Crowdsourced Perceptual Ratings of Voice Quality in People With Parkinson's Disease Before and After Intensive Voice and Articulation Therapies: Secondary Outcome of a Randomized Controlled Trial.

PURPOSE: Limited research has examined the suitability of crowdsourced ratings to measure treatment effects in speakers with Parkinson's disease (PD), particularly for constructs such as voice quality. This study obtained measures of reliability and validity for crowdsourced listeners' ratings of voice quality in speech samples from a published study. We also investigated whether aggregated listener ratings would replicate the original study's findings of treatment effects based on the Acoustic Voice Quality Index (AVQI) measure. METHOD: This study reports a secondary outcome measure of a randomized controlled trial with speakers with dysarthria associated with PD, including two active comparators (Lee Silverman Voice Treatment [LSVT LOUD] and LSVT ARTIC), an inactive comparator (untreated PD), and a healthy control group. Speech samples from three time points (pretreatment, posttreatment, and 6-month follow-up) were presented in random order for rating as "typical" or "atypical" with respect to voice quality. Untrained listeners were recruited through the Amazon Mechanical Turk crowdsourcing platform until each sample had at least 25 ratings. RESULTS: Intrarater reliability for tokens presented repeatedly was substantial (Cohen's κ = .65-.70), and interrater agreement significantly exceeded chance level. There was a significant correlation of moderate magnitude between the AVQI and the proportion of listeners classifying a given sample as "typical." Consistent with the original study, we found a significant interaction between group and time point, with the LSVT LOUD group alone showing significantly higher perceptually rated voice quality at posttreatment and follow-up relative to the pretreatment time point. CONCLUSIONS: These results suggest that crowdsourcing can be a valid means to evaluate clinical speech samples, even for less familiar constructs such as voice quality. The findings also replicate the results of the study by Moya-Galé et al. (2022) and support their functional relevance by demonstrating that the effects of treatment measured acoustically in that study are perceptually apparent to everyday listeners.

Using Crowdsourced Listeners' Ratings to Measure Speech Changes in Hypokinetic Dysarthria: A Proof-of-Concept Study.

Purpose Interventions for speech disorders aim to produce changes that are not only acoustically measurable or perceptible to trained professionals but are also apparent to naive listeners. Due to challenges associated with obtaining ratings from suitably large listener samples, however, few studies currently evaluate speech interventions by this criterion. Online crowdsourcing technologies could enhance the measurement of intervention effects by making it easier to obtain real-world listeners' ratings. Method Stimuli, drawn from a published study by Sapir et al. ("Effects of intensive voice treatment (Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson disease: Acoustic and perceptual findings" in Journal of Speech, Language, and Hearing Research, 50(4), 2007), were words produced by individuals who received intensive treatment (LSVT LOUD) for hypokinetic dysarthria secondary to Parkinson's disease. Thirty-six online naive listeners heard randomly ordered pairs of words elicited pre- and posttreatment and reported which they perceived as "more clearly articulated." Results Mixed-effects logistic regression indicated that words elicited posttreatment were significantly more likely to be rated "more clear." Across individuals, acoustically measured magnitude of change was significantly correlated with pre-post difference in listener ratings. Conclusions These results partly replicate the findings of Sapir et al. (2007) and demonstrate that their acoustically measured changes are detectable by everyday listeners. This supports the viability of using crowdsourcing to obtain more functionally relevant measures of change in clinical speech samples. Supplemental Material https://doi.org/10.23641/asha.12170112.

The impact of extended voice use on the acoustic characteristics of phonation after training and performance of actors from the La MaMa Experimental Theater club.

PURPOSES: To test the hypothesis that extensive use of La MaMa vocal technique may result in symptoms of vocal abuse, an evaluation of the acoustic and perceptual characteristics of voice for eight performers from the Great Jones Repertory Company of the La MaMa Experimental Theater was conducted. This vocal technique includes wide ranges of frequency from 46 to 2003 Hz and vocal intensity that is sustained at 90-108 dB sound pressure level with a mouth-to-microphone distance of 30 cm for 3-4 hours per performance. METHODS: The actors rehearsed for 4 hours per day, 5 days per week for 14 weeks before the series of performances. Thirty-nine performances were presented in 6 weeks. Three pretraining, three posttraining, and two postperformance series data collection sessions were carried out for each performer. Speech samples were gathered using the CSL 4500 and analyzed using Real-Time Pitch program and Multidimensional Voice Program. Acoustic analysis was performed on 48 tokens of sustained vowel phonation for each subject. Statistical analysis was performed using the Friedman test of related samples. Perceptual analysis included professional listeners rating voice quality in pretraining, posttraining, and postperformance samples of the Rainbow Passage and sample lines from the plays. RESULTS: The majority of professional listeners (11/12) judged that this technique would result in symptoms of vocal abuse; however, acoustic data revealed statistically stable or improved measurements for all subjects in most dependent acoustic variables when compared with both posttraining and postperformance trials. CONCLUSION: These findings add support to the notion that a technique that may be perceived as vocally abusive, generating 90-100 dB sound pressure level and sustained over 6 weeks of performances, actually resulted in improved vocal strength and flexibility.

Speech treatment for Parkinson's disease.

Researchers estimate that 89% of people with Parkinson's disease (PD) have a speech or voice disorder including disorders of laryngeal, respiratory, and articulatory function. Despite the high incidence of speech and voice impairment, studies suggest that only 3-4% of people with PD receive speech treatment. The authors review the literature on the characteristics and features of speech and voice disorders in people with PD, the types of treatment techniques available, including medical, surgical, and behavioral therapies, and provide recommendations for the current efficacy of treatment interventions and directions of future research.

Fragments of a Greek Trilogy: impact on phonation.

This study documents the vocal characteristics of an actor before and after a series of eight performances involving extended voice use. The hypothesis was that this type of extended voice use would result in symptoms of vocal abuse and that damage to the actor's voice would be evident in measures made after the performance series. Three pre-performance and three post-performance speech samples were gathered and analyzed using the CSL and Visipitch II. Measurements taken included maximum phonational range; maximum sustained phonation; fundamental frequency during reading; maximum intensity levels; sound pressure levels for soft, moderate, and loud productions of sustained /a/; and perturbation including jitter, shimmer, harmonics-to-noise ratio, and an s/z ratio. Pre- and post-performance samples of the "Rainbow passage" and sustained vowel phonation were rated by a group of blinded listeners that included professional voice trainers and speech pathologists. In addition, sample lines from the performance were played for the listeners to judge whether this technique would result in symptoms of vocal abuse. Eleven out of 12 professional voice trainers rated that this technique would result in symptoms of vocal abuse. The data revealed post-performance improvement in phonational range, maximum intensity levels, perturbation measures, and s/z ratio. Measures of maximum sustained phonation, fundamental frequency, and sound pressure levels remained stable. Videoendoscopy revealed normal function of the larynx and vocal folds.

Parkinson's disease: speech and voice disorders and their treatment with the Lee Silverman Voice Treatment.

Speech and voice disorders are very common among individuals suffering from idiopathic Parkinson's disease. In this article we review evidence for laryngeal, respiratory, articulatory, and velopharyngeal disorders in this population. We present the essential concepts and outcome data for the Lee Silverman Voice Treatment, a behavioral treatment program that has yielded significant long-term improvement in speech and voice functions in individuals with idiopathic Parkinson's disease.