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PubMed1999

Cochlear implants in young children: the relationship between speech perception and speech intelligibility.

OBJECTIVE: To determine the relationship between measures of speech perception and speech production after cochlear implantation of young children with profound congenital and prelingual deafness. DESIGN: A prospective study was undertaken on a consecutive group of children with profound deafness. There were 126 children at the preimplantation interval and 71, 50, 26, and 20 children, respectively, at the 2, 3, 4, and 5 yr follow-up after implantation. Speech perception and speech intelligibility were assessed using hierarchical rating scales. Spearman rank correlation coefficients were used to determine the statistical correlations. All patients were either congenitally deaf or deafened before the age of 3 yr and were implanted before age 7 yr. The patients all received the Nucleus multichannel cochlear implant system with the most appropriate speech encoding strategy. RESULTS: Speech intelligibility at 5 yr was strongly correlated with speech perception at the 2, 3, 4, and 5 yr intervals after implantation (Spearman coefficients 0.77, 0.81, 0.58, 0.58; p < or = 0.01). Speech intelligibility at the 2, 3, and 4 yr intervals also correlated in a similar manner with earlier speech perception abilities (p < or = 0.01). CONCLUSIONS: The results suggest that speech intelligibility between 2 and 5 yr after implantation in young children with congenital and prelingual profound deafness can be predicted by measures of earlier speech perception.

Age Factors↗

PubMed2000

Effect of placement of a speech appliance on levator veli palatini muscle activity during speech.

OBJECTIVE: The purposes of this electromyographic study were to examine whether levator veli palatini muscle activity during speech can be changed with placement of a speech appliance and to clarify whether or not the change is related to the type of speech appliance used. DESIGN: Electromyography (EMG) was performed during production of speech samples in two conditions: with placement and with removal of a speech appliance. Speech samples were the vowel /omega/ and consonant-vowel (omega) syllables, including nasal, plosive, fricative, and affricate consonants. SETTING: Division for Oral-Facial Disorders, Faculty of Dentistry, Osaka University Dental Hospital, Japan. PARTICIPANTS: Subjects were six patients with repaired cleft palate and velopharyngeal inadequacy (VPI); three routinely wore a palatal lift prosthesis to correct borderline VPI, and the other three wore a speech appliance hybrid that consisted of a pharyngeal bulb and a palatal lift. INTERVENTIONS: Each patient was asked to produce each speech sample in both conditions of placement and removal of their respective appliances. MAIN OUTCOME MEASURES: Smoothed EMG signals of the levator veli palatini muscle were recorded with and without the appliance during five repetitions of each speech sample. The average value of peak smoothed levator EMG was compared between placement and removal conditions for all subjects and between the two subject groups in each experimental condition. RESULTS: With a speech appliance in place, the range of levator activity was distributed in a portion lower than that in the removed condition for subjects in both appliance groups. In addition, the intervals were smaller in the placement condition than in the removed condition. CONCLUSION: A speech appliance may prevent hypernasality, nasal emission of air, or both associated with VPI because of mechanical obturation of the velopharynx and an alteration in velopharyngeal function.

Adolescent↗

PubMed2001

Speech intelligibility after glossectomy and speech rehabilitation.

