Dysarthria describes the impaired speech intelligibility caused by weakness of muscles involved in speech following stroke. This is a common consequence of stroke and can have a detrimental impact on self-confidence leading to social isolation for many. There is limited evidence for dysarthria intervention but we know that research into speech difficulties after stroke is a priority for stroke survivors. An online speech rehabilitation programme was developed, ReaDySpeech, with the potential to offer improved quality of independent practice, increased intensity of practice and the ability to record interaction. The research presented in this thesis aimed to systematically examine the existing evidence base, to carry out some preliminary acceptability work on ReaDySpeech, and implement a feasibility trial. The initial study was a Cochrane systematic review of the effectiveness of interventions for people with non-progressive dysarthria after stroke or other adult-acquired brain injury. This found insufficient evidence to know whether dysarthria intervention is effective or not. This led to a study of early acceptability work for ReaDySpeech and whether there were any technical barriers to use. This found no significant technical barriers other than lack of Wi-Fi and it was acceptable to participants and therapists. This enabled a progression to a feasibility trial following amendments and improvements to the protocol and ReaDySpeech itself. The feasibility trial found recruitment, retention and the intervention were all feasible to carry out during a trial. Further in-depth consideration of the findings indicates more work is needed to widen recruitment and to develop the intervention, comparator and methodology of a future trial for this to be a success with valid clinical implications. This thesis reports this body of work and discusses potential future directions for dysarthria research.

Parkinson's disease is an incurable, progressive neurodegenerative brain disorder. Individuals living with Parkinson's disease often face considerable challenges in managing the progressive decline of their symptoms and maintaining their quality of life (Broadfoot et al., 2019). During the progression of PD, 75-90% of individuals will have a speech and voice disorder (National Center for Voice and Speech, 2019). The communication disorder most commonly associated with PD is hypokinetic dysarthria (HKD). Many individuals with PD may have significant difficulty communicating and participating effectively in a variety of speaking situations due to their communication deficits (Dykstra et al., 2015). Addressing an individuals perceived quality of communication and their perceived communication effectiveness should be an essential target during intervention due to the implications it has on the psychological well-being and prognosis for people with PD. Participants in this study were recruited from individuals previously diagnosed with Parkinson's disease attending the SPEAK OUT! & LOUD Crowd® program. The research questions included (1) Does the implementation of the SPEAK OUT! ® and the LOUD Crowd® program have a positive effect on participants’ perceived quality of communication (PQOC), and (2) Do these programs have a significant positive effect on participants perceived communicative effectiveness (PCE)? The Voice Handicap Index (VHI) and the Communicative Effectiveness Survey- Revised (CESR®) were utilized in this research study. The surveys were administered prior to the SPEAK OUT!® training and following the completion of this portion of the program. They were administered every 16 weeks while the participant was in the LOUD Crowd® training during the duration of this project. It was hypothesized that participants' PQOC related to their voice and their PCE will improve following the implementation of this program. Due to COVID-19 restrictions, results from this study only considered baseline scores and post-test 1 scores following the completion of the SPEAK OUT!® program. The results from this study support the hypothesis that the SPEAK OUT!® program has a positive effect on the participants’ PQOC. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2021. / FAU Electronic Theses and Dissertations Collection

Although recent literature suggests that fatigue influences the communication of people with multiple sclerosis (MS), its relationship to acoustic measures of speech, specifically formant transitions during diphthongs, has not been explored. In the present study, 11 participants diagnosed with MS, two of whom were perceptually dysarthric, and 12 control subjects were recorded as they performed selected speech tasks in both the morning and the afternoon. Before each recording session, participants rated their fatigue level. The participants with MS gave significantly higher ratings of fatigue than the control group. The speakers with MS had longer diphthong durations in a non-fatigued state, but not in a fatigued state, which was indicative of the variability in this group of speakers. Fatigue was not shown to affect any other acoustic variables. This finding may be attributable to the mildness of the speech impairment of this sample of speakers with MS.

