Evaluation Of Speech Intelligibility Research Articles

Refining the evaluation of speech synthesis: A summary of the Blizzard Challenge 2023

The Blizzard Challenge has benchmarked progress in Text-to-Speech (TTS) since 2005. The Challenge has seen important milestones passed, with results suggesting that synthetic speech was indistinguishable from natural speech in terms of intelligibility in 2021 and that by that same year it was perhaps even indistinguishable in naturalness. The high quality of synthetic speech generated by the latest TTS systems has thus revealed limitations with ITU-T P.800.1 Mean Opinion Score (MOS) in detecting the remaining differences between synthetic and natural speech. Yet, it was the only method used in previous Challenges and is still the most popular method in the field for speech synthesis evaluation. In the 2023 Challenge, we addressed observed limitations of past Challenges by incorporating state-of-the-art speech synthesis evaluation techniques to refine the evaluation of speech quality, speaker similarity and intelligibility. For speech quality, a relative comparison of the systems receiving the best MOS was able to discover a greater number of significant differences between systems. Regarding speaker similarity, we demonstrated that there is a strong bias depending on whether the listeners are familiar with the target voice or not. As for intelligibility, the evaluation of language-specific phenomena, such as the pronunciation of homographs, better highlighted system limits compared to global transcription tasks of synthesised utterances. In addition to reporting results for the 18 entries to the 2023 Challenge, we extend the results analysis to type of TTS module to provide some insights on the most recent advances in model design. Overall, this year’s results demonstrate the need for a shift towards new methods for refining TTS evaluation to shed light on increasingly smaller and localised differences between synthesised and natural speech.

Empirical method for predicting speech sound propagation in offices

The room acoustic parameters of ISO 3382-3 allow for an evaluation of sound propagation and speech intelligibility in open-plan offices and have increasingly been used in the planning process since their introduction in 2012. The input parameters are the speech sound pressure levels and the speech transmission indices at the workstations along a measurement path including a sound source (imaginary speaker). ISO 3382-3 is a measurement standard - a calculation method is not defined. However, it is possible to calculate the necessary input data, namely the speech sound pressure levels and the speech transmission indices, using room acoustic computer simulations. Although computing power is no longer a limiting factor today, the modeling and verification of computer models are still complex and correspondingly time and cost intensive. Hongisto and Keränen (2013, 2015) describe a model for predicting the ISO 3382-3 parameters. In this study, this prediction model was tested using measurement data from several open-plan offices in Germany. Recommendations for the application of the model are derived from preliminary investigations, and the limitations and boundaries of the method are further specified.

Speech intelligibility evaluation of small-scale mosque with multiple domes design

PurposeMosques are built with dome-shaped ceilings for communal worship with common architectural styles worldwide for prayer. Since the acoustics of worship buildings are just as significant as their aesthetics, they should enhance people’s sense of hearing. This study evaluates the speech intelligibility of a small mosque with multiple domes to determine the space acoustic conditions.Design/methodology/approachThe investigation involved extensive literature reviews to collect relevant data to model the case study. The Enhanced Acoustics Simulator for Engineers (EASE) software program was used to integrate critical parameters such as the absorption coefficient of materials, dome shapes and the number of domes in the simulation. The study employed speech intelligibility parameters such as C50, S.T.I. and %ALcons to assess the acoustic conditions. The assessment model was validated through statistical analysis and a paired t-test.FindingsThe study discovered that varying shapes of the multiple domes showed no significant impact on speech intelligibility. However, different multiple domes materials resulted in significant disparities in speech intelligibility. Applying high-absorption materials in multiple dome designs achieved the most effective acoustic performance. Except for C50 in some circumstances and receiver positions, all other alternatives met the optimal value for overall speech intelligibility because the sound was not sufficiently diffused early on, suggesting that the early reflection sounds were either weak or insufficient.Originality/valueThis study not only helps to determine the multiple-dome effect on mosque acoustics but also empowers archaeoacoustics and historic conservation by documenting these significant places of worship. The findings advocate using high-absorption materials in multiple dome designs and offer practical insight into mosque design material selection. By enhancing the understanding of the acoustic conditions in small-scale mosques, this study equips architects, engineers and builders with the knowledge to create spaces prioritizing speech clarity and intelligibility.