BACKGROUND: Oral tumor resections cause articulation deficiencies, depending on the site, extent of resection, type of reconstruction, and tongue stump mobility. OBJECTIVES: To evaluate the speech intelligibility of patients undergoing total, subtotal, or partial glossectomy, before and after speech therapy. PATIENTS AND METHODS: Twenty-seven patients (24 men and 3 women), aged 34 to 77 years (mean age, 56.5 years), underwent glossectomy. Tumor stages were T1 in 3 patients, T2 in 4, T3 in 8, T4 in 11, and TX in 1; node stages, N0 in 15 patients, N1 in 5, N2a-c in 6, and N3 in 1. No patient had metastases (M0). Patients were divided into 3 groups by extent of tongue resection, ie, total (group 1; n = 6), subtotal (group 2; n = 9), and partial (group 3; n = 12). Different phonological tasks were recorded and analyzed by 3 experienced judges, including sustained 7 oral vowels, vowel in a syllable, and the sequence vowel-consonant-vowel (VCV). The intelligibility of spontaneous speech (sequence story) was scored from 1 to 4 in consensus. All patients underwent a therapeutic program to activate articulatory adaptations, compensations, and maximization of the remaining structures for 3 to 6 months. The tasks were recorded after speech therapy. To compare mean changes, analyses of variance and Wilcoxon tests were used. RESULTS: Patients of groups 1 and 2 significantly improved their speech intelligibility (P<.05). Group 1 improved vowels, VCV, and spontaneous speech; group 2, syllable, VCV, and spontaneous speech. Group 3 demonstrated better intelligibility in the pretherapy phase, but the improvement after therapy was not significant. CONCLUSIONS: Speech therapy was effective in improving speech intelligibility of patients undergoing glossectomy, even after major resection. Different pretherapy ability between groups was seen, with improvement of speech intelligibility in groups 1 and 2. The improvement of speech intelligibility in group 3 was not statistically significant, possibly because of the small and heterogeneous sample.

Adult↗

PubMed2003

Implementing speech supplementation strategies: effects on intelligibility and speech rate of individuals with chronic severe dysarthria.

A growing body of experimental research suggests that speech supplementation strategies can markedly increase speech intelligibility for individuals with dysarthria (D. Beukelman & K. Yorkston, 1977; E. Crow & P. Enderby, 1989; L. Hunter, T. Pring, & S. Martin, 1991; K. C. Hustad & D. R. Beukelman, 2001). However, studies in which speech supplementation strategies were actually implemented by speakers with dysarthria are limited, leaving their clinical efficacy unknown. The present study compared intelligibility and speech rate differences following speaker implementation of 3 strategies (topic, alphabet, and combined topic and alphabet supplementation) and a habitual (noncued) speech control condition for 5 speakers with severe dysarthria. Results revealed that combined cues and alphabet cues yielded significantly higher intelligibility scores and slower speech rates than topic cues and noncued speech. Overall, topic cues and noncued speech did not differ from one another with regard to intelligibility or speech rate. Combined cues and alphabet cues did not differ from one another with regard to intelligibility; however, speech rate was significantly different between the 2 strategies. Individual differences among speakers were generally consistent with group findings. Results were somewhat different from previous research in which strategies were experimentally superimposed on the habitual speech signal. However, findings provide evidence that alphabet cues and combined cues can have an important effect on intelligibility for speakers with severe dysarthria.

Adult↗

PubMed1990

Perception of sentences, words, and speech features by profoundly hearing-impaired children using a multichannel electrotactile speech processor.

Fourteen prelinguistically profoundly hearing-impaired children were fitted with the multichannel electrotactile speech processor (Tickle Talker) developed by Cochlear Pty. Ltd. and the University of Melbourne. Each child participated in an ongoing training and evaluation program, which included measures of speech perception and production. Results of speech perception testing demonstrate clear benefits for children fitted with the device. Thresholds for detection of pure tones were lower for the Tickle Talker than for hearing aids across the frequency range 250-4000 Hz, with the greatest tactual advantage in the high-frequency consonant range (above 2000 Hz). Individual and mean speech detection thresholds for the Ling 5-sound test confirmed that speech sounds were detected by the electrotactile device at levels consistent with normal conversational speech. Results for three speech feature tests showed significant improvement when the Tickle Talker was used in combination with hearing aids (TA) as compared with hearing aids along (A). Mean scores in the TA condition increased by 11% for vowel duration, 20% for vowel formant, and 25% for consonant manner as compared with hearing aids alone. Mean TA score on a closed-set word test (WIPI) was 48%, as compared with 32% for hearing aids alone. Similarly, mean WIPI score for the combination of Tickle Talker, lipreading, and hearing aids (TLA) increased by 6% as compared with combined lipreading and hearing aid (LA) scores. Mean scores on open-set sentences (BKB) showed a significant increase of 21% for the tactually aided condition (TLA) as compared with unaided (LA). These results indicate that, given sufficient training, children can utilize speech feature information provided through the Tickle Talker to improve discrimination of words and sentences. These results indicate that, given sufficient training, children can utilize speech feature information provided through the Tickle Talker to improve discrimination of words and sentences. These results are consistent with improvement in speech discrimination previously reported for normally hearing and hearing-impaired adults using the device. Anecdotal evidence also indicates some improvements in speech production for children fitted with the Tickle Talker.

