Speech Intelligibility Test Research Articles

Development and cultural adaptation of the Saudi pediatric speech intelligibility test.

To report the development and administration of the Saudi pediatric speech intelligibility (SPSI) test. This study was carried out at King Abdullah Ear Specialist Center, King Saud University, Riyadh, Saudi Arabia, between 2021 and 2023. A pilot study was carried out in 5 regions of Saudi Arabia including 100 normal hearing children aged 7-11 years old, with 20 children from each region. The final test materials were voice-recorded by a native Saudi radio announcer, and a software-based application for administering the SPSI was developed. During the pilot study, minor adjustments were carried out to the test for more clarity. The developed SPSI software is an android-based application that includes features like automatic result calculation, data saving, and individual user accounts for examiners to review results. The SPSI test comprises 4-word cards and 2 sentence cards, each with 5 pictures, and operates in 3 modes: quiet, background noise, and competing sentences. The SPSI test has been developed in an android-based software using the Saudi local dialects. It can facilitate comprehensive and accurate assessment of speech intelligibility, particularly in children with hearing impairments.

Maxillectomy patients' speech and performance of contemporary speaker-independent automatic speech recognition platforms in Japanese.

Automatic speech recognition (ASR) can potentially help older adults and people with disabilities reduce their dependence on others and increase their participation in society. However, maxillectomy patients with reduced speech intelligibility may encounter some problems using such technologies. To investigate the accuracy of three commonly used ASR platforms when used by Japanese maxillectomy patients with and without their obturator placed. Speech samples were obtained from 29 maxillectomy patients with and without their obturator and 17 healthy volunteers. The samples were input into three speaker-independent speech recognition platforms and the transcribed text was compared with the original text to calculate the syllable error rate (SER). All participants also completed a conventional speech intelligibility test to grade their speech using Taguchi's method. A comprehensive articulation assessment of patients without their obturator was also performed. Significant differences in SER were observed between healthy and maxillectomy groups. Maxillectomy patients with an obturator showed a significant negative correlation between speech intelligibility scores and SER. However, for those without an obturator, no significant correlations were observed. Furthermore, for maxillectomy patients without an obturator, significant differences were found between syllables grouped by vowels. Syllables containing /i/, /u/ and /e/ exhibited higher error rates compared to those containing /a/ and /o/. Additionally, significant differences were observed when syllables were grouped by consonant place of articulation and manner of articulation. The three platforms performed well for healthy volunteers and maxillectomy patients with their obturator, but the SER for maxillectomy patients without their obturator was high, rendering the platforms unusable. System improvement is needed to increase accuracy for maxillectomy patients.

How to Efficiently Measure the Intelligibility of People With Parkinson's Disease.

The purpose of this study was to determine the most efficient approaches to measuring the intelligibility of people with Parkinson's disease (PD) when considering the estimation method, listener experience, number of listeners, number of sentences, and the ways these factors may interact. Speech-language pathologists (SLPs) and inexperienced listeners estimated the intelligibility of people with and without PD using orthographic transcription or a visual analog scale (VAS). Intelligibility estimates were based on 11 Speech Intelligibility Test sentences. We simulated all combinations of listeners and sentences to compare intelligibility estimates based on fewer listeners and sentences to a speaker-specific benchmark estimate based on the mean intelligibility across all sentences and listeners. Intelligibility estimates were closer to the benchmark (i.e., more accurate) when more listeners and sentences were included in the estimation process for transcription- and VAS-based estimates and for SLPs and inexperienced listeners. Differences between the benchmark and subset-based intelligibility estimates were, in some cases, smaller than the minimally detectable change in intelligibility for people with PD. The intelligibility of people with PD can be measured more efficiently by reducing the number of listeners and/or sentences, up to a point, while maintaining the ability to detect change in this outcome. Clinicians and researchers may prioritize either fewer listeners or fewer sentences, depending on the specific constraints of their work setting. However, consideration must be given to listener experience and estimation method, as the effect of reducing the number of listeners and sentences varied with these factors.

