[Analysis of neuropsychological development characteristics and influencing factors in children with speech sound disorder].

Objective: Exploring the neuropsychological developmental characteristics and influencing factors of children with speech disorder. Methods: A case-control study was conducted. A total of 395 children diagnosed with speech disorders were selected as speech sound disorder (SSD) group from January 2019 to September 2021 in the speech-speech outpatient department of the Children's Hospital Affiliated to Capital Institute of Pediatrics, and 1 179 healthy children who underwent physical examination in the health department during the same period were selected as the control group. All the children were examined by the "Children's Neuropsychological Behavior Scale 2016 Edition" (Children's Mind Scale 2016 edition). Independent sample t test was used to compare the developmental levels of the two groups of children, including total developmental quotient, gross motor, fine motor, adaptive ability, language and social behavior ability. The influential factors of children's speech disorders were analyzed by univariate Chi-square analysis and multivariate logistic regression. Results: There were 395 SSD children, including 296 males and 99 females, 4≤ age ≤6, (4.71±0.76) years. There were 1 179 children in the control group, including 864 males and 315 females, 4≤ age ≤6, (4.64±0.78) years. The mean value of total developmental factors in SSD group was lower than that in control group [(86.45±11.57)/(91.24±8.0), t=-7.78, P<0.01], and the mean values of total developmental markers in both boys and girls in SSD group were lower than those in control group [(86.00±11.40)/(90.78±7.86), t=-6.70, P<0.01; (87.82±12.03)/(92.87±8.49), t=-3.88, P<0.01]. The mean values of gross motor, fine motor, adaptive ability, language ability and social behavior in SSD group were lower than those in control group [(89.76±12.47)/(92.01±10.69), t=-3.21, P<0.01; (80.62±13.64)/(84.49±11.55), t=-5.06, P<0.01; (87.92±15.25)/(92.98±12.06), t=-6.00, P<0.01; (86.48±16.30)/(94.55±12.08), t=-9.04, P<0.01; (87.02±15.18)/(92.63±12.57), t=-6.62, P<0.01]; The mean value of fine motor in boys was lower than that in girls in SSD group [(79.80±13.42)/(83.08±14.05), t=-2.08, P<0.05]. Independent mealtimes. 2 years old (OR=1.527, 95%CI: 1.180-1.977, P=0.001), delay in adding supplemental food (OR=1.510, 95%CI: 1.123-2.029, P=0.006), dialect in the home language environment (OR=1.351, 95%CI: 1.060-1.723, P=0.015) were risk factors for children with speech disorders. Conclusion: Children with speech disorders are more common in boys. The overall development level of SSD children is lower than that of normal children, and the fine motor of SSD boys is lower than that of girls. The incidence of children's speech disorders is related to the addition time of supplementary food, independent meal time and family language environment.

[A tool to assess functional communication skills and its correspondence with traditional language testing in patients with brain tumors]. / Instrument izmereniya funktsional'nykh kommunikativnykh navykov i sopostavlenie ego s traditsionnym rechevym testirovaniem u patsientov s opukholyami golovnogo mozga.

OBJECTIVE: To identify the relationship between speech impairment as measured by the Russian Aphasia Test (RAT) and functional communication as assessed by the Communicative Effectiveness Index (CETI). MATERIAL AND METHODS: RAT and CETI were administered to 87 patients at two time points, before surgery and in 3 months after brain tumor resection surgery. RESULTS: There were significant correlations between CETI and the total scores on RAT subtests for speech comprehension and production before surgery but not in the follow-up period. CONCLUSION: The present research is the first to present the Russian version of CETI and to confirm the relationship between speech disorders measured by the comprehensive standardized battery for evaluating speech function RAT and functional communication as measured by CETI.

Comorbidity and Severity in Childhood Apraxia of Speech: A Retrospective Chart Review.