Adolescent↗

PubMed2002

Contribution of speech rate to speech perception in multichannel cochlear implant users.

This study describes the effect of speech rate (fast, 11 syllables per second; medium, 9 syllables per second; slow, 6 syllables per second) on speech perception in 10 cochlear implant users. The speech perception performance was evaluated on the basis of the percentage score of syllables that were correctly recalled in sentences composed of 4 to 6 words. The percentage scores at the fast, medium, and slow speech rates were 15.7%, 39.0%, and 56.0%, respectively. The effect of speech rate slowing was significant (p < .0001). Variations in the effect of speech rate slowing were observed in the cochlear implant users. The improvement of speech perception by speech rate slowing was significantly (p < .005) related to the word test score and the score at the fast speech rate. The results reveal that the rate of speech is an important factor in improving the speech perception of cochlear implant users.

Cochlear Implants↗

PubMed1999

The intrajudge reliability of the perceptual rating of cleft palate speech before and after pharyngeal flap surgery: the effect of judges and speech samples.

OBJECTIVE: In this pilot study, the reliabilities of the perceptual ratings of four types of speech samples by six judges, with and without expertise in evaluating cleft palate speech, were studied. DESIGN: Pre- and postoperative tape recordings of 15 patients with cleft lip and palate who had undergone a superiorly based pharyngeal flap operation were selected. Five speech-language pathologists and one oral and maxillofacial surgeon perceptually rated the following variables on separate 100-mm visual analog scales: hypernasality, audible nasal emission, intelligibility, misarticulations associated with velopharyngeal insufficiency, voice quality, and the presence or absence of hyponasality. These six variables were rated in four types of speech samples: reading of three sentences, repeating after the speech pathologist of three sentences, 10 sentences containing the aforementioned material, and the same 10 sentences in paired comparison. All speech samples were rerated after 3 months by the same judges. RESULTS: Judges differed largely in the range they used in their rating. Intrajudge reliability of .56 to .78 was found for ratings of hypernasality. No significant differences in intrajudge reliability were found for the ratings with the different types of speech samples. The intrajudge reliability of a judge with expertise was not necessarily higher than of a judge without this expertise. CONCLUSIONS: The improvement in speech is most reliably assessed with speech samples in paired comparison. A speech-language pathologist with expertise in evaluating cleft palate speech does not guarantee a high intrajudge reliability of the rating.

Adolescent↗

PubMed1994

Costs and effects of tracheoesophageal speech compared with esophageal speech in laryngectomy patients.

The hospital costs and the effects on speech are compared for tracheoesophageal (TE) speech and esophageal (E) speech in laryngectomy patients. TE-speech is more intelligible and the rehabilitation is faster (four versus nine months), but it is more expensive for the hospital. E-speech needs more speech rehabilitation sessions (average of 23,422 BF/patient) than TE-speech (7,157 BF). TE-speech involves primary (6,192 BF) or secondary placement (25,357 BF), replacement (average of 19,443 BF/patient/year) and in about ten percent closure of the fistula (39,135 BF/patient) and switching over to E-speech. On the basis of these data the expected average costs per patient can be calculated. These are definitely higher for the TE-speech than for E-speech.

Aged↗

PubMed2004

Speech perception and speech intelligibility in children after cochlear implantation.

