35 Tjaden K, Sussman JE, Wilding GE. Impact of clear, loud, and slow speech on scaled intelligibility and speech severity in Parkinson's disease and multiple sclerosis. J Speech Lang Hear Res 2014; 57 (03) 779-792
- 36 Plomp R. Auditory handicap of hearing impairment and the limited benefit of hearing aids. J Acoust Soc Am 1978; 63 (2, S2): 533-549
- 37 Fontan L, Tardieu J, Gaillard P, Woisard V, Ruiz R. Relationship between speech intelligibility and speech comprehension in babble noise. J Speech Lang Hear Res 2015; 58 (03) 977-986
- 38 Bunton K, Keintz CK. The use of a dual-task paradigm for assessing speech intelligibility in clients with Parkinson disease. J Med Speech-Lang Pathol 2008; 16 (03) 141-155