Altered Auditory Feedback Improves Speech Intelligibility in Individuals Diagnosed with Parkinson’s Disease: A Pilot Study

Introduction: The purpose of the current study was to evaluate speech intelligibility and speech rate in individuals with Parkinson’s disease using altered auditory feedback (AAF) in comparison to age-matched healthy controls. Based on prior research, it is hypothesized that the use of AAF will improve participants’ speech intelligibility. Methods: Five individuals with Parkinson’s disease (clinical group) and five age-matched healthy controls aged 50 years and above participated in this pre-/post-group experiment. All participants completed reading and monologue tasks with and without AAF. The AAF delayed the participants’ auditory feedback by 150 ms and altered it by 1/20 octave. Thirty-two naïve listeners listened to the recorded participants’ speech samples (with and without AAF) randomly and rated the participants’ speech intelligibility. Results: Results of the mixed model ANOVA revealed that participants in the control group had significantly higher speech intelligibility scores than the participants in the clinical group. Post hoc tests indicated that only participants in the clinical group were more intelligible with AAF than without AAF. Participants in the clinical group had better speech intelligibility when reading the passage than speaking the monologue. With regards to speech rate, participants spoke more slowly with AAF than without. Finally, there was a negative correlation between speech rate and speech intelligibility. Discussion: The current findings support our hypothesis that AAF improves speech intelligibility in people with Parkinson’s disease, though not in healthy controls. Future research should evaluate the long-term effect of AAF use on speech intelligibility in people with Parkinson’s disease.

Neural envelope tracking predicts speech intelligibility and hearing aid benefit in children with hearing loss

Early assessment of hearing aid benefit is crucial, as the extent to which hearing aids provide audible speech information predicts speech and language outcomes. A growing body of research has proposed neural envelope tracking as an objective measure of speech intelligibility, particularly for individuals unable to provide reliable behavioral feedback. However, its potential for evaluating speech intelligibility and hearing aid benefit in children with hearing loss remains unexplored. In this study, we investigated neural envelope tracking in children with permanent hearing loss through two separate experiments. EEG data were recorded while children listened to age-appropriate stories (Experiment 1) or an animated movie (Experiment 2) under aided and unaided conditions (using personal hearing aids) at multiple stimulus intensities. Neural envelope tracking was evaluated using a linear decoder reconstructing the speech envelope from the EEG in the delta band (0.5-4 Hz). Additionally, we calculated temporal response functions (TRFs) to investigate the spatio-temporal dynamics of the response. In both experiments, neural tracking increased with increasing stimulus intensity, but only in the unaided condition. In the aided condition, neural tracking remained stable across a wide range of intensities, as long as speech intelligibility was maintained. Similarly, TRF amplitudes increased with increasing stimulus intensity in the unaided condition, while in the aided condition significant differences were found in TRF latency rather than TRF amplitude. This suggests that decreasing stimulus intensity does not necessarily impact neural tracking. Furthermore, the use of personal hearing aids significantly enhanced neural envelope tracking, particularly in challenging speech conditions that would be inaudible when unaided. Finally, we found a strong correlation between neural envelope tracking and behaviorally measured speech intelligibility for both narrated stories (Experiment 1) and movie stimuli (Experiment 2). Altogether, these findings indicate that neural envelope tracking could be a valuable tool for predicting speech intelligibility benefits derived from personal hearing aids in hearing-impaired children. Incorporating narrated stories or engaging movies expands the accessibility of these methods even in clinical settings, offering new avenues for using objective speech measures to guide pediatric audiology decision-making.

Feasibility of Speech Testing Using Wireless Connection in Single-Sided Cochlear Implant Users.

The speech tests used to evaluate language performance in patients with bilateral deafness (BiD) and cochlear implant (CI) are problematic if applied to patients with single-sided deafness (SSD) because normal ear hearing should be excluded. Thus, we investigated the feasibility of using wireless connection to evaluate speech intelligibility of the CI ear in patients with SSD. Subjects and. Patients with BiD and SSD were administered the word recognition scores (WRS) and speech intelligibility tests using an iPadbased wireless connection and conventional methods. To exclude normal side hearing in patients with SSD, masking noise and "plugged and muffed" method were used in the WRS and speech intelligibility tests, respectively. In patients with BiD, the WRS and speech intelligibility tests results using wireless connection and conventional methods were similar. In patients with SSD, the WRS using masking noise in the normal hearing ear was similar to that of using wireless connection. However, 3 of 11 patients with SSD showed under-masked results if using the "plugged and muffed" method. Speech intelligibility testing using wireless connection is a convenient and reliable method for evaluating CI performance in patients with SSD. The "plugged and muffed" method is not recommended for evaluating CI performance in patients with SSD.