OBJECTIVE: This study aimed to evaluate the long-term speech perception and speech intelligibility of congenitally and prelingually deaf children after cochlear implantation. It was a longitudinal study following 63 congenitally or prelingually deaf children up to 5 years after implantation. They each received a nucleus multichannel cochlear implant before they were 10 years old. METHODS: Perception is evaluated using the Test for the Evaluation of Voice Perception and Production (TEPP) and concerns closed- and open-set word and sentence perception without lip-reading. The intelligibility is classified according to the Speech Intelligibility Rating (SIR). The evaluations have been made every 3 months for 1 year, then at 18 months, 2 years, 3 years and 5 years after the cochlear implantation. RESULTS: After 5 years of implantation, the median percentage of closed-words speech perception (CSW) is 95.5%-93.67% for closed-sentence speech perception (CSS) and 76.3% for open-sentence speech perception (OSS); the median Speech Intelligibility Rating is 3.83. CONCLUSIONS: Congenitally and prelingually deaf children who receive cochlear implant before the age of 10 years develop speech perception and speech intelligibility abilities. The closed-set perception progresses quickly and seems to reaching a plateau at 5 years post implantation. The improvement of open-sentence perception is not significant until the first year post implantation. The speech intelligibility improves regularly the five first year post implantation.

Audiometry, Speech↗

PubMed1984

A functional speech impression used to fabricate a maxillary speech prosthesis for a partial glossectomy patient.

Surgery for cancer of the floor of the mouth often results in alteration of the muscles of the tongue and floor of the mouth. Both primary and secondary surgical procedures often result in scar formation with reduced mobility of the tongue during speech and deglutition. Speech is often used as a diagnostic tool in the placement of the anterior teeth during fabrication of a prosthesis. Speech can similarly be used to help determine the proper placement of a speech portion of the prosthesis. The prosthetic rehabilitation approach described lowers the palatal vault with a false palate to enable the tongue to function against it during speech (Fig. 15). Group studies have shown that the design and fabrication of speech prostheses for partial glossectomy patients have significantly improved speech and swallowing for these patients. A speech pathologist is helpful during diagnosis, and speech therapy is necessary for significant speech improvement. Prosthetic rehabilitation alone cannot be expected to improve speech.

Adenocarcinoma↗

PubMed2005

The effect of different noise types on the speech and non-speech elicited mismatch negativity.

The effect of different types of real-life noise on the central auditory processing of speech and non-speech sounds was evaluated by the means of mismatch negativity and behavioral responses. Subjects (19-34 years old; 6 males, 4 females) were presented, in separate conditions, with either speech or non-speech stimuli of approximately equal complexity in five background conditions: babble noise, industrial noise, traffic noise, wide band noise, and silent condition. Whereas there were no effects of stimuli or noise on the behavioral responses, the MMN results revealed that speech and non-speech sounds are processed differently both in silent and noisy conditions. Speech processing was more affected than non-speech processing in all noise conditions. Moreover, different noise types had a differential effect on the pre-attentive discrimination, as reflected in MMN, on speech and non-speech sounds. Babble and industrial noises dramatically reduced the MMN amplitudes for both stimulus types, while traffic noise affected only speech stimuli.

Acoustic Stimulation↗

PubMed2006

The inhibition of stuttering via the presentation of natural speech and sinusoidal speech analogs.

Sensory signals containing speech or gestural (articulatory) information (e.g., choral speech) have repeatedly been found to be highly effective inhibitors of stuttering. Sine wave analogs of speech consist of a trio of changing pure tones representative of formant frequencies. They are otherwise devoid of traditional speech cues, yet have proven to evoke consistent linguistic percepts in listeners. Thus, we investigated the potency of sinusoidal speech for inhibiting stuttering. Ten adults who stutter read while listening to (a) forward-flowing natural speech; (b) forward-flowing sinusoid analogs of natural speech; (c) reversed natural speech; (d) reversed sinusoid analogs of natural speech; and (e) a continuous 1000 Hz pure tone. The levels of stuttering inhibition achieved using the sinusoidal stimuli were potent and not significantly different from those achieved using natural speech (approximately 50% in forward conditions and approximately 25% in the reversed conditions), suggesting that the patterns of undulating pure tones are sufficient to endow sinusoidal sentences with 'quasi-gestural' qualities. These data highlight the sensitivity of a specialized 'phonetic module' for extracting gestural information from sensory stimuli. Stuttering inhibition is thought to occur when perceived gestural information facilitates fluent productions via the engagement of mirror neurons (e.g., in Broca's area), which appear to play a crucial role in our ability to perceive and produce speech.

Brain↗

PubMed1997

[Effects of imagery ability and speech anxiety on imagery vividness of imaginary of speech scene].