PURPOSE: The purpose of this study was to investigate comorbidity prevalence and patterns in childhood apraxia of speech (CAS) and their relationship to severity. METHOD: In this retroactive cross-sectional study, medical records for 375 children with CAS (M age = 4;9 [years;months], SD = 2;9) were examined for comorbid conditions. The total number of comorbid conditions and the number of communication-related comorbidities were regressed on CAS severity as rated by speech-language pathologists during diagnosis. The relationship between CAS severity and the presence of four common comorbid conditions was also examined using ordinal or multinomial regressions. RESULTS: Overall, 83 children were classified with mild CAS; 35, with moderate CAS; and 257, with severe CAS. Only one child had no comorbidities. The average number of comorbid conditions was 8.4 (SD = 3.4), and the average number of communication-related comorbidities was 5.6 (SD = 2.2). Over 95% of children had comorbid expressive language impairment. Children with comorbid intellectual disability (78.1%), receptive language impairment (72.5%), and nonspeech apraxia (37.3%; including limb, nonspeech oromotor, and oculomotor apraxia) were significantly more likely to have severe CAS than children without these comorbidities. However, children with comorbid autism spectrum disorder (33.6%) were no more likely to have severe CAS than children without autism. CONCLUSIONS: Comorbidity appears to be the rule, rather than the exception, for children with CAS. Comorbid intellectual disability, receptive language impairment, and nonspeech apraxia confer additional risk for more severe forms of CAS. Findings are limited by being from a convenience sample of participants but inform future models of comorbidity. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22096622.

A Comprehensive Analysis of Speech Disfluencies in Autistic Young Adults and Control Young Adults: Group Differences in Typical, Stuttering-Like, and Atypical Disfluencies.

PURPOSE: The purpose of this study was to examine the nature of speech disfluencies in autistic young adults and controls by using a wide-range disfluency classification of typical disfluencies (TD; i.e., filled pauses, revisions, abandoned utterances, and multisyllable word and phrase repetitions), stuttering-like disfluencies (SLD; i.e., sound and syllable repetitions, monosyllable word repetitions, prolongations, blocks, and broken words), and atypical disfluencies (AD; i.e., word-final prolongations and repetitions and atypical insertions). METHOD: Thirty-two autistic young adults and 35 controls completed a narrative telling task based on socially complex events. Frequencies of total disfluencies, TD, SLD, AD and stuttering severity were compared between groups. RESULTS: The overall frequency of disfluencies was significantly higher in the autistic group and significant between-group differences were found for all disfluency categories. The autistic group produced significantly more revisions, filled pauses, and abandoned utterances, and each subtype of SLD and AD than the control group. In total, approximately every fourth autistic participants scored at least a very mild severity of stuttering, and every fifth produced more than three SLD per 100 syllables. CONCLUSIONS: Disfluent speech can be challenging for effective communication. This study revealed that the speech of autistic young adults was highly more disfluent than that of the controls. The findings provide information on speech disfluency characteristics in autistic young adults and highlight the importance of evaluating speech disfluency with a wide-range disfluency classification in autistic persons in order to understand their role in overall communication. The results of this study offer tools for SLPs to evaluate and understand the nature of disfluencies in autistic persons.

Bye-Bye Bunny: Place and Manner Sequences in Children's C1VC2V-Shaped Words.

PURPOSE: Place and manner of articulation in American English-learning children's salient consonant-vowel-consonant-vowel (C1VC2V) target words (e.g., baby, bunny, and cookie) were compared with their actual productions of these words. We hypothesized that target words with repeated place and/or manner characteristics in C1VC2V consonant sequences would be matched in children's actual productions more frequently than target words with variegated place and manner sequences. This hypothesis was based on a proposal that children use available production system capacities to produce salient word forms derived from perceptual input on those word forms. METHOD: Place and manner sequences were analyzed in 2,092 tokens of C1VC2V target words produced by 18 typically developing children in the single-word period. All data were from these children's spontaneous functional speech in a familiar speaking context. Both target word forms and actual child productions of those targets were analyzed. RESULTS: Results indicated that C1VC2V word target sequences predominantly consisted of repetitions in both place and manner of articulation (e.g., labial-labial, stop-stop). Targets with repetitions of consonant sequences were matched more frequently than targets with variegated sequences for both place and manner (e.g., labial-coronal, stop-nasal) in these children's actual productions. Results also indicated that C1VC2V target words beginning with a labial consonant (e.g., baby, bunny, and piggy) were matched in children's actual productions more frequently than words with coronal or dorsal consonant onsets (e.g., daddy and cookie). DISCUSSION: In C1VC2V word forms, occurring in early output, children's actual productions matched their target word sequences when the words consisted of repeated sequences in both place and manner. These results suggest that salient target words with repeated sequences may help children support increases in their repertoire of meaningful vocalizations during the transition from babbling to meaningful speech.