Impact of contextual and lip-sync-related visual cues on speech intelligibility through immersive audio-visual scene recordings in a reverberant conference room

Recent hearing research has benefitted from the latest Virtual Reality systems that allowed the reproduction of immersive Audio-Visual scenarios to achieve more ecological listening tests. Indeed, efforts have been spent to identify the aspects that convey actual ecological validity, particularly investigating the effects of visual cues and self-motion on Speech Intelligibility through tests mainly based on simulated scenes. However, work must still be addressed when sceneries developed through real recordings inside reverberant environments are concerned. This study used 3rd-order ambisonics recordings and stereoscopic 360° videos inside a reverberant conference hall to create three virtual audio-visual scenes where speech intelligibility tests were performed, introducing informational noise from different angles. A 16-speaker spherical array synced with a headmounted display was used to administer the immersive tests to 50 normal-hearing subjects. Firstly, tests only composed of the auditory scenes were compared, based on the achieved scores, with tests also providing contextual and positional source-related visual cues, both with and without self-motion, for a total of four different test configurations. Then, to complete the investigation of the visual cues' impact on speech intelligibility, ten normal-hearing subjects were recruited to performaudio-visual tests incorporating lip-sync-related visual cues for the target speech.

Development and content validation of coordinate response measure (CRM) corpus in Kannada for informational masking measurement

BackgroundAssessing informational masking (IM) involves various methods, broadly categorized as electrophysiological and behavioral approaches. In behavioral methods, researchers often use a range of stimulus types such as tone-in-noise masking, speech masking, music masking, gap detection, modulation masking, and spatial masking. The evaluation of speech perception in noisy conditions often utilizes the coordinate response measure (CRM), a publicly available test developed by Moore (AGARD conference proceedings 311, 1981). The objective of the study is to develop and content validate the Kannada coordinate response measure (CRM) sentences corpus for the information masking measurement.ResultsStage 1: A total of thirty-eight call signs, eight colors, and eight numbers in the Kannada language were compiled and were given to 15 experts to select the appropriate stimuli. Those stimuli that satisfied the criteria of CVI ≥ 0.90 and CVR ≥ .90 were selected, which consisted of eight call signs, seven numbers, and five colors. Stage 2: By incorporating the chosen call signs, numbers, and colors, seven sentence structures were formulated and were subjected to content validation (criteria of CVI ≥ 0.90 and CVR ≥ .90). The sentence structure “(Call sign) iga (Color) bannada (Number) torsu” was finalized.Stage 3: Eight speakers (four males and four females) recorded Kannada sentences of about 3.5 s each, which were evaluated by five audiologists for voice quality, rate, and speech clarity using a 4-point scale. The evaluation identified two male and two female speakers with the best recordings.Stage 4: The final stage involved recording 235 sentences by the selected speakers, which were then assessed by two Kannada-speaking audiologists for face validity on various parameters, ensuring linguistic appropriateness and cultural relevance for inclusion in the final CRM corpus.ConclusionThe resulting corpus, meticulously curated and content-validated, presents significant potential for advancing research and clinical assessment of informational masking within the Kannada-speaking community. Overall, the CRM’s exceptional performance in challenging listening environments, inherent adaptability across languages, versatility for different age and literacy levels, and effectiveness in speech-intelligibility testing with multiple simultaneous talkers due to its use of call signs underscores its value as a superior measurement tool, which can be used in IM measurement in Kannada-speaking population.

Tipping the Scales: Indiscriminate Use of Interval Scales to Rate Diverse Dysarthric Features.