Effects of imagery ability and speech anxiety on imagery vividness of imaginary of speech scene were examined. Subjects were divided into four groups in terms of high and low scores of Scale of Mental Imagery-Short Form (SMI-S) and a speech anxiety scale. They imagined themselves in neutral, action and speech scenes. They were asked to rate valence, arousal, and dominance of associated emotion, as well as imagery vividness, of each scene. An SMI-S effect was found on the vividness for neutral and action scenes. For vividness of the speech scene, however, speech anxiety had a stronger effect than imagery ability. The subjects with high speech anxiety significantly decreased imagery vividness, and experienced stronger arousal during imaginary speech. Good-imagery subjects with high speech anxiety reported stronger arousal than poor-imagery subjects. These results suggested that speech anxiety was a major determinant of imagery vividness of imaginary of speech scene.

Adult↗

PubMed2006

Evaluation of speech intelligibility for children with cleft lip and palate by means of automatic speech recognition.

OBJECTIVE: Cleft lip and palate (CLP) may cause functional limitations even after adequate surgical and non-surgical treatment, speech disorders being one of them. Interindividually, they vary a lot, showing typical articulation specifics such as nasal emission and shift of articulation and therefore a diminished intelligibility. Until now, an objective means to determine and quantify the intelligibility does not exist. METHOD: An automatic speech recognition system, a new method, was applied on recordings of a standard test to evaluate articulation disorders (psycholinguistic analysis of speech disorders of children PLAKSS) of 31 children at the age of 10.1+/-3.8 years. Two had an isolated cleft lip, 20 a unilateral cleft lip and palate, 4 a bilateral cleft lip and palate, and 5 an isolated cleft palate. The speech recognition system was trained with adults and children without speech disorders and adapted to the speech of children with CLP. In this study, the automatic speech evaluation focussed on the word accuracy which represents the percentage of correctly recognized words. Results were confronted to a perceptive evaluation of intelligibility that was performed by a panel of three experts. RESULTS: The automatic speech recognition yielded word accuracies between 1.2 and 75.8% (mean 48.0+/-19.6%). The word accuracy was lowest for children with isolated cleft palate (36.9+/-23.3) and highest for children with isolated cleft lip (72.8+/-2.9). For children with unilateral cleft lip and palate it was 48.0+/-18.6 and for children with bilateral cleft lip and palate 49.3+/-9.4. The automatic evaluation complied with the experts' subjective evaluation of intelligibility (p<0.01). The multi-rater kappa of the experts alone differed only slightly from the multi-rater kappa of experts and recognizer. CONCLUSION: Automatic speech recognition may serve as a good means to objectify and quantify global speech outcome of children with cleft lip and palate.

Adolescent↗

PubMedDate not supplied

A diagnostic marker for speech delay associated with otitis media with effusion: the intelligibility-speech gap.

The goal of this study was to determine if notably reduced intelligibility is a potential diagnostic marker for children with speech delay and histories of early recurrent otitis media with effusion (SD-OME). Intelligibility was assessed in one 5-10 minute conversational speech sample from each of 281 speakers. The OME histories of 148 of these children with normal speech acquisition were described in two prior reports. OME histories of 85 additional children with speech delay were obtained from case history reports. For both groups, the children with positive OME (OME+) histories had significantly lower intelligibility scores but significantly higher speech production scores than children with negative OME (OME-) histories. Findings for a diagnostic marker to discriminate speech delayed children with OME+ versus OME- histories were promising, considering that the data were obtained retrospectively and did not include audiological information characterizing children's concurrent fluctuant hearing loss. The formula for the diagnostic marker, termed the Intelligibility-Speech Gap, was identified by a machine learning routine. Diagnostic accuracy findings for the marker were as follows: positive predictive value = 74%, negative predictive value = 86%, sensitivity = 79%, specificity = 83%, positive likelihood ratio = 4.6 and negative likelihood ratio = 0.25. Discussion considers speech processing perspectives on the source of the intelligibility-speech gap in children with suspected SD-OME, and methodological perspectives on its development as a diagnostic marker of one etiological subtype of speech delay.