Dysarthria is one of the most common signs of speech impairment in the cerebral palsy (CP) population. Facilitating strategies for speech enhancement in this population often include training on speech breathing. Treatment efficacy studies with cross-system measures in this population are needed for improved understanding and management of the interrelationship between respiratory, phonatory, and articulatory systems. The purpose of this study was to investigate the effect of breath group control on the coordination of articulatory and phonatory muscles and the acoustic measures related to speech and voice quality. A simultaneous acoustic, electroglottographic (EGG), and marker-based facial tracking recording system was employed to monitor the speech production behaviors of four adults with CP and 16 neurologically healthy controls. Subjects were instructed to perform three tasks, each containing speech targets with a voiceless plosive (/p/, /t/, or /k/) preceding a vowel (/i/, /a/, /u/, or /ɔ/). Task 1 consisted of a short reading passage embedded with target vowels without cueing from breath group markers. Task 2 included reading a series of monosyllabic and 3-syllable or 5-syllable non-speech words with the speech targets. Task 3 included reading the same short passage from Task 1 with cueing from breath group markers separating the passage into phrases with no more than five syllables per phrase. Measures from the acoustic, EGG and facial tracking recordings of the first and last syllable of all syllable trains produced in the non-speech task and the target vowels in the passage reading task were examined. Acoustic measures included voice onset time (VOT), vowel duration, fundamental frequency (F0), percent jitter (%jitter), percent shimmer (%shimmer), signal-to-noise ratio (SNR), and frequencies of Formants one and two (F1 and F2). EGG measures included speed quotient (SQ) and open quotient (OQ). Facial tracking measures consisted of maximum jaw displacement. Individual and averaged data were submitted to a series of two-way Analysis of Variances (ANOVAs) or two-way Repeated Measures ANOVAs to determine the effects of the relative position of an utterance in the breath group and the place of articulation of the consonants involved. In addition, mean vowel spaces derived from all three tasks were examined. Results revealed significant changes of VOT, F1, F2, SNR and SQ as a function of position. Significant changes of VOT, vowel duration, F2, F0, %jitter, %shimmer, and maximum jaw displacement as a function of place of articulation were also evident. In particular, breath group control was found to result in expansion of vowel space, especially for individuals with CP. These findings suggest that proper phrasing enhances articulatory and phonatory stability, providing empirical evidences in support of its usage in treating individuals with CP.

Alterações fonoarticulatórias caracterizam a disartria hipocinética e podem ocorrer ao longo da evolução da doença de Parkinson (DP). No entanto, não existem estudos que evidenciem a influência da idade nessas alterações. Objetivo: Comparar e correlacionar selecionadas características fonoarticulatórias em pacientes com DP de início na meia idade e tardio. Método: Participaram 50 pacientes que constituíram dois grupos. O Grupo I foi composto por 30 (60%) pacientes com idade de início da DP entre 40 e 55 anos e o Grupo II, por 20 (40%) pacientes com início da doença após os 65 anos, ambos com a duração da doença variando de 2 a 18 anos. Todos foram submetidos à avaliação neurológica a partir da Parte III da Escala Unificada para a Doença de Parkinson (UPDRS) e Escala Modificada de Hoehn & Yahr e, fonoaudiológica, realizada por meio de análise perceptivo-auditiva (velocidade, inteligibilidade e tipo articulatório da fala e qualidade da voz) e acústica computadorizada (freqüência fundamental e intensidade da voz). Resultados: Não houve diferença estatisticamente significativa entre os dois grupos no que diz respeito ao estágio da doença, aos escores da escala UPDRS e às análises fonoaudiológicas. As análises de correlação não mostraram diferença estatisticamente significativa entre a qualidade, a freqüência fundamental e a intensidade da voz, bem como a velocidade da fala e o estágio da doença. Contudo, houve diferença estatística significativa entre a articulação e a inteligibilidade da fala e o estágio da doença. Os escores da escala UPDRS não revelaram diferença estatisticamente significativa quando comparados com a qualidade, a freqüência fundamental e a intensidade da voz e a velocidade da fala. Diferença estatisticamente significativa foi encontrada na correlação entre a articulação e os acometimentos axiais e também entre a velocidade da fala e os escores dos acometimentos axiais, da rigidez e da bradicinesia. Conclusões: A idade de início da DP não se relacionou com as características fonoarticulatórias analisadas. A função articulatória (articulação e inteligibilidade da fala) estava prejudicada sobremaneira nos estágios mais avançados da DP e foi associada ao maior tempo de duração da doença e aos escores mais elevados de manifestações axiais, de rigidez e de bradicinesia. A função fonatória (freqüência fundamental, qualidade e intensidade da voz) apresentou-se com características semelhantes em todos os estágios da DP e não se associou com a duração da doença e tampouco com os escores motores analisados. / Parkinson\'s disease (PD) patients may develop speech and voice abnormalities during the course of their illness, typically hypokinetic dysarthria. There are no studies to date describing the influence of age on these abnormalities. Objective: To describe and to correlate selected speech and voice characteristics in PD patients with middle-age and late-onset disease and compare each group\'s findings. Methods: Fifty PD patients were enrolled in this study and subsequently divided into two groups. Group I included 30 (60%) patients with PD onset between 40 and 55 years old and Group II consisted of 20 (40%) patients with disease onset after the age of 65. In both groups disease duration ranged from 2 to 18 years. All patients were submitted to neurological evaluation based on the motor Unified Parkinson\'s Disease Rating Scale (UPDRS - part III) and the Modified Hoehn and Yahr Staging Scale plus speech and voice evaluation, performed through perceptual analysis (speech velocity and intelligibility, articulatory speech type and voice quality) and computerized acoustic (fundamental frequency and voice intensity). Results: There was no statistically significant difference between the groups concerning disease stage, UPDRS scores and speech and voice analysis. Disease stage was not associated to quality, fundamental frequency and intensity of voice. There was also no difference between speech velocity and disease stage. On the other hand, there was statistically significant difference between articulation and speech intelligibility and disease stage. UPDRS scores did not reveal a statistically significant difference when compared to quality, fundamental frequency and voice intensity and speech velocity, but there was a difference in the correlation between articulation and axial symptoms and also between speech velocity and scores for axial symptoms, rigidity and bradykinesia. Conclusion: The age of onset of PD was not associated with speech and voice characteristics analysed. Articulatory function (speech articulation and intelligibility) was remarkably affected in advanced PD and was associated with not only with longer disease duration, but also with more axial symptoms, rigidity and bradykinesia. Phonatory function (fundamental frequency, quality and intensity of voice) disclosed similar characteristics in all PD stages and was not associated with disease duration or with motor scores analysed.