Error related to incorrect use of rating scales is problematic in the assessment and treatment of dysarthria. The main purpose of this project was to determine scale fit for cardinal speech features of hypokinetic dysarthria. A secondary aim was to determine rater reliability for the two different scales explored. Forty-three speakers with Parkinson's disease (PD) and 25 neurologically healthy control talkers were recorded reading sentences from the Speech Intelligibility Test. Twenty-two healthy female listeners used both an equal appearing interval (EAI) scale and a direct magnitude estimation (DME) scale to rate five perceptual speech features (i.e., overall speech severity, articulatory imprecision, reduced loudness, short rushes of speech, and monotony) from these recordings. Regression analyses were used to determine the linearity of the relationship between the means of the EAI and DME ratings. Inter- and intrarater reliability was calculated using intraclass correlation coefficients and Spearman's correlation coefficients, respectively, for both EAI and DME ratings. There was a linear relationship between EAI and DME means for monotony, indicating it is a metathetic dimension. Curvilinear relationships were observed between the EAI and DME means for the other four features, indicating prothetic dimensions. Intra- and interrater reliability values were similar for EAI and DME ratings. Overall, results of this work suggest that DME is the best fit for scaling several hypokinetic dysarthria features, and not the conventionally used EAI scale. Prothetic dimensions best scaled by DME include overall speech severity, articulatory imprecision, reduced loudness, and short rushes of speech. Monotony was the only feature found to be a metathetic dimension and would be best scaled using EAI or DME. Findings call for rethinking the widespread use of EAI scales for rating perceptual features as part of the assessment and treatment of motor speech disorders.

Patient-related outcome measures (PROM) in adult cochlear implant patients

Cochlear implants (CI) provide individuals with severe sensorineural hearing loss the opportunity for artificial auditory perception. The standardized documentation of speech intelligibility tests is widespread, while the systematic capture of patient-related outcome measures (PROMs) remains inconsistent. Relevant PROM instruments were evaluated and selected based on the criteria of dissemination, clarity, and relevance, integrated into routine clinical practice, and tested at longitudinal time points. A total of three PROM instruments were selected and successfully integrated into the clinical routine. The comparison of 2measurement points from 25individuals showed improvements in subjective speech comprehension and tinnitus perception. This study demonstrates the clinical implementation and integration of PROMs in adult CI candidates and patients. The PROMs are apromising tool to support various phases of treatment, both as adecision aid for potential CI candidates and for monitoring after implantation.

Speech recognition and speech audiometry parameters in evaluation of aural rehabilitation progress in cochlear implant patients. Review paper.

<b>Introduction:</b> Speech audiometry is well established and frequently used test in audiology as well as in cochlear implant recipient's performance evaluation. Expanding indications for cochlear implantation forces use of more refined methods of both assessment and prognosis of outcome of aural rehabilitation. Variability of speech intelligibility tests and materials require standardized protocol facilitating outcome comparison.<b>Aim:</b> Aim of this review paper is analysis of usage of speech audiometry and other speech intelligibility tests and its results reporting in patients with cochlear implant in Poland and in the World.<b>Materials and methods:</b> Protocols of many different domestic and foreign health centers where compared, showing many methodological differences. Selection of literature for analysis was made according to PRISMA algorithm recommendations. Twenty research papers were chosen for review process.<b>Discussion:</b> In many papers we found lack of data regarding methodology of performed tests. Many authors indicate difficulties in comparing results, especially if publication lacks basic technical information. Despite that if right method is applied, results can be compared. In literature only one level of material presentation in test is prevalent. Speech audiometry is significant in exploring connections between multiple pre-op and post-op prognostic aspects of cochlear implantation.<b>Conclusions:</b> Because of variability in presentation and reporting of CI patients outcomes, consensus is needed in area of system facilitating comparison of research results. This may provide simple solution for accurate analysis and choosing right set of data. Schematic of presentation of audiological data in authors health center was proposed as example.

Speech intelligibility in reverberation based on audio-visual scenes recordings reproduced in a 3D virtual environment