Lower lip reconstruction using McGregor fan technique with or without depressor anguli oris chimeric flap. Is there a difference in function and aesthetic outcomes?

Lower lip reconstruction aims to maintain facial subunit function and aesthetics. We present a minor modification of the McGregor flap technique, in which depressor anguli oris (DAO) muscle is separately elevated as a chimeric flap together to investigate the outcomes for reconstructing lower lip defects using various functional parameters. The study included patients who underwent surgical repair of lower lip defects using a McGregor fan flap with or without DAO muscle chimeric flap between January 2018 and May 2021. The patients were divided into our modified technique with DAO chimeric flap (study group) and conventional McGregor (control group). The primary outcomes were functional evaluation of oral competency, speech intelligibility, and tactile sensation of reconstructed lip outcomes. The functional satisfaction and Patient and Observer Scar Assessment Scale (POSAS) were analyzed. A total of 20 patients were enrolled (10 patients for each group). Excellent oral competence was present in 12 patients, favorably significant in patients with DAO chimeric flap (n = 8/10, p = 0.018). All patients had intelligible speech with insignificant differences between the two groups. No patients demonstrated differences to light touch from baseline sensation at 1 year. Patients in the study group reported more lip function satisfaction (p = 0.049). The POSAS score indicates satisfaction with the appearance of all patients. McGregor fan technique combined with DAO muscle chimeric flap offers a good choice by maintaining sensory and motor functions. Our minor modification can ensure the integrity of the oral sphincter, leading to improved lower lip function.

Objective and subjective assessment of the speech intelligibility in rooms with an Active Acoustic Enhancement Systems

Speech Transmission Index (STI), apart from the Reverberation Time (RT), remains an important parameter used for the speech intelligibility assessment indoors. As the Active Acoustic Enhancement Systems (AAES) are getting more and more commonly used, it was verified how such systems affect speech perception. In accordance with the 3382-1 and 3382-2 regulations, objective parameters were measured in two enclosures with the AAES. The RT values varied from 0.91 to 1.61 [s] for the hall in Mińsk Mazowiecki and from 0.75 to 1.52 [s] in Puławy. The STI values varied from 0.57 to 0.64 in Mińsk Mazowiecki and 0.64 to 0.69 in Puławy. Despite the significant differences in the RT values, STI coefficients remained almost unchanged. The listening test was designed to verify if the subjectively assessed intelligibility would confirm the objective measurements' results. 50-element nonsense words (logatome) lists were used for in-situ experiments and, in the second part, binaural laboratory arrangement. Both parts involved over 120 listeners. Three scenes were selected: without AAES and two different AAES setups. In summary, subjective measurements' results were compared with the obtained STI, RT and Clarity (C50, C80) values to prove their importance in indoors speech intelligibility evaluation.

Evaluation of sound environment in departure lounges of a large hub airport

This paper presents the results of an intensive questionnaire survey of 515 passengers at two terminals of a large hub airport in China, along with measurements of sound pressure levels. A-weighted sound pressure levels were measured with and without broadcast in ten departure lounges of five terminal piers during normal operations. The results show significant negative correlations between sound pressure level and the subjective evaluations of loudness and acoustic comfort. Passengers tended to show more tolerance when evaluating acoustic comfort than subjective loudness. The speech-intelligibility evaluation of the broadcasts was significantly and positively correlated with the broadcast signal-to-noise ratio. The subjective evaluations of different individual sound sources' loudness and acoustic comfort and their relationships with the loudness and acoustic comfort of the overall sound environment were investigated. Passengers preferred broadcasts and were more tolerant of the sound made by themselves and their companions, but they were more averse to other passengers' voices and especially the sounds of their mobile phones. Demographic factors did not significantly affect passengers’ evaluations of the sound environment in the departure lounges, but social factors, especially traveling habits, made a significant difference.

Hypokinetic Dysarthria in Parkinson's Disease: A Narrative Review.

