Exploring the source of short-term variations in respiratory data.

This study explores short-term respiratory volume changes in German oral and nasal stops and discusses to what extent these changes may be explained by laryngeal-oral coordination. It is expected that respiratory volumes decrease more rapidly when the glottis and the vocal tract are open after the release of voiceless aspirated stops. Two experiments were performed using Inductance Plethysmography and acoustics, varying consonantal properties, loudness, and prosodic focus. Results show consistent differences in respiratory slopes between voiceless vs voiced and nasal stops, which are more extreme in a loud or focused position. Thus, respiratory changes can even occur at a local level.

A Standardized Protocol for Maximum Repetition Rate Assessment in Children.

BACKGROUND/AIMS: Maximum repetition rate (MRR) is often used in the assessment of speech motor performance in older children and adults. The present study aimed to evaluate a standardized protocol for MRR assessment in young children in Dutch. METHODS: The sample included 1,524 children of 2-7 years old with no hearing difficulties and Dutch spoken in their nursery or primary school and was representative for children in the Netherlands. The MRR protocol featured mono-, tri-, and bisyllabic sequences and was computer-implemented to maximize standardization. RESULTS: Less than 50% of the 2-year-olds could produce >1 monosyllabic sequence correctly. Children who could not correctly produce ≥2 monosyllabic sequences could not produce any of the multisyllabic sequences. The effect of instruction ("faster" and "as fast as possible") was small, and multiple attempts yielded a faster MRR in only 20% of the cases. MRRs did not show clinically relevant differences when calculated over different numbers of repeated syllables. CONCLUSIONS: The MRR protocol is suitable for children of 3 years and older. If children cannot produce at least 2 of the monosyllabic sequences, the multisyllabic tasks should be omitted. Furthermore, all fast attempts of each sequence should be analyzed to determine the fastest MRR.

[Internal Validation of the Acoustic Voice Quality Index version 03.01 und Acoustic Breathiness Index]. / Interne Validität des Acoustic Voice Quality Index Version 03.01 und des Acoustic Breathiness Index.

OBJECTIVE: Acoustics might have the potential to objectify voice quality (eg, hoarseness and breathiness). The Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) revealed sufficient valid and reliable results in the evaluation of voice quality. The aim of the present study is to validate the recent version of AVQI 03.01 and ABI in their internal validation. The responsiveness of change is evaluated on the hoarseness and breathiness severity after voice therapy. MATERIALS AND METHODS: In total, 84 voice samples of continuous speech and sustained vowel [a:] before and after a voice therapy were used. All 42 subjects presented organic and nonorganic voice disorders and various degrees of dysphonia severity before and after behavioral voice therapy. The voice samples were judged by three voice experts using the RBH-scale, which is based on the GRBAS-scale. RESULTS: The intra-rater reliability was high for hoarseness (mean kappa = 0.76) and breathiness (mean kappa = 0.69).The inter-rater reliability was lower for both voice quality characteristics and ranged between kappa = 0.27 to 0.29. A strong correlation was identified between the perceived rating of hoarseness and breathiness and AVQI and ABI before and after voice therapy (r = 0.715, p < 0.01, and r = 0.712, p < 0.01, respectively). Additionally, no significant differences were revealed. CONCLUSION: The present results showed that AVQI version 03.01 und ABI had a high internal validity to assess voice changes after voice therapy. AVQI and ABI are two valid and robust voice measures to objectify hoarseness and breathiness.

SVANTE - The Swedish Articulation and Nasality Test - Normative data and a minimum standard set for cross-linguistic comparison.

Normative language-based data are important for comparing speech performances of clinical groups. The Swedish Articulation and Nasality Test (SVANTE) was developed to enable a detailed speech assessment. This study's aim was to present normative data on articulation and nasality in Swedish speakers. Single word production, sentence repetition and connected speech were collected using SVANTE in 443 individuals. Mean (SD) and prevalences in the groups of 3-, 5-, 7-, 10-, 16- and 19-year-olds were calculated from phonetic transcriptions or ordinal rating. For the 3- and 5-year-olds, a consonant inventory was also determined. The mean percent of oral consonants correct ranged from 77% at age 3 to 99% at age 19. At age 5, a mean of 96% was already reached, and the consonant inventory was established except for /s/, /r/, /ɕ/. The norms on the SVANTE, also including a short version, will be useful in the interpretation of speech outcomes.

Recommendations for real-time speech MRI.