The aim of this thesis is to investigate computerized voice assessment methods to classify between the normal and Dysarthric speech signals. In this proposed system, computerized assessment methods equipped with signal processing and artificial intelligence techniques have been introduced. The sentences used for the measurement of inter-stress intervals (ISI) were read by each subject. These sentences were computed for comparisons between normal and impaired voice. Band pass filter has been used for the preprocessing of speech samples. Speech segmentation is performed using signal energy and spectral centroid to separate voiced and unvoiced areas in speech signal. Acoustic features are extracted from the LPC model and speech segments from each audio signal to find the anomalies. The speech features which have been assessed for classification are Energy Entropy, Zero crossing rate (ZCR), Spectral-Centroid, Mean Fundamental-Frequency (Meanf0), Jitter (RAP), Jitter (PPQ), and Shimmer (APQ). Naïve Bayes (NB) has been used for speech classification. For speech test-1 and test-2, 72% and 80% accuracies of classification between healthy and impaired speech samples have been achieved respectively using the NB. For speech test-3, 64% correct classification is achieved using the NB. The results direct the possibility of speech impairment classification in PD patients based on the clinical rating scale.

Purpose: The Everyday Speech Production Assessment Measure (E-SPAM) is a novel test for assessing changes in clients‟ speech production skills after intervention. This study provides information on reliability and validity for the test and overviews its clinical application. Method & Procedures: E-SPAM, oral reading, and sequential motion rate tasks were administered to 15 participants with motor speech disorders (MSDs). E-SPAM responses were scored using a 5-point system by four graduate students to assess inter-scorer and temporal reliability and to determine validity for E-SPAM. Results: Findings of this study indicate that the E-SPAM can be scored with sufficient reliability for clinical use, yields stable scores on repeat administrations, and that its results correlate highly with other accepted measures of speech production ability, specifically sentence intelligibility and severity. Conclusions: While the results of this study must be considered preliminary because of the small sample size, it does appear that the E-SPAM can provide information about aspects of speech production such as intelligibility, efficiency, and speech naturalness, that are important when treatment focuses on improving speech. The E-SPAM also appears to be a “clinician-friendly” test as it is quick to administer and score and can be administered to patients across the severity continuum.

No description available.

Dysarthria is one of the most common signs of speech impairment in the cerebral palsy (CP) population. Facilitating strategies for speech enhancement in this population often include training on speech breathing. Treatment efficacy studies with cross-system measures in this population are needed for improved understanding and management of the interrelationship between respiratory, phonatory, and articulatory systems. The purpose of this study was to investigate the effect of breath group control on the coordination of articulatory and phonatory muscles and the acoustic measures related to speech and voice quality. A simultaneous acoustic, electroglottographic (EGG), and marker-based facial tracking recording system was employed to monitor the speech production behaviors of four adults with CP and 16 neurologically healthy controls. Subjects were instructed to perform three tasks, each containing speech targets with a voiceless plosive (/p/, /t/, or /k/) preceding a vowel (/i/, /a/, /u/, or /ɔ/). Task 1 consisted of a short reading passage embedded with target vowels without cueing from breath group markers. Task 2 included reading a series of monosyllabic and 3-syllable or 5-syllable non-speech words with the speech targets. Task 3 included reading the same short passage from Task 1 with cueing from breath group markers separating the passage into phrases with no more than five syllables per phrase. Measures from the acoustic, EGG and facial tracking recordings of the first and last syllable of all syllable trains produced in the non-speech task and the target vowels in the passage reading task were examined. Acoustic measures included voice onset time (VOT), vowel duration, fundamental frequency (F0), percent jitter (%jitter), percent shimmer (%shimmer), signal-to-noise ratio (SNR), and frequencies of Formants one and two (F1 and F2). EGG measures included speed quotient (SQ) and open quotient (OQ). Facial tracking measures consisted of maximum jaw displacement. Individual and averaged data were submitted to a series of two-way Analysis of Variances (ANOVAs) or two-way Repeated Measures ANOVAs to determine the effects of the relative position of an utterance in the breath group and the place of articulation of the consonants involved. In addition, mean vowel spaces derived from all three tasks were examined. Results revealed significant changes of VOT, F1, F2, SNR and SQ as a function of position. Significant changes of VOT, vowel duration, F2, F0, %jitter, %shimmer, and maximum jaw displacement as a function of place of articulation were also evident. In particular, breath group control was found to result in expansion of vowel space, especially for individuals with CP. These findings suggest that proper phrasing enhances articulatory and phonatory stability, providing empirical evidences in support of its usage in treating individuals with CP.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.