Numerous disabling motor and non-motor symptoms occur during Parkinson's disease (PD), including speech disorders, often referred to as hypokinetic dysarthria. PD is the most common cause of this type of dysarthria. About 90% of PD patients experience hypokinetic dysarthria, which is exacerbated as the disease progresses and makes it very difficult for other people to understand the person with PD. This disorder is characterized by a monotonous speech pattern, reduced and monotonous loudness, decreased stress, a breathy or hoarse voice quality, an increase in speech rate, rapid repetition of phonemes, and impreciseness in consonant production. However, patients may also have sensory symptoms including inaccurate perceptions of their own loudness and decreased awareness of speech problems. Hypokinetic dysarthria in PD may not only result from dopamine degeneration in the nigrostriatal pathway but also from disturbances in the motor and somatosensory systems. All speech components, such as phonation, articulation, respiration, resonance, and prosody should be assessed carefully in PD patients with hypokinetic dysarthria. Taking medical history, an oral motor assessment, a perceptual evaluation of speech characteristics, intelligibility, efficiency, and participation in communication all need to be a part of the assessment. The tasks of maximum phonation time, diadochokinetic rate, reading sentences, words, and passages, describing pictures, and spontaneous speech are used to assess the features of speech components and intelligibility. The evaluation should include physiological, acoustic, or imaging modalities as well. Speech therapy is typically the main treatment of speech problems in PD. The management of PD-related hypokinetic dysarthria basically focuses on speaker-oriented and communication-oriented strategies. In addition to these strategies, Augmentative Alternative Communication (AAC) should be considered in patients with severe dysarthria. Loudness, intelligibility, and sound perception may all significantly improve with the Lee Silverman Voice Therapy LOUD (LSVT LOUD) program which is an evidence-based program. The beneficial effect of pharmacological and surgical treatment approaches has not been proven in improving speech. Deep brain stimulation may carry the risk of the deterioration of speech as the illness progresses.

Developing an Evidence-Based Military Auditory Fitness-for-Duty Standard Based on the 80-Word Modified Rhyme Test.

One important function of military audiology is to conduct evaluations of service members (SMs) with hearing loss to ensure they are fit for deployment in dangerous operational environments. The objective of this study was to establish evidence-based auditory fitness-for-duty criteria based on speech-in-noise performance on the 80- and 160-word clinical versions of the Modified Rhyme Test (MRT 80 and MRT 160 ). Approximately 2400 SMs with various levels of hearing loss were recruited to complete the MRT 80 in conjunction with their annual hearing conservation evaluations. These SMs were also asked to perform one or more operationally-relevant listening tasks based on audio recordings made in highly realistic military training environments. The scores on these tests were compared to determine how well a proposed cutoff criterion for the MRT 80 was able to identify individuals who are hard of hearing with an exceptionally high risk of abnormally poor performance on operationally-relevant hearing tasks. The results show that a cutoff criterion that combines the percent correct score on two lists of the MRT 80 (i.e. MRT 160 ) with information about the better-ear threshold at 2 kHz is generally able to separate listeners with hearing loss into those who are likely to perform relatively well on operational listening tests and those who are likely to perform poorly on these tasks. This is consistent with current military acquisition standards, which identify the MRT as the preferred test for evaluating speech intelligibility for radios, headsets, and other communication equipment. It is also consistent with prior studies conducted in high-fidelity military simulations which have shown a significant correlation between MRT performance and operational outcomes. The proposed selection criteria, along with the new hearing profile standards that were recently adopted by the US Army, appear to provide an effective evidence-based methodology for identifying those SMs with hearing loss who are most at risk for poor performance on hearing-critical military tasks.

Regional Language Speech Recognition from Bone-Conducted Speech Signals through Different Deep Learning Architectures.

Bone-conducted microphone (BCM) senses vibrations from bones in the skull during speech to electrical audio signal. When transmitting speech signals, bone-conduction microphones (BCMs) capture speech signals based on the vibrations of the speaker's skull and have better noise-resistance capabilities than standard air-conduction microphones (ACMs). BCMs have a different frequency response than ACMs because they only capture the low-frequency portion of speech signals. When we replace an ACM with a BCM, we may get satisfactory noise suppression results, but the speech quality and intelligibility may suffer due to the nature of the solid vibration. Mismatched BCM and ACM characteristics can also have an impact on ASR performance, and it is impossible to recreate a new ASR system using voice data from BCMs. The speech intelligibility of a BCM-conducted speech signal is determined by the location of the bone used to acquire the signal and accurately model phonemes of words. Deep learning techniques such as neural network have traditionally been used for speech recognition. However, neural networks have a high computational cost and are unable to model phonemes in signals. In this paper, the intelligibility of BCM signal speech was evaluated for different bone locations, namely the right ramus, larynx, and right mastoid. Listener and deep learning architectures such as CapsuleNet, UNet, and S-Net were used to acquire the BCM signal for Tamil words and evaluate speech intelligibility. As validated by the listener and deep learning architectures, the Larynx bone location improves speech intelligibility.