Real-time magnetic resonance imaging (RT-MRI) is being increasingly used for speech and vocal production research studies. Several imaging protocols have emerged based on advances in RT-MRI acquisition, reconstruction, and audio-processing methods. This review summarizes the state-of-the-art, discusses technical considerations, and provides specific guidance for new groups entering this field. We provide recommendations for performing RT-MRI of the upper airway. This is a consensus statement stemming from the ISMRM-endorsed Speech MRI summit held in Los Angeles, February 2014. A major unmet need identified at the summit was the need for consensus on protocols that can be easily adapted by researchers equipped with conventional MRI systems. To this end, we provide a discussion of tradeoffs in RT-MRI in terms of acquisition requirements, a priori assumptions, artifacts, computational load, and performance for different speech tasks. We provide four recommended protocols and identify appropriate acquisition and reconstruction tools. We list pointers to open-source software that facilitate implementation. We conclude by discussing current open challenges in the methodological aspects of RT-MRI of speech.

Multimodal acquisition of articulatory data: Geometrical and temporal registration.

Acquisition of dynamic articulatory data is of major importance for studying speech production. It turns out that one technique alone often is not enough to get a correct coverage of the whole vocal tract at a sufficient sampling rate. Ultrasound (US) imaging has been proposed as a good acquisition technique for the tongue surface because it offers a good temporal sampling, does not alter speech production, is cheap, and is widely available. However, it cannot be used alone and this paper describes a multimodal acquisition system which uses electromagnetography sensors to locate the US probe. The paper particularly focuses on the calibration of the US modality which is the key point of the system. This approach enables US data to be merged with other data. The use of the system is illustrated via an experiment consisting of measuring the minimal tongue to palate distance in order to evaluate and design Magnetic Resonance Imaging protocols well suited for the acquisition of three-dimensional images of the vocal tract. Compared to manual registration of acquisition modalities which is often used in acquisition of articulatory data, the approach presented relies on automatic techniques well founded from geometrical and mathematical points of view.

Assessment of intelligibility using children's spontaneous speech: methodological aspects.

BACKGROUND: Intelligibility is a speaker's ability to convey a message to a listener. Including an assessment of intelligibility is essential in both research and clinical work relating to individuals with communication disorders due to speech impairment. Assessment of the intelligibility of spontaneous speech can be used as an overall indicator of the severity of a speech disorder. There is a lack of methods for measuring intelligibility on the basis of spontaneous speech. AIMS: To investigate the validity and reliability of a method where listeners transcribe understandable words and an intelligibility score is calculated on the basis of the percentage of syllables perceived as understood. METHODS & PROCEDURES: Spontaneous speech from ten children with speech-sound disorders (mean age = 6.0 years) and ten children with typical speech and language development (mean age = 5.9 years) was recorded and presented to 20 listeners. Results were compared between the two groups and correlation with percentage of consonants correct (PCC) was examined. OUTCOMES & RESULTS: The intelligibility scores obtained correlated with PCC in single words and differed significantly between the two groups, indicating high validity. Inter-judge reliability, analysed using intra-class correlation (ICC), was excellent in terms of the average measure for several listeners. CONCLUSIONS & IMPLICATIONS: The results suggest that this method can be recommended for assessing intelligibility, especially if the mean across several listeners is used. It could also be used in clinical settings when evaluating intelligibility over time, provided that the same listener makes the assessments.

Systematic studies of modified vocalization: the effect of speech rate on speech production measures during metronome-paced speech in persons who stutter.

BACKGROUND: Metronome-paced speech results in the elimination, or substantial reduction, of stuttering moments. The cause of fluency during this fluency-inducing condition is unknown. Several investigations have reported changes in speech pattern characteristics from a control condition to a metronome-paced speech condition, but failure to control speech rate between conditions limits our ability to determine if the changes were necessary for fluency. AIMS: This study examined the effect of speech rate on several speech production variables during one-syllable-per-beat metronomic speech in order to determine changes that may be important for fluency during this fluency-inducing condition. METHODS & PROCEDURES: Thirteen persons who stutter (PWS), aged 18-62 years, completed a series of speaking tasks. Several speech production variables were compared between conditions produced at different metronome beat rates, and between a control condition and a metronome-paced speech condition produced at a rate equal to the control condition. OUTCOMES & RESULTS: Vowel duration, voice onset time, pressure rise time and phonated intervals were significantly impacted by metronome beat rate. Voice onset time and the percentage of short (30-100 ms) phonated intervals significantly decreased from the control condition to the equivalent rate metronome-paced speech condition. CONCLUSIONS & IMPLICATIONS: A reduction in the percentage of short phonated intervals may be important for fluency during syllable-based metronome-paced speech for PWS. Future studies should continue examining the necessity of this reduction. In addition, speech rate must be controlled in future fluency-inducing condition studies, including neuroimaging investigations, in order for this research to make a substantial contribution to finding the fluency-inducing mechanism of fluency-inducing conditions.