Child↗

PubMed1992

[Effect of the rate of speech flow on speech intelligibility in normal and hearing-impaired subjects].

The relationship between the rate of speech flow and speech intelligibility was investigated in normal and hearing-impaired subjects. It is usually observed that a slowly and clearly delivered speech is easier for hearing-impaired patients to understand. The purpose of paper is to analyze this phenomenon clinically and to present useful data for developing new hearing aids. Four or 5 syllabic words lists were prepared for this experiment and speech stimuli were chosen from these lists. The subjects consisted of 15 normal subjects and 79 hearing-impaired patients (57 with inner ear hearing loss and 22 with retrocochlear hearing loss). Hearing tests were performed using a tape recorder with various speech control systems in a soundproof room. Speech samples were presented at three speaking rates, that is, a conversational speech rate, a rate one and a half times as fast as the conversational speech rate and a rate twice as fast as that rate. The results obtained in the normal subjects confirmed that the faster the speaking rate was, the more the word intelligibility was reduced. According to the results in the hearing-impaired subjects, both the correlation coefficient and regression parameter between the word intelligibility in this experiment and speech discrimination scores measured by 57S-monosyllabic lists were low at the conversational speaking rate, but the higher the speaking rate was, the closer the relation between the both factors was. It was estimated by analyzing the data of inner ear hearing loss and retrocochler hearing loss separately that the subjects with retrocochler hearing loss had more difficulty in speech-mediated communication than the subjects with inner ear hearing loss.

Hearing Loss↗

PubMed2000

Effect of compression ratio on speech recognition and speech-quality ratings with wide dynamic range compression amplification.

This project examined the effect of varying compression ratio on speech recognition and quality. Both listeners with mild-to-moderate sensorineural hearing loss and a control group of listeners with normal hearing participated. Test materials were sentences from the Connected Speech Test (R. M. Cox, G. C. Alexander, & C. Gilmore, 1987) which were digitally processed with linear amplification and wide dynamic range compression amplification with 3 compression ratios. Speech-recognition scores were obtained with sentences in quiet and in noise at a 10-dB signal-to-noise ratio for each amplification condition. Additionally, the participants rated each amplification condition in terms of clarity, pleasantness, ease of understanding, and overall impression. Results indicated that, for speech in quiet, compression ratio had no effect on speech-recognition scores; however, speech-quality ratings decreased as compression ratio increased. For speech in noise, both speech-recognition scores and ratings decreased with increasing compression ratio for the listeners with hearing loss. These results suggest that selection of compression ratio on the basis of speech-quality judgments does not compromise speech recognition.

Adult↗

PubMed2003

Comparison of different speech coding strategies using a disability-based inventory and speech perception tests in quiet and in noise.

OBJECTIVE: Intraindividual comparison of two cochlear implant speech coding strategies implemented in the Nucleus 24M system (SPEAK versus ACE). Reasons for subjective preference were evaluated using a combination of speech perception scores and a disability-based inventory. STUDY DESIGN: Cross-over study with two groups of cochlear implant subjects, assigned to first receive ACE or SPEAK strategy. SETTING: Cochlear implant program. SUBJECTS: Twelve postlingually deaf adults using a Nucleus 24M cochlear implant system. INTERVENTION: Subjects consecutively used the two different speech coding strategies and completed speech perception tests in quiet and in noise and a disability-based inventory (Abbreviated Profile of Hearing Aid Benefit). MAIN OUTCOME MEASURES: Individual differences between the two different speech coding strategies and the relation with subjective strategy preference. RESULTS: The ACE strategy produced somewhat better speech recognition scores in quiet and in noise, although the difference in the scores in noise did not reach the 95% level of significance. The first coding strategy chosen did not affect the results or subjective preference. Preference according to the APHAB results were not a priori in conformity with the speech recognition scores. CONCLUSION: Most subjects preferred the ACE strategy. Subjective preference was in agreement with the APHAB results in three subjects, in agreement with speech recognition in two subjects, and in agreement with both in seven subjects. The present results support the use of both speech recognition tests and questionnaires to evaluate different speech coding strategies.

Adult↗