Comparative Evaluation of Compliance and Speech Intelligibility among Complete Denture Wearers Based on Modifications in Anterior Palate

Comparative Evaluation of Compliance and Speech Intelligibility among Complete Denture Wearers Based on Modifications in Anterior Palate

Evaluation of Speech Intelligibility And Factors Influencing Its Outcome in Patients with Tongue Reconstruction Using Radial Forearm Free Flap

Objective: To study the speech outcomes in patients undergoing tongue reconstruction after tumour resection in terms of intelligibility and to examine the factors influencing the outcome.
 Study Design: Prospective observational study.
 Place and Duration of Study: Department of Plastic Surgery, Shifa International Hospital, Islamabad, Jan 2015 to Jan 2020.
 Methodology: A total of 109 patients diagnosed with tongue cancer meeting the inclusion criteria were included in the study. All the participants underwent tumor resection followed by adjuvant radiotherapy (unless refused by the patients). Patients were followed for six months and then underwent speech evaluation via the Functional Intra-oral Glasgow Scale score and Likert scale.
 Results: Thirty (27.5%) patients could be clearly understood at all the times, while 27 (24.8%) and 42 (38.5%) required some and frequent repetition, respectively. Nine (8.3%) patients could only be understood by close relations and one patient was completely unintelligible. Advancing age (p=0.01), male gender (p=0.01), tumour stage (p=0.004), presence of comorbidities (p=0.004) and degree of resection (p=0.004) had a significant statistical relationship with speech outcome. Addiction (p=0.32), adjuvant radiotherapy (p=0.97) and the development of complications (p=0.59) had no effect on speech.
 Conclusion: The provision of a mobile reconstructed tongue gives speech intelligibility in a majority of the patients however, the degree of speech recovery is directly dependent on advanced age, disease stage, the presence of comorbidities and degree of resection.

Speech Intelligibility evaluation in the presence of speech masker of cochlear implant in a reverberant room

In this report, we investigated the performance of a cochlear implant (CI) in a reverberant room with the presence of a competing speech masker. We compared Short-Time Objective Intelligibility (STOI) and Perceptual Speech Quality (PESQ) to represent the objective, to percent correct word (PCW) and Mean Opinion Score (MOS) as subjective evaluations, respectively. The target and the masker speech were convoluted with 0.4- and 0.7-s reverberation time, respectively, then processed with a 14-channel vocoder. We set the target to the masker 5dB and 0 dB SNR. We simulated two well-known techniques, namely CIS and SPEAK processors. Ten normal-hearing paid subjects were participated to evaluate the performance in clean, reverberant with no masker and reverberant with masker. The results showed that performance degraded significantly as the reverberation duration increased. Furthermore, the presence of a masker to a target speech in a reverberant room worsened all the evaluated performances compared to the reverberant alone. The results suggested that further investigation is required to reduce the masker effect to improve CI intelligibility.

An Observational Study to Evaluate Association Between Velopharyngeal Anatomy and Speech Outcomes in Adult Patients With Severe Velopharyngeal Insufficiency.

