Comparison of In-Person and Online Recordings in the Clinical Teleassessment of Speech Production: A Pilot Study.

In certain circumstances, speech and language therapy is proposed in telepractice as a practical alternative to in-person services. However, little is known about the minimum quality requirements of recordings in the teleassessment of motor speech disorders (MSD) utilizing validated tools. The aim here is to examine the comparability of offline analyses based on speech samples acquired from three sources: (1) in-person recordings with high quality material, serving as the baseline/gold standard; (2) in-person recordings with standard equipment; (3) online recordings from videoconferencing. Speech samples were recorded simultaneously from these three sources in fifteen neurotypical speakers performing a screening battery of MSD and analyzed by three speech and language therapists. Intersource and interrater agreements were estimated with intraclass correlation coefficients on seventeen perceptual and acoustic parameters. While the interrater agreement was excellent for most speech parameters, especially on high quality in-person recordings, it decreased in online recordings. The intersource agreement was excellent for speech rate and mean fundamental frequency measures when comparing high quality in-person recordings to the other conditions. The intersource agreement was poor for voice parameters, but also for perceptual measures of intelligibility and articulation. Clinicians who plan to teleassess MSD should adapt their recording setting to the parameters they want to reliably interpret.

Differentiation of Motor Speech Disorders through the Seven Deviance Scores from MonPaGe-2.0.s.

For the clinical assessment of motor speech disorders (MSDs) in French, the MonPaGe-2.0.s protocol has been shown to be sensitive enough to diagnose mild MSD based on a combination of acoustic and perceptive scores. Here, we go a step further by investigating whether these scores-which capture deviance on intelligibility, articulation, voice, speech rate, maximum phonation time, prosody, diadochokinetic rate-contribute to the differential diagnosis of MSDs. To this aim, we trained decision trees for two-class automatic classification of different pairs of MSD subtypes based on seven deviance scores that are computed in MonPaGe-2.0.s against matched normative data. We included 60 speakers with mild to moderate MSD from six neuropathologies (amyotrophic lateral sclerosis, Wilson, Parkinson and Kennedy disease, spinocerebellar ataxia, post-stroke apraxia of speech). The two-class classifications relied mainly on deviance scores from four speech dimensions and predicted with over 85% accuracy the patient's correct clinical category for ataxic, hypokinetic and flaccid dysarthria; classification of the other groups (apraxia of speech and mixed dysarthria) was slightly lower (79% to 82%). Although not perfect and only tested on small cohorts so far, the classification with deviance scores based on clinically informed features seems promising for MSD assessment and classification.

Contribution of acoustic analysis to the detection of vocoid epenthesis in apraxia of speech and other motor speech disorders.

Background: Vocoid epenthesis within consonant clusters has been claimed to contribute to the diagnosis of apraxia of speech. In clinical practice, the clinicians often doubt about the correct production of clusters as the C-C transition may be minimally disrupted. Aims: To demonstrate the value of acoustic analysis in clinical practice as a reliable complement to perceptive judgment. Methods & Procedures: We compared the acoustic signature and the perceptive detection of vocoid epentheses in unvoiced consonant clusters within pseudo-words produced by 40 participants presenting different subtypes of motor speech disorders (including apraxia of speech (AoS) and dysarthria) and matched neurotypical controls. Outcomes & Results: The results indicate that vocoid epenthesis was acoustically visible in 3 out of 10 participants with AoS, and in one out of 30 participants with dysarthria. One-quarter of these vocoid epentheses was not detected via auditory perception by expert listeners (speech and language therapists) who also made false detections. Conclusions: The current results indicate that vocoid epenthesis is not systematic at least in mild AoS. Moreover, an important proportion is misdetected by ear, even by expert clinicians, meaning that visualisation of the acoustic signal can be of precious help.

Acoustic Change Over Time in Spastic and/or Flaccid Dysarthria in Motor Neuron Diseases.

PURPOSE: This study aims to investigate acoustic change over time as biomarkers to differentiate among spastic-flaccid dysarthria associated with amyotrophic lateral sclerosis (ALS), spastic dysarthria associated with primary lateral sclerosis (PLS), flaccid dysarthria associated with spinal and bulbar muscular atrophy (SBMA), and to explore how these acoustic parameters are affected by dysarthria severity. METHOD: Thirty-three ALS patients with mixed flaccid-spastic dysarthria, 17 PLS patients with pure spastic dysarthria, 18 SBMA patients with pure flaccid dysarthria, and 70 controls, all French speakers, were included in the study. Speakers produced vowel-glide sequences targeting different vocal tract shape changes. The mean and coefficient of variation of the total squared change of mel frequency cepstral coefficients were used to capture the degree and variability of acoustic changes linked to vocal tract modifications over time. Differences in duration of acoustic events were also measured. RESULTS: All pathological groups showed significantly less acoustic change compared to controls, reflecting less acoustic contrast in sequences. Spastic and mixed spastic-flaccid dysarthric speakers showed smaller acoustic changes and slower sequence production compared to flaccid dysarthria. For dysarthria subtypes associated with a spastic component, reduced degree of acoustic change was also associated with dysarthria severity. CONCLUSIONS: The acoustic parameters partially differentiated among the dysarthria subtypes in relation to motor neuron diseases. While similar acoustic patterns were found in spastic-flaccid and spastic dysarthria, crucial differences were found between these two subtypes relating to variability. The acoustic patterns were much more variable in ALS. This method forms a promising clinical tool as a diagnostic marker of articulatory impairment, even at mild stage of dysarthria progression in all subtypes.