[Surgical treatment of tumors of the supplementary motor area]. / Khirurgicheskoe lechenie opukholei dopolnitel'noi motornoi oblasti.

After surgical treatment of tumors of the supplementary motor area (SMA) post-operative speech and/or motor neurological deficit may occur. OBJECTIVE: To determinate frequency and reversibility of such deficit and identify risk factors for its development. MATERIAL AND METHODS: We retrospectively analyzed postoperative outcomes in 34 patients with SMA tumors. Pre- and postoperative neurological status, localization of tumors, extent of resection relative to adjacent regions and relationship of tumor with white matter tracts were assessed. We also analyzed the influence of these factors on the risk of postoperative neurological impairment. RESULTS: Postoperative neurological impairment occurred in 47% of cases. Complete or significant regression was observed in all patients within 5.7 month after surgery. Major risk factors were lesion of dominant hemisphere (p=0.029), tumor spreading to primary motor cortex (p=0.018) and resection of SMA together with cingulate gyrus (p=0.000). Location of frontal aslant tract in dominant hemisphere just near the tumor contributed to disorders regarding speech initiation and fluency (p=0.016). Resection of SMA with cingulate gyrus in dominant hemisphere affected development of more serious speech disorders (p=0.003). CONCLUSION: Surgery for SMA tumors is safe and followed by favorable functional outcomes.

Anti-Gad 65 encephalitis with rapidly progressive temporal atrophy reveals the involvement of the temporal lobe in the neuroanatomical basis of palilalia.

Palilalia is an acquired speech disorder characterized by the reiteration of words or sentences, historically divided in two main subtypes: "palilalie heterolalique" and "palilalie homolalique". In the former, the reiteration is characterized by rate increase and volume decrease, while in the latter these features remain unaltered. While the "heterolalique" subtype has been mainly observed in the context of basal ganglia diseases, the neuroanatomical basis of the "homolalique" subtype has never been completely clarified. Here we report the case of an 81 years-old woman who developed an extremely repetitive and perseverative language with "homolalique" subtype features and a rapidly progressive course with severe bitemporal atrophy, as a consequence of anti-glutamic acid decarboxylase 65 (GAD 65) antibodies encephalitis. To the best of our knowledge, this is the first report of palilalia in the context of anti-GAD 65 encephalitis. Through the support of voxel-based morphometry and hippocampal subfields analysis, this case study provides a fascinating way of understanding the networks responsible for palilalia, shedding some light on the critical role of temporal areas in the onset of this rare language disorder.

Assessing speech intelligibility of pathological speech in sentences and word lists: The contribution of phoneme-level measures.

INTRODUCTION: Speech intelligibility is an important indicator of the degree of speech impairment in pathological speech. Articulation, as a key feature of dysarthria, has been found to be a stronger contributor to intelligibility of dysarthric speech compared to voice quality, nasality, and prosody. In fact, therapy addressing articulation is often used by speech-language pathologists. Since phoneme-level measures are more directly related to articulation, they may contribute to better evaluating articulation imprecision in speakers with dysarthria and to monitoring the effectiveness of therapy. METHOD: We collected two types of phoneme-level measures: a) Accuracy of Phonemes, the percentage of correctly transcribed phonemes, and b) Phonetic Distance, from orthographic transcriptions obtained from expert raters in two types of speech materials (i.e., meaningful sentences and word lists). We first examined the measures' interrater reliability using Generalizability Theory. Then we studied the validity of the measures by correlating them to three criterion variables. Following this, we explored their ability in distinguishing speakers in two classification tasks according to speakers' types (i.e., healthy vs dysarthric) and their severity levels of dysarthria, respectively. RESULTS: The results showed that both types of phoneme-level measures are highly reliable and valid in two different speech materials. They also showed acceptable results for both classification tasks in different speech materials, with word lists performing better than meaningful sentences. The differences between the two speech materials may be largely caused by differences in word structures and contextual cues in the materials. CONCLUSION: The results indicate that both types of phoneme-level measures show largely similar reliability and validity in both speech materials. These measures perform better in word lists than in meaningful sentences, suggesting an advantage for using word lists in clinical practice and research. On the other hand, meaningful sentences can be used for classifying healthy and dysarthric speakers. Our results suggest that using different speech materials gives a better overview of the speakers' intelligibility at the segmental level and the implications of their articulation impairments.