By measuring velopharyngeal structure and evaluating speech intelligibility, to explore and observe the association between velopharyngeal anatomy and speech outcomes in these patients. Thirty-one adult patients with velopharyngeal insufficiency after the primary palatoplasty aged 18 to 35 years (mean 22.03 years) were enrolled as the study group. The patients had significant hypernasality and audible nasal emission. The degree of velopharyngeal closure assessed by electronic nasopharyngeal fiberoptic endoscopy was grade III. Cephalometric analysis was performed on lateral cephalograms to measure velopharyngeal structure, including hard palate length (ANS-PNS), velar length (PNS-U), pharyngeal depth (PNS-PPW), and oropharyngeal airway space (U-MPW). Their speech intelligibility was evaluated through the Mandarin Chinese speech intelligibility test, and each speech sample was examined by 2 speech and language pathologists. The results were assessed with the SPSS 23.0 software package, and regression analysis was used to examine the relationship between velopharyngeal structure and speech outcomes. A significant negative correlation was confirmed between speech intelligibility and pharyngeal depth. Pharyngeal depth also showed a linear relationship with speech intelligibility, and there was no significant correlation between speech intelligibility and other measures (hard palate length, velar length, oropharyngeal airway space). In the velopharyngeal anatomy, only pharyngeal depth was associated with speech intelligibility in adult patients with severe velopharyngeal insufficiency, this is consistent with our clinical observation. It suggests that appropriate reduction of pharyngeal depth during palatopharyngoplasty may have a good effect on the speech recovery in patients with cleft palate and patients with velopharyngeal insufficiency after palatorrhaphy.

Assessment of speech intelligibility in university lecture rooms of different sizes using objective and subjective methods

The scores of speech intelligibility, obtained using objective and subjective methods for three university lecture rooms of the small, medium, and large sizes with different degrees of filling, were presented. The problem of achieving high speech intelligibility is relevant for both students and university administration, and for architects designing or reconstructing lecture rooms. Speech intelligibility was assessed using binaural room impulse responses which applied an artificial head and non-professional quality audio equipment for measuring. The Speech Transmission Index was an objective measure of speech intelligibility, while the subjective evaluation of speech intelligibility was carried out using the articulation method. Comparative analysis of the effectiveness of parameters of impulse response as a measure of speech intelligibility showed that Early Decay Time exceeded the score of the T30 reverberation time but was ineffective in a small lecture room. The C50 clarity index for all the considered lecture rooms was the most informative. Several patterns determined by the influence of early sound reflections on speech intelligibility were detected. Specifically, it was shown that an increase in the ratio of the energy of early reflections to the energy of direct sound leads to a decrease in speech intelligibility. The exceptions are small, up to 30‒40 cm, distances from the back wall of the room, where speech intelligibility is usually slightly higher than in the middle of the room. At a distance of 0.7–1.7 m from the side walls of the room, speech intelligibility is usually worse for the ear, which is closer to the wall. The usefulness of the obtained results lies in refining the quantitative characteristics of the influence of early reflections of sound on speech intelligibility at different points of lecture rooms.

Dysarthria following acute ischemic stroke: Prospective evaluation of characteristics, type and severity

Dysarthria is a common symptom following stroke and represents an important cause of functional impairment in stroke patients. A better characterization of dysarthria could facilitate differential diagnosis and optimize healthcare service distribution. To determine the speech characteristics, dysarthria type and severity in the acute phase following ischemic stroke in a comprehensive stroke centre. First-ever ischemic stroke patients consecutively admitted to the Stroke Unit of Ghent University Hospital were included in this prospective clinical study between March 2018 and October 2019. All participants admitted to the Stroke Unit were screened for dysarthria by a speech-language pathologist within 72 h after admission. When dysarthria was identified, speech characteristics were evaluated via auditory-perceptual assessment and objective measurement of acoustic parameters. Dysarthria type was determined based on the Mayo Classification System. Severity of impairment was scored at function and activity level using the Radboud Dysarthria Assessment and the evaluation of speech intelligibility at sentence level using the Dutch Speech Intelligibility Assessment. In addition, dysarthria recovery was separately evaluated in all participants using the National Institutes of Health Stroke Scale (NIHSS) at hospital admission, day 3 ± 2 and day 7. A total of 67 out of 151 participants (44%; mean age = 69 years; SD = 13; 28 females) were diagnosed with dysarthria in the acute phase following stroke. Standardized assessments were possible in 72% (48/67) of participants. Imprecise articulation of consonants, harsh voice quality and audible inspiration were the most frequent observed speech characteristics. The acoustic parameters maximum phonation time and maximum loudness deviated most from normative values. Unilateral upper motor neuron (UUMN) was the main dysarthria type present in 52% (25/48) of participants. A total of 58% (28/48) and 71% (34/48) of participants had no/minimal/mild difficulties at the functional and activity levels, respectively. Speech intelligibility was mildly impaired (median = 91%; IQR = 73-97). According to the NIHSS, sub-item speech score at hospital admission, 46% (70/151) of participants had dysarthria, of which half recovered completely from their dysarthria within 1 week after stroke symptom onset. UUMN was the dominant dysarthria type, and the majority of participants had a mild dysarthria. Half the participants showed complete recovery within 1 week following symptom onset. The observed speech characteristics mainly reflect impairments in the subsystem's articulation, phonation and respiration. Objective measurements of acoustic parameters corroborate these findings. Future research should focus on longitudinal assessment to investigate recovery of symptoms and the long-term impact of dysarthria on social participation. What this paper adds What is already known on the subject There are few data concerning the presentation of dysarthria following acute ischemic stroke. Moreover, previous research did not include objective measurements of speech characteristics and dysarthria severity. There was a need to determine prospectively speech characteristics, dysarthria type and severity in a stroke population using standardized assessments. What this paper adds to existing knowledge The findings of this study show a high prevalence of dysarthria following acute ischemic stroke. This study confirms previous findings that the speech of dysarthric patients following acute ischemic stroke was mostly characterized by imprecise articulation of consonants, a harsh voice quality and audible inspiration. The results of the objective measures confirm these findings. We added evidence that UUMN is the most prevalent dysarthria type in a stroke population, and that the majority of participants had mild dysarthria. A high rate of dysarthria recovery was seen in the first week following symptom onset. What are the potential or actual clinical implications of this work? The findings of this study contribute to the limited research performed regarding post-stroke dysarthria. The results can help optimize the distribution of healthcare resources. The majority of participants have a mild dysarthria, making the identification of the specific needs of this group an important area of concern. The evaluation of impaired speech subsystems and characteristics, especially supplemented with objective measures of acoustic parameters, and the classification of the type and severity of dysarthria can be helpful to monitor early progress in the acute phase post-stroke.