[Implementation of the new quality assurance agreement for the fitting of hearing aids in daily practice. Part 2: New diagnostic aspects of speech audiometry]. / Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im Praxisalltag. Teil 2: Diagnostische Neuerungen in der Sprachaudiometrie.

Upon review of the statutory health insurance reimbursement guidelines, a specific quality assurance questionnaire concerned with the provision of hearing aids was introduced that assesses elements of patient satisfaction within Germany's public healthcare system. APHAB questionnaire-based patient evaluation of the benefit of hearing aids represents the third pillar of audiological diagnostics, alongside classical pure-tone and speech audiometry. Another new aspect of the national guidelines is inclusion of free-field measurements in noise with and without hearing aids. Part 2 of this review describes new diagnostic aspects of speech audiometry. In addition to adaptive speech audiometry, a proposed method for applying the gold standard of speech audiometry - the Freiburg monosyllabic speech test - in noise is described. Finally, the quality assurance questionnaire will be explained as an appendix to template 15 of the regulations governing hearing aids.

Consonant acquisition in the Malay language: a cross-sectional study of preschool aged Malay children.

To date, there has been little research done on phonological acquisition in the Malay language of typically developing Malay-speaking children. This study serves to fill this gap by providing a systematic description of Malay consonant acquisition in a large cohort of preschool-aged children between 4- and 6-years-old. In the study, 326 Malay-dominant speaking children were assessed using a picture naming task that elicited 53 single words containing all the primary consonants in Malay. Two main analyses were conducted to study their consonant acquisition: (1) age of customary and mastery production of consonants; and (2) consonant accuracy. Results revealed that Malay children acquired all the syllable-initial and syllable-final consonants before 4;06-years-old, with the exception of syllable-final /s/, /h/ and /l/ which were acquired after 5;06-years-old. The development of Malay consonants increased gradually from 4- to 6 years old, with female children performing better than male children. The accuracy of consonants based on manner of articulation showed that glides, affricates, nasals, and stops were higher than fricatives and liquids. In general, syllable-initial consonants were more accurate than syllable-final consonants while consonants in monosyllabic and disyllabic words were more accurate than polysyllabic words. These findings will provide significant information for speech-language pathologists for assessing Malay-speaking children and designing treatment objectives that reflect the course of phonological development in Malay.

Validation of the Intelligibility in Context Scale as a screening tool for preschoolers in Hong Kong.

The Intelligibility in Context Scale (ICS) is a parent report questionnaire for assessing children's speech intelligibility. The original version was developed in English and was based on Environmental Factors identified within the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). The ICS has been translated into over 30 languages, including Traditional Chinese (ICS-TC). The aims of the current study were to examine the psychometric properties of the ICS-TC with Cantonese-speaking parent--child dyads and to identify speech measures that were more sensitive to the ICS-TC ratings. A total of 72 Cantonese-speaking preschoolers with (n = 39) and without speech sound disorders (SSD; n = 33) were recruited. Native Cantonese-speaking parents completed the ICS-TC independently. The measure showed good internal consistency and test-retest reliability. Correlations with speech performance on the Hong Kong Cantonese Articulation Test (HKCAT), and significant difference in ICS-TC mean scores between the two groups provided preliminary support for the validity of ICS-TC and suggested that ICS-TC can differentiate between children with and without SSD with a large effect size of d = 0.74. The optimal cutoff was estimated using Receiver Operative Characteristic (ROC) curve analysis, giving a sensitivity of 0.70 and specificity of 0.59. ICS-TC mean scores showed a positive correlation with the percentage of initial consonants correct and negative correlation with frequency of atypical errors, and both were moderate in strength. Given the satisfactory psychometric properties of ICS-TC, it may be a valuable clinical tool for screening Cantonese-speaking preschool children's intelligibility.

Validation of an objective assessment tool for velopharyngeal insufficiency in cleft lip and palate children.