Peer attitudes towards adolescents with speech disorders due to cleft lip and palate.

BACKGROUND AND AIMS: Individuals with speech disorders are often judged more negatively than peers without speech disorders. A limited number of studies examined the attitudes of adolescents toward peers with speech disorders due to a cleft lip with or without a cleft of the palate (CL ± P). Therefore, the aim of the present study was to investigate the attitudes of peers toward the speech of adolescents with CL ± P. METHOD: Seventy-eight typically developing adolescents (15-18 years, 26 boys, 52 girls) judged audio and audiovisual samples of two adolescents with CL ± P based on three attitude components, i.e., cognitive, affective, and behavioral. The degree of speech intelligibility was also scored by their peers. The study investigated whether the three attitudes were determined by speech intelligibility or appearance of an individual with CL ± P. Furthermore, the influence of knowing someone with a cleft, the age, and gender of the listeners on their attitudes were explored. RESULTS: A significantly positive correlation was found between the speech intelligibility percentage and the three different attitude components: more positive attitudes were observed when the speech intelligibility of the speaker was higher. A different appearance due to a cleft lip does not lead to more negative attitudes. Furthermore, boys seem to have more negative attitudes toward individuals with CL ± P compared to girls. CONCLUSION: This study provided additional evidence that peers show more negative attitudes toward adolescents with less intelligible speech due to CL ± P. Intervention should focus on changing the cognitive, affective, and behavioral attitudes of peers in a more positive direction and remove the stigma of patients with a cleft. Further research is needed to verify these results.

A Comparative Investigation of Automatic Speech Recognition Platforms for Aphasia Assessment Batteries.

The rehabilitation of aphasics is fundamentally based on the assessment of speech impairment. Developing methods for assessing speech impairment automatically is important due to the growing number of stroke cases each year. Traditionally, aphasia is assessed manually using one of the well-known assessment batteries, such as the Western Aphasia Battery (WAB), the Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE), and the Boston Diagnostic Aphasia Examination (BDAE). In aphasia testing, a speech-language pathologist (SLP) administers multiple subtests to assess people with aphasia (PWA). The traditional assessment is a resource-intensive process that requires the presence of an SLP. Thus, automating the assessment of aphasia is essential. This paper evaluated and compared custom machine learning (ML) speech recognition algorithms against off-the-shelf platforms using healthy and aphasic speech datasets on the naming and repetition subtests of the aphasia battery. Convolutional neural networks (CNN) and linear discriminant analysis (LDA) are the customized ML algorithms, while Microsoft Azure and Google speech recognition are off-the-shelf platforms. The results of this study demonstrated that CNN-based speech recognition algorithms outperform LDA and off-the-shelf platforms. The ResNet-50 architecture of CNN yielded an accuracy of 99.64 ± 0.26% on the healthy dataset. Even though Microsoft Azure was not trained on the same healthy dataset, it still generated comparable results to the LDA and superior results to Google's speech recognition platform.

Black phosphorous-based human-machine communication interface.

