Assessment of Intelligibility in Children with Velopharyngeal Insufficiency: The Relationship between Intelligibility in Context Scale and Experimental Measures.

PURPOSE: The purpose of this study was to investigate the clinical application of the Intelligibility in Context Scale (ICS) instrument in children with velopharyngeal insufficiency (VPI). This study investigated the relationship between clinical speech outcomes and parental reports of speech intelligibility across various communicative partners. METHODS: The ICS was completed by the parents of 20 English-speaking children aged 4-12 years diagnosed with VPI. The parents were asked to rate their children's speech intelligibility across communication partners using a 5-point scale. Clinical metrics obtained using standard clinical transcription on the Picture-Cued SNAP-R Test were: (1) percentage of consonants correct (PCC), (2) percentage of vowels correct (PVC), and (3) percentage of phonemes correct (PPC). Nasalance from nasometer data was included as an indirect measure of nasality. Intelligibility scores obtained from naive listener's transcriptions and speech-language pathologists' (SLP) ratings were compared with the ICS results. RESULT: Greater PCC, PPC, PVC, and transcription-based intelligibility values were significantly associated with higher ICS values, respectively (r[20] = 0.84, 0.82, 0.51, and 0.70, respectively; p < 0.05 in all cases). There was a negative and significant correlation between ICS mean scores and SLP ratings of intelligibility (r = -0.74; p < 0.001). There was no significant correlation between ICS values and nasalance scores (r[20] = -0.28; p = 0.22). CONCLUSION: The high correlations obtained between the ICS with PCC and PPC measures indicate that articulation accuracy has had a great impact on parents' decision-making regarding intelligibility in this population. Significant agreement among ICS scores with naive listener transcriptions and clinical ratings supports use of the ICS in practice.

Speech exemplar and evaluation database (SEED) for clinical training in articulatory phonetics and speech science.

One challenge faced by teachers of phonetics, speech science, and clinical speech disorders courses is providing meaningful instruction that closes the theory to practice gap. One barrier to providing this type of deep learning experience is the lack of publicly available examples of speech recordings that illustrate comparisons between typical and disordered speech production across a broad range of disorder populations. Data of this type exist, but are typically collected for specific research projects under narrowly written IRB protocols that do not allow for release of even de-identified speech recordings to other investigators or teachers. As a partial corrective to this problem, we have developed an approved publicly available database of speech recordings that provides illustrative examples of adult and child speech production from individuals with and without speech disorders. The recorded speech materials were designed to illustrate important clinical concepts, and the recordings were collected under controlled conditions using high-quality equipment. The ultimate goal of creating this corpus is to improve practitioners' and scientists' understanding of the scientific bases of knowledge in our profession and improve our ability to develop clinical scientists and young researchers in the field.

Modelling category goodness judgments in children with residual sound errors.

This study investigates category goodness judgments of /r/ in adults and children with and without residual speech errors (RSEs) using natural speech stimuli. Thirty adults, 38 children with RSE (ages 7-16) and 35 age-matched typically developing (TD) children provided category goodness judgments on whole words, recorded from 27 child speakers, with /r/ in various phonetic environments. The salient acoustic property of /r/ - the lowered third formant (F3) - was normalized in two ways. A logistic mixed-effect model quantified the relationships between listeners' responses and the third formant frequency, vowel context and clinical group status. Goodness judgments from the adult group showed a statistically significant interaction with the F3 parameter when compared to both child groups (p < 0.001) using both normalization methods. The RSE group did not differ significantly from the TD group in judgments of /r/. All listeners were significantly more likely to judge /r/ as correct in a front-vowel context. Our results suggest that normalized /r/ F3 is a statistically significant predictor of category goodness judgments for both adults and children, but children do not appear to make adult-like judgments. Category goodness judgments do not have a clear relationship with /r/ production abilities in children with RSE. These findings may have implications for clinical activities that include category goodness judgments in natural speech, especially for recorded productions.

Tongue Part Movement Trajectories for /r/ Using Ultrasound.

PURPOSE: Because it shows the movement of different parts of the tongue in real time, ultrasound biofeedback therapy is a promising technology for speech research and remediation. One limitation is the difficulty of interpreting real-time ultrasound images of tongue motion. Our image processing system, TonguePART, tracks the tongue surface and allows for the acquisition of quantitative tongue part trajectories. METHOD: TonguePART automatically identifies the tongue contour based on ultrasound image brightness and tracks motion of the tongue root, dorsum, and blade in real time. We present tongue part trajectory data from 2 children with residual sound errors on /r/ and 2 children with typical speech, focusing on /r/ (International Phonetic Alphabet ɹ) in the phonetic context /ɑr/. We compared the tongue trajectories to magnetic resonance images of sustained vowel /ɑ/ and /r/. RESULTS: Measured trajectories show larger overall displacement and greater differentiation of tongue part movements for children with typical speech during the production of /ɑr/, compared to children with residual speech sound disorders. CONCLUSION: TonguePART is a fast, reliable method of tracking articulatory movement of tongue parts for syllables such as /ɑr/. It is extensible to other sounds and phonetic contexts. By tracking tongue parts, clinical researchers can investigate lingual coordination. TonguePART is suitable for real-time data collection and biofeedback. Ultrasound biofeedback therapy users may make more progress using simplified biofeedback of tongue movement.

Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors.

Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging structures internal to the body. There has been a recent increase in the use of ultrasound technology to visualize the shape and movements of the tongue during speech, both in typical speakers and in clinical populations. Ultrasound imaging of speech has greatly expanded our understanding of how sounds articulated with the tongue (lingual sounds) are produced. Such information can be particularly valuable for speech-language pathologists. Among other advantages, ultrasound images can be used during speech therapy to provide (1) illustrative models of typical (i.e. "correct") tongue configurations for speech sounds, and (2) a source of insight into the articulatory nature of deviant productions. The images can also be used as an additional source of feedback for clinical populations learning to distinguish their better productions from their incorrect productions, en route to establishing more effective articulatory habits. Ultrasound feedback is increasingly used by scientists and clinicians as both the expertise of the users increases and as the expense of the equipment declines. In this tutorial, procedures are presented for collecting ultrasound images of the tongue in a clinical context. We illustrate these procedures in an extended example featuring one common error sound, American English /r/. Images of correct and distorted /r/ are used to demonstrate (1) how to interpret ultrasound images, (2) how to assess tongue shape during production of speech sounds, (3), how to categorize tongue shape errors, and (4), how to provide visual feedback to elicit a more appropriate and functional tongue shape. We present a sample protocol for using real-time ultrasound images of the tongue for visual feedback to remediate speech sound errors. Additionally, example data are shown to illustrate outcomes with the procedure.

Acquiring rhoticity across languages: An ultrasound study of differentiating tongue movements.

Rhotics in many languages develop late and show clinically significant misarticulations. The English approximant and Spanish trill rhotics exhibit both a primary constriction along the palate and a secondary constriction in the pharynx. We speculate that the secondary constriction might be a cross-linguistic characteristic of rhotics and thus potentially a factor in delayed articulatory development/misarticulations. We describe an exploratory study analyzing rhotic tongue configurations in ultrasound videos from a small sample of native adult speakers of English, Malayalam, French, Persian and Spanish. Our findings confirm that rhotic sounds most subject to late development also involve tongue root movement towards a pharyngeal constriction, but this conclusion must remain tentative without further research. In the meantime, clinical strategies that include attention to primary and secondary constrictions should be explored for remediation of rhotic misarticulations across languages.

The Articulatory Phonetics of /r/ for Residual Speech Errors.

Effective treatment for children with residual speech errors (RSEs) requires in-depth knowledge of articulatory phonetics, but this level of detail may not be provided as part of typical clinical coursework. At a time when new imaging technologies such as ultrasound continue to inform our clinical understanding of speech disorders, incorporating contemporary work in the basic articulatory sciences into clinical training becomes especially important. This is particularly the case for the speech sound most likely to persist among children with RSEs-the North American English rhotic sound, /r/. The goal of this article is to review important information about articulatory phonetics as it affects children with RSE who present with /r/ production difficulties. The data presented are largely drawn from ultrasound and magnetic resonance imaging studies. This information will be placed in a clinical context by comparing productions of typical adult speakers to successful versus misarticulated productions of two children with persistent /r/ difficulties.

Acoustic noise characteristics of a 4 Telsa MRI scanner.

PURPOSE: To quantify the acoustic noise characteristics of a 4 Tesla MRI scanner, and determine the effects of structural acoustics and gradient pulse excitations on the sound field so that feasible noise control measures can be developed. MATERIALS AND METHODS: Acoustic noise emissions were measured in the ear and mouth locations of a typical adult. The sound pressure measurements were acquired simultaneously with the electrical current signals of the gradient pulses. Two forms of gradient waveforms (impulsive and operating pulses) were studied. RESULTS: The sound pressure levels (SPLs) emitted by the MRI scanner operating in echo-planar imaging (EPI) mode were in the range of 120-130 decibels. Three types of sound pressure responses were observed in the EPI sequences: 1) harmonic, 2) nonharmonic, and 3) broadband. The frequency-encoding gradient pulses were the most dominant and produced generally odd-number harmonics and nonharmonics. The phase-encoding gradient pulses generated mostly even-number harmonics, and the slice-selection gradient pulses produced primarily a broadband spectrum. CONCLUSION: The operating condition acoustic spectrum can be predicted from the magnet-structural acoustic transfer functions, which are independent of imaging sequences. This finding is encouraging because it shows that it is possible to treat such noises with an active noise control application.