Healthcare professionals' perspectives on development of assistive technology using the comprehensive assistive technology model.

The implementation of technology in healthcare shows promising results and provides new opportunities in rehabilitation. However, the adoption of technology into daily care is largely dependent on the acceptance rate of end-users. This study aims to gather information from healthcare professionals on the development of new assistive technology that match users' needs using the Comprehensive Assistive Technology model. In total 27 healthcare professionals (12 occupational therapists, 8 physiotherapists, 3 nurses, 2 allied health directors, a physician and a speech therapist) attended one of four online focus group discussions. These focus group discussions were structured using a question guide based on three predefined scenarios. Recordings were transcribed and data was analyzed using a thematic analysis (NVivo). Major themes identified in this study were safety, price and usability. Healthcare professionals focused on both functional capabilities of the user, as well as behavioral aspects of usability and attitude toward technology. Furthermore, the need for assistive technology that were catered toward the limitations in activity and user experience, was highlighted extensively. Based on information gathered from healthcare professionals a user-centered approach in development of safe, low-cost devices that maximize both functional outcomes and user acceptance, could potentially increase the adoption of new technology in rehabilitation.

Language-independent automatic evaluation of intelligibility of chronically hoarse persons.

OBJECTIVE: Automatic intelligibility assessment using automatic speech recognition is usually language specific. In this study, a language-independent approach is proposed. It uses models that are trained with Flemish speech, and it is applied to assess chronically hoarse German speakers. The research questions are here: is it possible to construct suitable acoustic features that generalize to other languages and a speech disorder, and is the generated model for intelligibility also suitable for specific subtypes of that disorder, i.e. functional and organic dysphonia? PATIENTS AND METHODS: 73 German-speaking persons with chronic hoarseness read the text 'Der Nordwind und die Sonne'. Perceptual intelligibility scores were used as ground truth during the training of an automatic model that converts speaker level acoustic measurements into intelligibility scores. Cross-validation is used to assess model performance. RESULTS: The interrater agreement for all patients (n = 73) and for the functional and organic dysphonia subgroups (n = 45 and n = 24) are r = 0.82, r = 0.83 and r = 0.75, respectively. The automatic assessment based on phonologically based acoustic models revealed correlations between perceptual and automatic intelligibility ratings of r = 0.79 (all patients), r = 0.78 (functional dysphonia) and r = 0.80 (organic dysphonia). CONCLUSION: The automatic, objective measurement of intelligibility is a valuable instrument in an evidence-based clinical practice.

Speech technology-based assessment of phoneme intelligibility in dysarthria.

BACKGROUND: Currently, clinicians mainly rely on perceptual judgements to assess intelligibility of dysarthric speech. Although often highly reliable, this procedure is subjective with a lot of intrinsic variables. Therefore, certain benefits can be expected from a speech technology-based intelligibility assessment. Previous attempts to develop an automated intelligibility assessment mainly relied on automatic speech recognition (ASR) systems that were trained to recognize the speech of persons without known impairments. In this paper automatic speech alignment (ASA) systems are used instead. In addition, previous attempts only made use of phonemic features (PMF). However, since articulation is an important contributing factor to intelligibility of dysarthric speech and since phonological features (PLF) are shared by multiple phonemes, phonological features may be more appropriate to characterize and identify dysarthric phonemes. AIMS: To investigate the reliability of objective phoneme intelligibility scores obtained by three types of intelligibility models: models using only phonemic features (yielded by an automated speech aligner) (PMF models), models using only phonological features (PLF models), and models using a combination of phonemic and phonological features (PMF + PLF models). METHODS & PROCEDURES: Correlations were calculated between the objective phoneme intelligibility scores of 60 dysarthric speakers and the corresponding perceptual phoneme intelligibility scores obtained by a standardized perceptual phoneme intelligibility assessment. OUTCOMES & RESULTS: The correlations between the objective and perceptual intelligibility scores range from 0.793 for the PMF models, over 0.828 for PLF models to 0.943 for PMF + PLF models. The features selected to obtain such high correlations can be divided into six main subgroups: (1) vowel-related phonemic and phonological features, (2) lateral-related features, (3) silence-related features, (4) fricative-related features, (5) velar-related features and (6) plosive-related features. CONCLUSIONS & IMPLICATIONS: The phoneme intelligibility scores of dysarthric speakers obtained by the three investigated intelligibility model types are reliable. The highest correlation between the perceptual and objective intelligibility scores was found for models combining phonemic and phonological features. The intelligibility scoring system is now ready to be implemented in a clinical tool.