Effects of Speech Cues on Acoustics and Intelligibility of Korean-Speaking Children With Cerebral Palsy.

PURPOSE: Reduced speech intelligibility is often a hallmark of children with dysarthria secondary to cerebral palsy (CP), but effects of speech strategies for increasing intelligibility are understudied, especially in children who speak languages other than English. This study examined the effects of (the Korean translation of) two cues, "speak with your big mouth" and "speak with your strong voice," on speech acoustics and intelligibility of Korean-speaking children with CP. METHOD: Fifteen Korean-speaking children with CP repeated words and sentences in habitual, big mouth, and strong voice conditions. Acoustic analyses were performed and intelligibility was assessed by means of 90 blinded listeners' ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC). RESULTS: In response to both cues, children's vocal intensity and utterance duration increased significantly and differentially, whereas their vowel space area gains did not reach statistical significance. EoU increased significantly in the big mouth condition at word, but not sentence, level, whereas in the strong voice condition, EoU increased significantly at both levels. PWC increases were not statistically significant. Considerable variability in children's responses to cues was noted overall. CONCLUSIONS: Korean-speaking children with CP modify their speech styles differentially when provided with cues aimed to increase their articulatory working space and vocal intensity. The results provide preliminary support for the use of the strong voice cue, in particular, to increase EoU. While the findings do not offer conclusive evidence of the intelligibility benefits of these cues, investigation with a larger sample size should provide further insight into optimal cueing strategies for increasing intelligibility in this population. Implications for language-specific versus language-independent treatment approaches are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25521052.

Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria.

Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.

Influence of a standard electropalatography artificial palate upon articulation. A preliminary study.

OBJECTIVE: This study investigated the influence of a standard electropalatography (EPG) palate upon speech articulation in 3 normal speakers under standard EPG testing conditions. PATIENTS AND METHODS: Three adult females aged 26, 31 and 34 years read the experimental phrase 'say CV again' 5 times under 3 experimental conditions: normal speech (without a palate in situ), 45 min after EPG palate insertion and 3 h after EPG palate insertion. Consonants and vowels commonly used in EPG research were studied and included /t/, /s/ and /integral/ in the /i/, /a/ and /u/ vowel environments. Perceptual and acoustic analysis of the data was completed. RESULTS: The results revealed varied patterns of adaptation across the 3 participants. Perceptual analysis suggested that 2 of the participants adapted to the presence of the palate; however, 1 did not. The presence of the palate resulted in significant changes to consonant duration for all 3 participants. Spectrally, production of /t/ was unaffected by the presence of the palate, while articulation of fricatives varied across the participants. CONCLUSION: Paired with a previous study examining the effects of an EPG palate upon speech articulation [McLeod S, Searl J: Am J Speech Lang Pathol 2006;15:192-206], the present data suggest that researchers and clinicians alike should be aware of the potential perturbing effects of the palate.

Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria.

Purpose: Reductions in articulatory working space and vocal intensity have been linked to intelligibility deficits in children with dysarthria due to cerebral palsy. However, few studies have examined the outcomes of behavioral treatments aimed at these underlying impairments or investigated which treatment cues might best facilitate improved intelligibility. This study assessed the effects of cues targeting clear speech (i.e., "Speak with your big mouth") and greater vocal intensity (i.e., "Speak with your strong voice") on acoustic measures of speech production and intelligibility. Method: Eight children with spastic dysarthria due to cerebral palsy repeated sentence- and word-level stimuli across habitual, big mouth, and strong voice conditions. Acoustic analyses were conducted, and 48 listeners completed orthographic transcription and scaled intelligibility ratings. Results: Both cues resulted in significant changes to vocal intensity and speech rate although the degree of change varied by condition. In a similar manner, perceptual analysis revealed significant improvements to intelligibility with both cues; however, at the single-word level, big mouth outperformed strong voice. Conclusion: Children with dysarthria are capable of changing their speech styles differentially in response to cueing. Both the big mouth and strong voice cues hold promise as intervention strategies to improve intelligibility in this population. Supplemental Material: https://doi.org/10.23641/asha.5116843.