Audio-visual scenes were collected in a medium-sized reverberant conference hall through in-field 3rd-order ambisonics impulse response recordings and 360-degree stereoscopic videos. The visual scenes included cues of the room and the location of the sound sources, without lip-sync-related cues. Speech intelligibility tests based on seven audio-visual scenes were administered inside an immersive virtual 3D environment reproduced through a spherical 16-speaker array synched with a head-mounted display. Forty normal-hearing subjects were engaged to test the effects on speech intelligibility of a talker in front of the listener and amplified by two lateral symmetrical loudspeakers, in the case of (i) different listener-to-talker distances, (ii) one-talker noise at various azimuth angles around the listener, (iii) high reverberation with –5 dB signal-to-noise ratio, (iv) self-motion, and (v) visual cues. We conducted tests in four configurations, that is, audio-visual and audio-only, both with self-motion and in the static condition. The static audio-only tests scored the highest speech intelligibility, followed by a tie between audio-visual with self-motion and in the static condition. Speech intelligibility decreased as the target-to-listener distance increased in all the noisy scenes. Additionally, speech intelligibility increased when the noise azimuth was at 120° compared to both 180° and 0° , with the talker at approximately 8 m from the listener. The advantage of the spatial separation of the noise signal in reverberation is evident in the case of the audio-visual with self-motion test. This suggests a spatial release from masking in the presence of reverberation, one-talker-interfering noise and within an more ecological scene.

Comparison of Vowel and Sentence Intelligibility in People With Dysarthria Secondary to Amyotrophic Lateral Sclerosis.

In this study, we examined the utility of vowel intelligibility testing for assessing the impact of dysarthria on speech characteristics in people with amyotrophic lateral sclerosis (ALS). We tested the sensitivity and specificity of overall vowel identification, as well as that of vowel-specific identification, to dysarthria presence and severity. We additionally examined the relationship between vowel intelligibility and sentence intelligibility. Twenty-three people with ALS and 22 age- and sex-matched control speakers produced sentences from the Speech Intelligibility Test (SIT), as well as 10 American English monophthongs in /h/-vowel-/d/ words for the vowel intelligibility test (VIT). Data for SIT and VIT scores came from 135 listeners. Diagnostic accuracy of VIT measures was evaluated using the area under the curve of receiver operator characteristics. We then examined differences between control speakers, speakers with mild dysarthria, and speakers with severe dysarthria in their relationship between SIT and VIT scores. The results suggest that the overall vowel intelligibility score showed high sensitivity and specificity in differentiating between speakers with and without dysarthria, even those with milder symptoms. In addition, single-vowel identification scores showed at least acceptable group differentiation between the mild and severe dysarthria groups, though fewer single vowels were acceptable discriminators between the control group and the group with mild dysarthria. Identification accuracy of /ɪ/ in particular showed excellent discrimination across all groups. Examination of the relationship between SIT and VIT scores suggests a severity-specific relationship. Speakers with SIT scores above 70% generally had higher SIT than VIT scores, whereas speakers with SIT below 70% generally had higher VIT than SIT scores. Vowel intelligibility testing can detect speech impairments in speakers with mild dysarthria and residual articulatory function in speakers with severe dysarthria. Vowel intelligibility testing may, therefore, be a useful addition to intelligibility testing for individuals with dysarthria.

Exploring the relation between the central auditory processing functions and language development among Arabic-speaking children with attention deficit hyperactivity disorder

Abstract Background Debate still exists on the effect of central auditory processing disorder (CAPD) on the language of children with attention deficit hyperactive disorder (ADHD). This study aimed to explore the deficits of the central auditory processing (CAP) functions and their relation to language development and ADHD symptoms in 30 Egyptian Arabic-speaking children with ADHD between 4 and ≤ 7 years old. ADHD symptoms were rated by Conners’ Parent Rating Scale–Revised. Language development was assessed by the Modified Pre-school Language Scale (PLS) 4th edition, the Arabic version, and the Egyptian Arabic Pragmatic Language Test. CAP functions were tested by the Pediatric Speech Intelligibility (PSI) test (Arabic version). Results Sixty percent of the ADHD children had comorbid CAPD with predominance among ADHD children of combined type. There was a significant positive correlation between all PSI subtests assessing the monotonic auditory closure and dichotic auditory separation abilities in both ears and the language ages by the modified PLS-4. There was also a significant positive correlation between scores of the Egyptian Arabic Pragmatic Language Test (EAPLT) and the monotonic auditory closure ability in both ears and auditory separation ability in the right ear only.There was a non-significant mild difference in scores of the modified PLS-4 in favor of the ADHD children with normal CAP functions. Conclusion Not all children with ADHD have central auditory processing disorder as both ADHD and CAPD are independent disorders. Better central auditory processing functions are associated with well-developed language and higher pragmatic skills in ADHD children.