Assistive technology involving auditory feedback is generally utilized by those who are visually impaired or have speech and language difficulties. Therefore, here we concentrate on an auditory human-machine interface that uses audio as a platform for conveying information between visually or speech-disabled users and society. We develop a piezoresistive tactile sensor based on a black phosphorous and polyaniline (BP@PANI) composite by the facile chemical oxidative polymerization of aniline on cotton fabric. Taking advantage of BP's puckered honeycomb lattice structure and superior electrical properties as well as the vast wavy fabric surface, this BP@PANI-based tactile sensor exhibits excellent sensitivity, low-pressure sensitivity, reasonable response time, and good cycle stability. For a real-world application, a prototype device employs six BP@PANI tactile sensors that correspond to braille characters and can convert pressed text into audio on reading or typing to assist visually or speech-disabled persons. Overall, this research offers promising insight into the material candidates and strategies for the development of auditory feedback devices based on layered and 2D materials for human-machine interfaces.

Speech Error Variability and Phonological Awareness in Preschoolers.

PURPOSE: The purpose of this article was to investigate the relationship between speech error variability and phonological awareness. METHOD: This article begins with a narrative review of the theoretical interpretation of speech error variability. The post hoc exploratory analysis of the relationship between speech error variability and phonological awareness included 40 children: 20 with typical speech and language and 20 with speech sound disorder and typical language. Groups were matched on gender, age, maternal education, receptive and expressive vocabulary, nonverbal intelligence, and expressive morphosyntax. Multiple regression was used to identify the best fit model for the relationship between vocabulary, speech errors, and phonological awareness. RESULTS: Segmental variability was associated with poor phonological awareness in preschool-aged children. CONCLUSION: Children with high levels of segmental variability have poor phonological awareness, likely due to unstable phonological representations.

The Language Profile of Preschool Children With 22q11.2 Deletion Syndrome and the Relationship With Speech Intelligibility.

PURPOSE: Young children with 22q11.2 deletion syndrome (22q11DS) often have impaired language development and poor speech intelligibility. Here, we report a comprehensive overview of standardized language assessment in a relatively large sample of preschool-aged children with 22q11DS. We furthermore explored whether speech ability explained variability in language skills. METHOD: Forty-four monolingual Dutch preschoolers (3-6 years) with a confirmed genetic 22q11DS diagnosis participated in this prospective cohort study. Standardized tests (Clinical Evaluation of Language Fundamentals Preschool-2-NL and Peabody Picture Vocabulary Test-III-NL) were administered. Speech intelligibility was rated by two expert speech and language therapists using a standardized procedure. RESULTS: Most children had impaired language skills across all tested domains. The composite score for expressive language was significantly lower than that for receptive language, but the two were strongly correlated. Only small differences between the mean scores on the various subtests were observed, with the lowest scores for expressive morphosyntactic skills. Language scores showed a moderate positive relation with speech intelligibility, but language abilities varied greatly among the children with intelligible speech. CONCLUSIONS: We show that the majority of preschool children with 22q11DS have a broad range of language problems. Other than the relatively larger impairment in expressive than in receptive language skills, our results do not show a clearly delineated language profile. As many of the children with intelligible speech still had below-average language scores, we highlight that language problems require a broad assessment and care in all young children with 22q11DS. Future research using spontaneous language and detailed speech analysis is recommended, to provide more in-depth understanding of children's language profile and the relationship between speech and language in 22q11DS.

GRIN2A-related epilepsy and speech disorders: A comprehensive overview with a focus on the role of precision therapeutics.

Language dysfunction is a common and serious comorbidity of epilepsy, especially in individuals with epilepsy aphasia spectrum syndromes. Childhood epilepsy with centrotemporal spikes is on the mild end of the spectrum, while epileptic encephalopathy with continuous spike-and-wave during sleep syndrome is on the severe end. Traditional antiseizure medicines and immunotherapy are currently used to treat severely affected patients, but the results are usually disappointing. The discovery that GRIN2A is the primary monogenic etiology of these diseases has opened the door to precision treatments. The GRIN2A gene encodes GluN2A protein, which constitutes a subunit of the NMDA receptor (NMDAR). The GRIN2A pathogenic variants cause gain or loss of function of NMDAR; the former can be treated with uncompetitive NMDAR antagonists, such as memantine, while the latter with NMDAR co-agonist serine. Hyper-precision therapies with various other effective agents are likely to be developed shortly to target the diverse functional effects of different variants. Precision treatments for GRIN2A-related disorders will benefit those who suffer from the condition and pave the way for new therapeutic approaches to a variety of other NMDAR-linked neurodegenerative and psychiatric diseases (schizophrenia, Parkinson's disease, Alzheimer's disease, and so on). Furthermore, more research into GRIN2A-related disorders will help us better understand the neuroinflammatory and neuroimmunological basis of epilepsy, as well as the pathological and physiological network activation mechanisms that cause sleep activation of central-temporal spikes and language impairment.