The objective of this study is to utilize the Nasometer to objectively assess velopharyngeal competence, specifically through the quantification of nasalance. Initial calibration of the nasometer was conducted on American adults. The objective of this study was to validate the use of the nasometer for the objective diagnosis of velopharyngeal insufficiency (VPI) in French children born with a total cleft lip and palate and to select relevant verbal stimuli for clinical practice. MATERIAL AND METHODS: The nasalance scores of 42 children aged 8 to 10 years old, born with a cleft lip and palate, were collected and compared with 50 control children. The scores were then analyzed in relation to 31 verbal stimuli from the French corpus created for this study (sentences and syllables). The most relevant threshold values were determined by receiver operating characteristic curves, which exhibited the highest sensitivity and specificity. RESULTS: The results demonstrated statistically significant differences (p < 0.05) in the mean nasalance scores of the control and cleft groups for all verbal stimuli containing oral phonemes. Threshold values with good diagnostic accuracy were defined, and 15 verbal stimuli were selected for use in clinical practice. CONCLUSION: The nasalance threshold values defined in this study can be utilized for the objective diagnosis of velopharyngeal insufficiency (VPI) and the subsequent monitoring of French children aged 8 to 10 years old, born with a cleft lip and palate.

Procedures used for assessment of stuttering frequency and stuttering duration.

Frequency of stuttered syllables and their durations were assessed using different procedures. The experiment examined overall syllable counts, counts of stuttered syllables and measures of stutter durations when they were made simultaneously or successively. Samples of speech with associated syllable, stuttered syllable and duration measurements of stuttering events were employed in reference transcriptions. Samples contained a minimum of 200 syllables. Ten participants assessed these samples for syllables, stuttered syllables and duration in an experiment. The responses of these participants were stored in alignment with the speech recordings for analysis. Performance was significantly more accurate (relative to transcriptions) for measures other than duration when the successive procedure was used as opposed to the simultaneous procedure. Although the successive method was more accurate, accuracy of stutter event identification was low for most participants. The procedure that allowed listeners to replay a speech sample and count the syllables, stuttered syllables and durations in three passes yielded more accurate syllable and stuttered syllable counts than procedures that required these judgments to be made in one pass.

A normative-speaker validation study of two indices developed to quantify tongue dorsum activity from midsagittal tongue shapes.

This study reported adult scores on two measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging. One of the measures quantified the extent of tongue dorsum excursion, and the other measure represented the place of maximal excursion. Data from six adult speakers of Scottish Standard English without speech disorders were analyzed. The stimuli included a range of consonants in consonant-vowel sequences, with the vowels /a/ and /i/. The measures reliably distinguished between articulations with and without tongue dorsum excursion, and produced robust results on lingual coarticulation of the consonants. The reported data can be used as a starting point for collecting more typical data and for analyzing disordered speech. The measurements do not require head-to-transducer stabilization. Possible applications of the measures include studying tongue dorsum overuse in people with cleft palate, and typical and disordered development of coarticulation.

Standardization of nasometry for normal Egyptian Arabic speakers.

OBJECTIVE: The aim of this study was to collect the normative values of nasalance for Egyptian Arabic speakers in different age groups, using Arabic speech samples in order to compare patients with disturbed nasality. MATERIAL AND METHODS: This study included 300 normal Egyptian volunteers divided into three groups according to their ages: group I = children (n = 92; age 3 years, 3 months to 9 years), group II = teenagers (n = 76; age 9-18 years) and group III = adults (n = 132; age above 18 years). The Nasometer II 6400 was used for the analysis of speech samples. All subjects were asked to perform four speech tasks that were based on the MacKay-Kummer SNAP Test-R and modified to be applicable to the Arabic language, especially to the Egyptian dialect. RESULTS: The normative values for nasometric assessment in the different age groups were studied. The results demonstrated nasalance score variations according to age and gender. Most of the nasalance score norms of the Egyptian children demonstrated statistically significant differences when compared with the norms of children for the MacKay-Kummer Test-R. CONCLUSION: The Egyptian Arabic SNAP test is an easy, noninvasive and objective procedure that is suitable for all age groups.

Reference data for the American English acoustic vowel space.

Reference data for the acoustic vowel space area (VSA) in children and adolescents do not currently appear to be available in a form suitable for normative comparisons. In the current study, individual speaker formant data for the four corner vowels of American English (/i, u, æ, ɑ/) were used to compute individual speaker VSAs. The sample included 300 children aged 5-18 years and 38 adults aged 25-50 years. Age trends and sex differences were examined and reference data for clinical application were developed. Findings indicated significant declines in VSA with age; sex differences were not fully apparent until late adolescence and adulthood. Implications are discussed.

Electropalatographic specification of Croatian fricatives /s/ and /z/.