Comparative Analysis of Methods of Audiological Screening of the Adult Population: Global and Kazakhstani Experience

Hearing impairment is currently recognized as the most prevalent sensory impairment and one of the leading causes of disability worldwide. It is estimated that one in five people on Earth has at least minimal hearing loss, and more than 5% of the population has disabling hearing loss. There are many methods for screening detection of hearing impairment, and the most common ones are mobile applications, recognition of whispered speech, a portable audiometer, questionnaires, the speech intelligibility test in noise, and others. Nevertheless, the “gold standard” for hearing testing has been and remains the method of pure-tone threshold audiometry. The purpose of this review is to study the currently available literature, analyze ongoing research in the field of audiological screening of adults, study the cost-effectiveness of ongoing screening activities, study the situation in Kazakhstan, and the possibility of using these screening methods in Kazakhstan. We selected 25 full-text articles that met the following criteria: the 2018-2023 time interval, adult population, screening methods, effectiveness, and article language (English, Russian, Kazakh). Conclusions. Despite a sufficient number of hearing screening methods, their sufficient reliability, sensitivity, and specificity, and their obvious cost-effectiveness in comparison with the costs of rehabilitation of hearing impairments, none of the hearing assessment methods are included in the National Screening Program for examining adult population in any country in the world. In Kazakhstan, a screening test of hearing function using a one-question survey, the HHIA/HHIE questionnaire, a study of whispered speech at the primary health care level, and also the use of a mobile version of a hearing test as a hearing self-diagnosis are applicabl

Cognitive Auditory Training: Comparative Impact of Telerehabilitation and In-person Training

Abstract Background: Cognitive auditory approach has been shown effective in assessment and intervention with children with Central Auditory Processing Disorders (CAPD). Objective: To compare the intervention methods: telerehabilitation for synchronous auditory training through an Online Cognitive Auditory Training Program, with the traditional rehabilitation method, called acoustically controlled auditory training, carried out in person in an acoustic booth. Methods: The sample included 23 children between the ages of 7 and 9, of both genders, living in the state of São Paulo, Brazil, who were divided into two groups: Group I - 13 children undergoing telerehabilitation and Group II - 10 children undergoing auditory training in an acoustic booth. The instruments used were: i) Pediatric Speech Intelligibility (PSI) test in the ipsilateral competitive messages (ICM condition); ii) Digit Dichotic (DD) in binaural integration and separation skills test in auditory separation and integration skills. Results: In this study the following results were: a) there were statistically significant differences in the performance of children who underwent telerehabilitation for CAPD, revealing the reliability of the method, b) there were statistically significant differences both in the effect of auditory training carried out through telerehabilitation and in the effect of auditory training carried out in person, proving that the effectiveness of the two methods is equivalent, c) there were statistically significant differences in the performance of school-age students with CAPD who used the Online Cognitive Auditory Training Program, showing that the cognitive auditory approach is effective in intervention with children with CAPD. Conclusion: There is efficacy in cognitive auditory training through the telerehabilitation intervention. Results shown that intervention through the Online Cognitive Auditory Training Program support student learning and communication skills. Keywords: Auditory Processing, Cognitive Auditory Training, Telerehabilitation, Central Auditory Processing Disorders (CAPD).

The Radboud dysarthria assessment: validity and reliability of the Arabic version