Eye Fixation Behaviors and Processing Time of People With Aphasia and Neurotypical Adults When Reading Narratives With and Without Text-to-Speech Support.

BACKGROUND: Researchers have used eye-tracking technology to investigate eye movements in neurotypical adults (NAs) when reading. The technology can provide comparable information about people with aphasia (PWA). Eye fixations occurring when PWA do and do not have access to text-to-speech (TTS) technology are of interest because the support improves reading comprehension and decreases processing time for at least some PWA. AIMS: This study's purpose was to examine forward, regressive, and off-track eye fixations when PWA and NAs read narratives in read-only (RO) and TTS conditions. A secondary aim was to examine the influence of eye fixations on processing time. METHOD AND PROCEDURE: A Tobii Dynavox Pro Spectrum eye tracker recorded eye movements of nine PWA and nine NAs while reading narratives in two conditions. Movements of interest were forward fixations; within-word, within-sentence, and previous-sentence regressive fixations; and off-track fixations. OUTCOMES AND RESULTS: PWA exhibited significantly more forward and regressive fixations in the RO than TTS condition, whereas NAs showed opposite behaviors. NAs had significantly more off-track fixations in the TTS than RO condition, whereas PWA exhibited no difference across conditions. PWA took significantly longer to process content in the RO condition, whereas NAs took longer in the TTS condition. CONCLUSIONS: PWA and NAs differ in important ways when processing texts with and without TTS support. Examining eye-tracking data provides a means of gaining insight into the decoding and reading comprehension challenges of PWA and helps elucidate how assistive technology can mediate these challenges.

Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements.

BACKGROUND: Cognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD. AIMS: Gauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load. METHODS AND PROCEDURES: Twenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked. OUTCOMES AND RESULTS: In the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD. CONCLUSIONS AND IMPLICATIONS: ADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. WHAT THIS PAPER ADDS?: We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.

Clinician vs. imaging-based subthalamic nucleus deep brain stimulation programming.

INTRODUCTION: We sought to explore whether electrode visualization tools (EVT) can accurately predict the selection of optimal Deep Brain Stimulation (DBS) electrode contacts. METHODS: Twelve patients with Parkinson's disease (PD) undergoing STN-DBS at The Ohio State University were enrolled in a prospective analysis to evaluate the accuracy of EVT-based vs. standard DBS programming. EVTs were generated by the Surgical Information Sciences (SIS) system to develop a 3D model showing the implanted lead location relative to the STN. Then, imaging-based data were compared to the results of a standard monopolar review to evaluate concordance with clinical data and time spent selecting useable, non-useable, and borderline electrode contacts. RESULTS: A total of 18 DBS leads (n = 68 electrode contacts) were analyzed. The concordance between EVT and standard clinical programming expressed as the kappa coefficient was 0.65 (82.35% raw agreement) for non-useable, 0.52 for useable (64.71% raw agreement), and 0.52 for borderline (58.82% raw agreement). The average time spent determining whether an electrode contact was useable, non-useable, or borderline was 1.46 ± 0.76 min with EVT vs. 61.25 ± 17.47 with standard monopolar review. Eight different categories of side effects were identified, with facial pulling and speech difficulties being observed with the most frequency. The type of side effect observed was accurately predicted using EVT 90% of the time. CONCLUSIONS: This study demonstrates that next-generation EVT-based programming can be implemented into STN-DBS programming workflows with a considerable saving of time and effort spent in testing combinations of stimulation settings, particularly for the identification of non-useable electrode contacts.

Decreasing nervous habits during public speaking: A component analysis of awareness training.