Intervention for lateral /s/ using electropalatography (EPG) biofeedback and an intensive motor learning approach: a case report.

BACKGROUND: Visual biofeedback using electropalatography (EPG) has been beneficial in the treatment of some cases of lateral /s/ misarticulation. While EPG intervention is motorically based, studies have not commonly employed a motor learning approach to treatment. Furthermore, treatment success is measured primarily by change to EPG tongue-palate contact patterns and listener ratings conducted by speech-language therapists. Studies have not commonly measured articulatory change without the palate in-situ using acoustic analysis and non-professional listeners. AIMS: To determine if an intensive treatment programme including both visual biofeedback (EPG) and traditional articulation techniques within a motor learning paradigm would result in functional improvement to /s/ articulation in an 11-year-old girl with persistent lateral misarticulation. METHODS & PROCEDURES: Treatment involved 12 sessions of therapist-delivered treatment over 4 weeks followed by a 6-week home programme. Outcomes of the treatment programme were measured primarily using naive listener ratings and acoustic analysis of /s/ spectra. OUTCOMES & RESULTS: Improvements to both the perceptual and spectral characteristics of /s/ articulation occurred following the treatment programme. CONCLUSIONS: The study highlighted the benefit of an intensive approach to intervention incorporating both visual biofeedback and traditional articulation approaches. The inclusion of a 6-week structured home-programme was beneficial and resulted in consolidation of treatment gains.

Acoustic and perceptual analysis of speech adaptation to an artificial palate.

The study investigated adaptation to a standard electropalatographic (EPG) practise palate in a group of eight adults (mean age = 24 years). The participants read the phrase "a CVC" over four sampling conditions: prior to inserting the palate, immediately following insertion of the palate, 45 minutes after palate insertion, and 3 hours after insertion of the palate. Perceptual and acoustic analyses were conducted on the initial CV portion of the stimuli. Consonants examined included: /t/, /k/, /s/, and // followed by the /i/, /a/, and /u/ vowels. Results revealed that individuals within the group were able to adapt their speech articulation to compensate for the presence of the artificial palate. Perceptually, mild consonant imprecision was observed upon insertion of the palate; however, this resolved following 45 minutes to 3 hours of adaptation. Acoustic findings indicated that the palate did not affect segment durations or vowel formant frequencies. However, a significant reduction in M1 for /s/ persisted across the sampling periods. Overall, the results suggest that a period of between 45 minutes and 3 hours of adaptation is generally suitable for participation in EPG studies.

Speech production in Parkinson's disease: I. An electropalatographic investigation of tongue-palate contact patterns.

Previous studies have indicated that consonant imprecision in Parkinson's disease (PD) may result from a reduction in amplitude of lingual movements or articulatory undershoot. While this has been postulated, direct measurement of the tongue's contact with the hard palate during speech production has not been undertaken. Therefore, the present study aimed to use electropalatography (EPG) to determine the exact nature of tongue-palate contact in a group of individuals with PD and consonant imprecision (n = 9). Furthermore, the current investigation also aimed to compare the results of the participants with PD to a group of aged (n = 7) and young (n = 8) control speakers to determine the relative contribution of ageing of the lingual musculature to any articulatory deficits noted. Participants were required to read aloud the phrase 'I saw a _ today' with the artificial palate in-situ. Target words included the consonants /l/, /s/ and /t/ in initial position in both the /i/ and /a/ vowel environments. Phonetic transcription of phoneme productions and description of error types was completed. Furthermore, representative frames of contact were employed to describe the features of tongue-palate contact and to calculate spatial palatal indices. Results of the perceptual investigation revealed that perceived undershooting of articulatory targets distinguished the participant group with PD from the control groups. However, objective EPG assessment indicated that undershooting of the target consonant was not the cause of the perceived articulatory errors. It is, therefore, possible that reduced pressure of tongue contact with the hard palate, sub-lingual deficits or impaired articulatory timing resulted in the perceived undershooting of the target consonants.