Purpose To cross-culturally adapt and validate the Radboud Dysarthria Assessment (RDA) and the speech component of the Radboud Oral Motor inventory for Parkinson’s disease (ROMP-speech) into the Arabic language among Lebanese subjects with dysarthria. Materials and methods This study included 50 participants with dysarthria. The Arabic versions of the RDA (A-RDA) and the ROMP-speech (A-ROMP-speech) were administered in addition to the Arabic Speech Intelligibility test, the Lebanese Voice Handicap Index–10 (VHI-10lb) and semantic verbal fluency tasks. The maximum performance tasks were analyzed using the Praat software. The A-RDA qualitative recording form and the A-ROMP-speech were assessed for construct validity and internal consistency. The convergent validity of the maximum performance tasks, the severity scale, and the A-ROMP-speech were evaluated. Results Exploratory factor analysis of the qualitative recording form extracted 3 factors explaining 82.973% of the total variance, and it demonstrated high internal consistency (α = 0.912). The maximum performance tasks of the RDA correlated significantly with the corresponding Praat scores. The severity scale and the A-ROMP-speech correlated fairly to strongly with the Arabic Speech Intelligibility test (rs=-0.695 and −0.736, p < 0.001) and the VHI-10lb (r = 0.539 and 0.640, p < 0.001). Conclusion The A-RDA and the A-ROMP-speech are valid and reliable dysarthria tools among Lebanese subjects.

Challenges for Children with Cochlear Implants in Everyday Listening Scenarios: The Competitive Effect of Noise and Face Masks on Speech Intelligibility

Speech intelligibility (SI) tests under realistic acoustic scenarios are complex tasks to perform. Optimal acoustics, in terms of reverberation and noise, are thus needed. This is particularly true in the presence of young hard-of-hearing (HoH) children equipped with cochlear implants who need speech to be highly intelligible to learn. During the COVID-19 pandemic starting in early 2020, wearing face masks became common to avoid the spread of infection, mainly impacting the increasingly challenging task of listening for HoH listeners. This study investigated the influence of different types of face masks on speech intelligibility and listening difficulty under competitive noise scenarios. Fourteen children with cochlear implants were involved, as well as six children with typical hearing. Three types of face masks with different acoustic, filtration, and breathability characteristics were considered; three signal-to-noise ratios (SNR) of +10 dB, +5 dB, and 0 dB were used. As expected, lower SNRs corresponded to lower speech intelligibility, and SI without a mask was similar to that obtained with a mask at the lowest acoustic attenuation, albeit with a low filtration efficiency. These preliminary outcomes help improve speech communication strategies in classrooms to support optimal listening conditions.

Speech Intelligibility Test for Polish Language – Relation to the Acoustic Properties of Classrooms and Comparison to Other Languages

Numerous studies have shown that teachers often speak louder in classrooms because of the acoustic properties of the spaces. To improve the acoustics in classrooms, it is necessary to develop relevant acoustic criteria. Existing evaluation scales for parameters of room acoustics have been developed on the basis of studies of adults for a variety of languages (e.g. Dutch and English). One of the issues still not fully recognized is the effect of the respondents’ language and age on the results of speech intelligibility tests. The aim of the study was to recognize the possibility of applying some international guidelines for room acoustics developed on the basis of adult studies to classrooms in Polish schools. This paper presents a study of the speech intelligibility of Polish-speaking children (10–13 years old) in conjunction with parameters of room acoustics. It also compares studies of speech intelligibility for other languages. The study confirmed a relationship between the results of speech intelligibility tests and speech transmission index STI for classrooms with varied acoustics. It also showed that the results of Polish word test are similar to results of English tests (Anderson, Kalb, 1987; Jacob et al., 1990).

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.

Classroom Acoustics for Enhancing Students' Understanding When a Teacher Suffers From a Dysphonic Voice.

The purpose of this project is to assess the acoustical conditions in which optimal intelligibility and low listening difficulty can be achieved in real classrooms for elementary students, taking into consideration the effects of dysphonic voice and typical classroom noise. Speech intelligibility tests were performed in six elementary classrooms with 80 normal-hearing students aged 7-11 years. The speech material was produced by a female actor using a normal voice quality and simulating a dysphonic voice. The stimuli were played by a Head and Torso Simulator. Child babble noise and classrooms with different reverberation times were used to obtain a Speech Transmission Index (STI) range from 0.2 to 0.7, corresponding to the categories bad, poor, fair, and good. The results showed a statistically significant decrease in intelligibility when the speaker was dysphonic, in STI higher than 0.33. The rating of listening difficulty showed a significantly greater difficulty in perceiving the dysphonic voice. In addition, younger children showed poorer performance and greater listening difficulty compared with older children when listening to the normal voice quality. Both groups were equally impacted when the voice was dysphonic. The results suggested that better acoustic conditions are needed for children to reach a good level of intelligibility and to reduce listening difficulty if the teacher is suffering from voice problems. This was true for children regardless of grade level, highlighting the importance of ensuring more favorable acoustic conditions for children throughout all elementary schools. https://doi.org/10.23641/asha.23504487.