Sensitivity and specificity of an acoustic- and perceptual-based tool for assessing motor speech disorders in French: the MonPaGe-screening protocol.

To respond to the need of objective screening tools for motor speech disorders (MSD), we present the screening version of a speech assessment protocol (MonPaGe-2.0.s), which is based on semi-automated acoustic and perceptual measures on several speech dimensions in French. We validate the screening tool by testing its sensitivity and specificity and comparing its outcome with external standard assessment tools. The data from 80 patients diagnosed with different types of mild to moderate MSD and 62 healthy test controls were assessed against the normative data obtained on 404 neurotypical speakers, with Deviance Scores computed on seven speech dimensions (voice, speech rate, articulation, prosody, pneumophonatory control, diadochokinetic rate, intelligibility) based on acoustic and perceptual measures. A cut-off of the MonPaGe total deviance score (TotDevS) >2 allowed MSD to be diagnosed with specificity of 95% and an overall sensitivity of 83.8% on all patients pulled, reaching 91% when very mildly impaired patients were excluded. A strong correlation was found between the MonPaGe TotDevS and an external composite perceptual score of MSD provided by six experts. The MonPaGe screening protocol has proven its sensitivity and specificity for diagnosing presence and severity of MSD. Further implementations are needed to complement the characterization of impaired dimensions in order to distinguish subtypes of MSD.

Effect of Domain Initial Strengthening on Vowel Height and Backness Contrasts in French: Acoustic and Ultrasound Data.

Purpose: Phonetic variation due to domain initial strengthening was investigated with respect to the acoustic and articulatory distinctiveness of vowels within a subset of the French oral vowel system /i, e, ɛ, a, o, u/, organized along 4 degrees of height for the front vowels and 2 degrees of backness at the close and midclose height levels. Method: Acoustic and lingual ultrasound data were examined to characterize the production of vowels in intonational phrase initial position, compared with intonational phrase medial position, for 4 speakers. Results: Formant values and estimates of lingual constriction location and degree differed according to the prosodic position independent of vowel duration, with a higher F1 for /a/, a higher F2 for /ɛ/, a backer constriction for /o/ and /a/ but a fronter constriction for /ɛ/, and a narrower constriction for /e, ɛ, u, o/ but a wider constriction for /a/. For most speakers, these variations enlarge the acoustic and/or articulatory distance between members of the pairs /e-ɛ/, /ɛ-a/, /u-o/, /i-u/, and /e-o/ but reduce the distinction within the pair /i-e/. Conclusions: These changes in intonational phrase initial position are vowel dependent and frequently contribute to augmenting the phonetic distinctiveness between vowels contrasting along the height and backness dimensions.

Speech production after glossectomy: methodological aspects.

This article focuses on methodological issues related to quantitative assessments of speech quality after glossectomy. Acoustic and articulatory data were collected for 8 consonants from two patients. The acoustic analysis is based on spectral moments and the Klatt VOT. Lingual movements are recorded with ultrasound without calibration. The variations of acoustic and articulatory parameters across pre- and post-surgery conditions are analyzed in the light of perceptual evaluations of the stimuli. A parameter is considered to be relevant if its variation is congruent with perceptual ratings. The most relevant acoustic parameters are the skewness and the Center of Gravity. The Klatt VOT explains differences that could not be explained by spectral parameters. The SNTS ultrasound parameter provides information to describe impairments not accounted for by acoustical parameters. These results suggest that the combination of articulatory, perceptual and acoustic data provides comprehensive complementary information for a quantitative assessment of speech after glossectomy.

What affects the presence versus absence of schwa and its duration: a corpus analysis of French connected speech.

This study presents an analysis of over 4000 tokens of words produced as variants with and without schwa in a French corpus of radio-broadcasted speech. In order to determine which of the many variables mentioned in the literature influence variant choice, 17 predictors were tested in the same analysis. Only five of these variables appeared to condition variant choice. The question of the processing stage, or locus, of this alternation process is also addressed in a comparison of the variables that predict variant choice with the variables that predict the acoustic duration of schwa in variants with schwa. Only two variables predicting variant choice also predict schwa duration. The limited overlap between the predictors for variant choice and for schwa duration, combined with the nature of these variables, suggest that the variants without schwa do not result from a phonetic process of reduction; that is, they are not the endpoint of gradient schwa shortening. Rather, these variants are generated early in the production process, either during phonological encoding or word-form retrieval. These results, based on naturally produced speech, provide a useful complement to on-line production experiments using artificial speech tasks.