The simplified French Matrix. A tool for evaluation of speech intelligibility in noise

IntroductionIn audiology, the usual tests of speech perception in silence are non-predictive of intelligibility in noise. The French Matrix was developed to assess intelligibility in noise in adults with normal cognitive capacity. A simplified adaptive version, FRA-SIMAT, was derived for use with children and elderly persons with diminished memory span. The aim of the present study was to apply this adaptive procedure to determine signal-to-noise ratio (SNR) according to percentage intelligibility. MethodsTwenty normal-hearing adults and 60 normal-hearing children aged 5–6 years (G1), 7–8 years (G2) and 9–10 years (G3) were included. FRA-SIMAT uses groups of 3 words, to limit memory demand. ResultsIn adults, SNR for 50% (SNR-50) and 80% intelligibility (SNR-80) was respectively −7.1±1.4dB and −3.7±1.6dB. In children, SNR-50 was −4.2±1.3dB in G1, −4.6±1.2dB in G2, and −5.5±1.5dB in G3. ConclusionThe FRA-SIMAT test of speech perception in noise was validated in adults and children of different ages, and can be implemented as a diagnostic and rehabilitation tool in clinical practice.

Speech intelligibility in people with Amyotrophic Lateral Sclerosis (ALS).

To evaluate speech intelligibility and dysarthria, correlated to the functional assessment of Amyotrophic Lateral Sclerosis (ALS). Quantitative-descriptive study approved by REC under No. CAAE 62912416.4.0000.5404, comprised of 19 individuals with sporadic or familiar ALS. Data were collected using the Dysarthria Protocol and the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-Re). We used visual analogue scale (VAS) to assess speech intelligibility and summary measures; and Spearman's coefficients of correlation for the instruments with significance level of 5%. Speech intelligibility is compromised (41.37±39.73) in varied degrees with positive correlation with the general degree of dysarthria (p=<.0001), and with all the analyzed speech parameters, indicating impact on the speech deterioration of the studied group. There is negative correlation between speech intelligibility and the results of the bulbar sections - speech and deglutition (p=0.0166), arm - activities with the upper limb (p=0.0064) and leg - activities with the lower limb (p=0.0391). Breathing (p=0.0178), phonation (p=0.0334) and resonance (p=0.0053) parameters showed a negative correlation with the item "speech" of the ALSFRS-Re. Results show impaired speech intelligibility and dysarthria, and evidence breathing, phonation and resonance as important markers of the disease progression. A thorough and early evaluation of the oral motor production allows for a better management of alterations in ALS.