Sensitivity and specificity of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised to detect dysarthria in individuals with amyotrophic lateral sclerosis.

Given the widespread use of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) to measure disease progression in ALS and recent reports demonstrating its poor sensitivity, we aimed to determine the sensitivity and specificity of the ALSFRS-R bulbar subscale and speech item to detect validated clinical ratings of dysarthria in individuals with ALS. Paired ALSFRS-R and validated Speech Intelligibility Test (SIT) data from individuals with ALS were analyzed. Trained raters completed duplicate, independent, and blinded ratings of audio recordings to obtain speech intelligibility (%) and speaking rate (words per minute, WPM). Binary dysarthria profiles were derived (dysarthria ≤96% intelligible and/or <150 WPM). Data were obtained using the Kruskal-Wallis test, receiver-operating characteristic (ROC) curve, area under the curve (AUC), sensitivity and specificity percentages, and positive/negative predictive values (PPV/NPV). A total of 250 paired SIT and ALSFRS-R data points were analyzed. Dysarthria was confirmed in 72.4% (n = 181). Dysarthric speakers demonstrated lower ALSFRS-R bulbar subscale (8.9 vs. 11.2) and speech item (2.7 vs. 3.7) scores (P < .0001). The ALSFRS-R bulbar subscale score had an AUC of 0.81 (95% confidence interval [CI] 0.75 to 0.86). A subscale score of ≤11 yielded a sensitivity of 86%, specificity of 57%, PPV of 84%, and NPV of 60% to correctly identify dysarthria status. The ALSFRS-R speech item score demonstrated an AUC of 0.81 to detect dysarthria (95% CI 0.76 to 0.85), with sensitivity of 79%, specificity of 75%, PPV of 89%, and NPV of 58% for a speech item cutpoint of ≤3. The ALSFRS-R bulbar and speech item subscale scores may be useful, inexpensive, and quick tools for monitoring dysarthria status in ALS.

Lexical Characteristics of the Speech Intelligibility Test: Effects on Transcription Intelligibility for Speakers With Multiple Sclerosis and Parkinson's Disease.

Lexical characteristics of speech stimuli can significantly impact intelligibility. However, lexical characteristics of the widely used Speech Intelligibility Test (SIT) are unknown. We aimed to (a) define variation in neighborhood density, word frequency, grammatical word class, and type-token ratio across a large corpus of SIT sentences and tests and (b) determine the relationship of lexical characteristics to speech intelligibility in speakers with multiple sclerosis (MS), Parkinson's disease (PD), and neurologically healthy controls. Using an extant database of 92 speakers (32 controls, 30 speakers with MS, and 30 speakers with PD), percent correct intelligibility scores were obtained for the SIT. Neighborhood density, word frequency, word class, and type-token ratio were calculated and summed for each of the 11 sentences of each SIT test. The distribution of each characteristic across SIT sentences and tests was examined. Linear mixed-effects models were performed to assess the relationship between intelligibility and the lexical characteristics. There was large variability in the distribution of lexical characteristics across this large corpus of SIT sentences and tests. Modeling revealed a relationship between intelligibility and the lexical characteristics, with word frequency and word class significantly contributing to the model. Three primary findings emerged: (a) There was considerable variability in lexical characteristics both within and across the large corpus of SIT tests; (b) there was not a robust association between intelligibility and the lexical characteristics; and (c) findings from a study demonstrating an effect of neighborhood density and word frequency on intelligibility were replicated. Clinical and research implications of the findings are discussed, and three exemplar SIT tests systematically controlling for neighborhood density and word frequency are provided.