Awareness training can produce decreases in nervous habits during public speaking. A systematic replication of Montes et al. (2020) was conducted to evaluate the independent and additive effects of awareness training components (i.e., response description, response detection) on speech disfluencies during public speaking. We extended prior research by evaluating response description alone, delivering the intervention virtually, using novel videos and speech topics during training, and measuring collateral effects on untargeted responses and speech rate. Response description was sufficient at reducing speech disfluencies for 4 of 9 participants. Response detection (video training) was necessary for 2 participants, and the subsequent addition of response detection (in-vivo training) was necessary for 3 participants. Reductions were maintained during follow-up and generalization probes for most participants. Collateral effects of awareness training components were idiosyncratic. A post-hoc analysis revealed that response description, when effective as a stand-alone intervention, may be more efficient than the full awareness training package.

Validation of an Intelligibility Test Based on Acoustic-Phonetic Decoding of Pseudo-Words: Overall Results from Patients with Cancer of the Oral Cavity and the Oropharynx.

OBJECTIVES: Loss of intelligibility is a major complaint for patients with speech disorders, as it affects their everyday communication and thus contributes to a decrease in their quality of life. Several tests are available to measure intelligibility, but these tests do not take into account the evaluators' ability to restore distorted sequences. Due to this ability, the evaluator will tend to recognize words despite phonetic distortions, and speech production deficit can go undetected. The results of these tests therefore overestimate the intelligibility of patients and may mask real functional limitations. We propose a new test which uses a large number of pseudowords in order to neutralize the unwanted perceptual effects that cause this overestimation. The purpose of this test is to measure the speech production deficit. It is not intended to assess the communication deficit. Our objective is to validate this test based on acoustic-phonetic decoding of productions from patients with speech disorders. MATERIALS AND METHODS: We tested this method with a population of 39 healthy participants and 78 post-treatment patients with cancers of the oral cavity and the oropharynx (HNC patients). Each speaker produced 52 pseudowords taken from randomly generated lists from large common dictionary, each list of 52 pseudowords containing the same number of phonemes. Forty everyday listeners then transcribed these productions. The orthographic transcriptions were phonetized and compared to the expected phonetic forms. An algorithm provided a Perceived Phonological Deviation score (PPD) based on the number of features that differed between the expected forms and the transcribed items. The PPD thus provided a score representing the loss of intelligibility. RESULTS: The 39 participants in the control group demonstrated significantly lower PPD scores compared to the 41 patients with a T1T2 tumor size or compared to the 37 patients with a T3T4 tumor size. The differences between the three groups were significant. If we use the PPD as a predictor to identify patients versus control group subjects, the AUC of the ROC curve is equal to 0.94, which corresponds to an outstanding group separability. A PPD threshold at 0.6 features per phoneme is the boundary between normal and dysfunctional speech. The analysis showed a close correlation between the PPD and a clinical judgment of the disorder severity obtained from experts. CONCLUSION: This test appears to be effective in measuring the intelligibility of speakers at a phonological level, in particular in the case of head and neck cancers.

Correlates of vowel clarity in the spectrotemporal modulation domain: Application to speech impairment evaluation.

This article reports on vowel clarity metrics based on spectrotemporal modulations of speech signals. Motivated by previous findings on the relevance of modulation-based metrics for speech intelligibility assessment and pathology classification, the current study used factor analysis to identify regions within a bi-dimensional modulation space, the magnitude power spectrum, as in Elliott and Theunissen [(2009). PLoS Comput. Biol. 5(3), e1000302] by relating them to a set of conventional acoustic metrics of vowel space area and vowel distinctiveness. Two indices based on the energy ratio between high and low modulation rates across temporal and spectral dimensions of the modulation space emerged from the analyses. These indices served as input for measurements of central tendency and classification analyses that aimed to identify vowel-related speech impairments in French native speakers with head and neck cancer (HNC) and Parkinson dysarthria (PD). Following the analysis, vowel-related speech impairment was identified in HNC speakers, but not in PD. These results were consistent with findings based on subjective evaluations of speech intelligibility. The findings reported are consistent with previous studies indicating that impaired speech is associated with attenuation in energy in higher spectrotemporal modulation bands.