Electropalatographic specification of alveolar fricatives in Croatian is aimed at providing speech therapists with normative data about the range of acceptable productions of /s/ and /z/ in adult speakers of Croatian. Four variables were analysed: place of articulation, total contact, groove width and hold phase duration. Intra- and inter-speaker variability for each variable was analysed. Lingual palatal cues for voicing difference were also quantified and discussed. Results show that Croatian /s/ and /z/ are alveolar and not dental as previously reported. The comparison between the voiced and the voiceless fricative shows that durational measures provide the best differentiation. The voiceless counterpart is significantly longer. The difference between voiced and voiceless is also found in the total contact, with /z/ having more contact in the anterior four rows of electrodes, while /s/ has more contact in the posterior four rows of electrodes. This difference is also reflected in the anterior and the posterior groove widths. Possibilities of using these results as normative data for the diagnosis and treatment of atypical articulation of /s/ and /z/ are discussed.

The impact of speech material on speech judgement in children with and without cleft palate.

BACKGROUND: The chosen method of speech assessment, including type of speech material, may affect speech judgement in children with cleft palate. AIM: To assess the effect of different speech materials on speech judgement in 5-year-old children born with or without cleft palate, as well as the reliability of materials by means of intra- and inter-transcriber agreement of consonant transcriptions. METHODS & PROCEDURES: Altogether 40 children were studied, 20 born with cleft palate, 20 without. The children were audio recorded at 5 years of age. Speech materials used were: single-word naming, sentence repetition (both developed for cleft palate speech assessment), retelling of a narrative and conversational speech. The samples were phonetically transcribed and inter- and intra-transcriber agreement was calculated. Percentage correct consonants (PCC), percentage correct places (PCP), percentage correct manners (PCM), and percentage active cleft speech characteristics (CSC) were assessed. In addition, an analysis of phonological simplification processes (PSP) was performed. OUTCOME & RESULTS: The PCC and CSC results were significantly more accurate in word naming than in all other speech materials in the children with cleft palate, who also achieved more accurate PCP results in word naming than in sentence repetition and conversational speech. Regarding PCM and PSP, performance was significantly more accurate in word naming than in conversational speech. Children without cleft palate did better, irrespective of the speech material. The medians of intra- and inter-transcriber agreement were good in both groups and all speech materials. The closest agreement in the cleft palate group was seen in word naming and the weakest in the retelling task. CONCLUSION & IMPLICATIONS: The results indicate that word naming is the most reliable speech material when the purpose is to assess the best speech performance of a child with cleft palate. If the purpose is to assess connected speech, sentence repetition is a reliable and also valid speech material, with good transcriber agreement and equally good articulation accuracy as in retelling and conversational speech. For typically developing children without a cleft palate, the chosen speech material appears not to affect speech judgement.

[Phonological processing in preschool children. Test standardisation]. / Basale phonologische Verarbeitung im Vorschulalter. Normierung eines Tests.

BACKGROUND: We recently proposed test material for the purpose of testing phonological processing. While data regarding validity and reliability could already be established, normative data for preschool children are lacking. MATERIAL AND METHODS: A total of 203 preschool children aged 5.0-5.11 years participated in the study. Low level phonological processing was tested using minimal pairs for both words and non-words (logatoms). The items were chosen with respect to age-appropriate vocabulary, phoneme features, phoneme contrast and phoneme position. RESULTS: Our results indicate that overall test results follow a normal distribution. In contrast, the test subscales exhibited a skew. However, no significant ceiling effect was observed. There were no significant gender differences but differences among mono- versus bilingually raised children. DISCUSSION: As predicted from previous results and calculations our data now confirm a distribution following a Gaussian curve. Thus, one important prerequisite for using this test material for clinical purposes has been met. This material can now be applied for preschool children and individual raw scores may be transformed to percentile ranks. Ceiling effects of individual subscales can be explained by each specific level of difficulty.

Comparison of alternative methods for obtaining severity scores of the speech of people who stutter.

Riley's Stuttering Severity Instrument (SSI) is widely used. The manuals allow SSI assessments to be made in different ways (e.g. from digital recordings or whilst listening to speech live). Digital recordings allow segments to be selected and listened to, whereas the entire recording has to be judged when listened to live. Comparison was made between expert judges when they used these digital and live procedures to establish whether one method was more sensitive and reliable than the other. Five expert judges assessed eight speakers four times each in two judgment conditions (digital vs. live). The eight speakers were chosen so that they spanned a wide range of stuttering severity. SSI version 3 (SSI-3) estimates were obtained on all occasions. An ANOVA showed a three-way interaction between sessions, speakers and condition that indicated that digital and live judgments varied across speakers and across sessions. The predictions that were upheld were (1) SSI-3 scores made from digital segments are more sensitive than SSI-3 scores made on the entire live signal; (2) digital and live judgments vary with respect to speaker's stuttering severity and across test sessions.