Estudou-se a fala de idosos submetidos a diferentes modalidades de reabilitação oral para verificar se o tipo de modalidade interferiu na produção da fala. Após aprovação do Comitê de Ética em Pesquisa, 36 idosos (média=68 anos) foram avaliados, formando-se 3 grupos: 13 com dentes naturais no mínimo até o 2º pré-molar (A) e outros dois grupos de desdentados reabilitados, sendo um com 13 usuários de prótese total mucosossuportada superior e inferior (B) e outro com 10 usuários de prótese total mucosossuportada superior e implantossuportada inferior (C). Excluíram-se casos com histórico de doenças neurológica, oncológica da região da cabeça e pescoço e psiquiátrica; realização de cirurgia laríngea; etilismo; usuários de medicamentos que causasse xerostomia; malformação craniofacial, má oclusão e disfunção velofaríngea; dificuldade auditiva ou usuário de Aparelho de Amplificação Sonora Individual e alteração cognitiva. A estabilidade das próteses foi avaliada por um cirurgião-dentista e amostras de fala foram registradas e analisadas por 5 fonoaudiólogos, orientados a: identificar articulação exagerada ou fechada, redução dos movimentos labiais e falta de controle salivar na fala espontânea; determinar a freqüência de alteração dos fones na análise da repetição de vocábulos e frases para o cálculo da Porcentagem de Consoantes Corretas (PCC); e a detectar troca de ponto articulatório, projeção lingual, ceceio, desvio mandibular ou distorção acústica na repetição de vocábulos e frases e na contagem de números. Análise acústica do fone [s] também foi realizada pela gravação digital das palavras-chave sapo, suco, siga, inseridas na frase-veículo: Digo ____ aqui, considerando-se os parâmetros: duração e freqüência do fone [s]. Segundo a opinião da maioria dos juízes observaram-se em todos os grupos poucos casos com alguma alteração de fala, com maior freqüência no grupo C, sendo a articulação travada verificada em todos os grupos, a redução dos movimentos labiais em dois grupos (A e B) e a articulação exagerada e a falta de controle salivar em um dos grupos (C e B). A concordância quanto à PCC entre os juízes foi verificada pela Estatística Kappa, observando-se variação entre concordância regular a quase perfeita. Verificou-se menor valor da PCC para os fonemas linguodentais nos grupos B e C, portanto com maior ocorrência de alteração, seguido dos fonemas alveolares. Houve predomínio de casos sem alteração no grupo A, contrariamente aos grupos B e C, nas duas amostras de fala estudadas, sendo a projeção lingual e o ceceio os tipos de alteração que mais ocorreram. A comparação entre os grupos não mostrou diferença. Quanto às próteses, a maioria do grupo B estava com a prótese inferior insatisfatória, não havendo associação entre alteração de fala e prótese insatisfatória. Em relação à análise acústica, a comparação dos valores da duração e da freqüência do fone [s] entre os grupos não mostrou diferença e, quando comparada à presença ou ausência de alteração na produção do [s] com a duração e a freqüência, também não se observou diferença. Apesar da amostra estudada ser pequena, pode-se concluir que o tipo de prótese, bem como a estabilidade desta parece não interferir na produção da fala. / In order to study the speech production of subjects submitted to different oral rehabilitation modalities, and to verify whether the modality type used would interfere in speech production, 36 elderly (average age = 68 years), both gender, were evaluated after the Research Ethics Committees approval. The sample was divided into 3 groups: group A, composed by 13 subjects with natural teeth, at least up to second premolar; group B, with 13 edentate subjects using maxillary and mandibular conventional denture; and group C, with 10 edentate subjects using maxillary conventional denture and mandibular implant-supported prosthesis. Exclusion criteria were medical history of neurological diseases, head and neck oncologic disease, psychiatric disease; laryngeal surgery; alcoholism; users of any drugs whose side effects could cause xerostomia; craniofacial malformation, malocclusion, and velopharyngeal dysfunction; hearing disorders or hearing aid users and cognitive alteration. A dentist evaluated the prosthesis stability. Recorded speech samples were obtained through spontaneous speech, vocable and sentences repetition, and counting of numbers. The analysis was executed by 5 speech pathologists. They were guided to perform a general impression of the spontaneous speech, identifying articulation, labial movements, and saliva control alterations. Besides that, they had to identify the frequency of phonemes alterations through the vocable and phrase repetition sample, and to detect the phonemes alterations types such as: articulation point changes, tongue projection, lisp or mandibular deviation, in the vocable and phrase repetition as well as in the counting of numbers. Analysis of the alterations frequency involved the calculation of Percentage of Correct Consonants (PCC), to verify the agreement among the observers, besides the comparison among groups, and between the association of alteration presence or absence, in the spontaneous speech, and the prosthesis stability. Acoustic analysis of the phoneme /s/ was also performed, throug h digital record of the speech. For that, a sentence-vehicle (Digo ____ aqui) reading or repetition was used, where Portuguese language key-words were inserted (sapo, suco, siga). Duration and frequency parameters of the phoneme /s/ were considered and compared among groups. Also, the alteration presence or absence in the /s/ production was compared to the duration and frequency of this phoneme. The results showed that, in spontaneous speech, there was a large speech alteration in group C. However, the alterations types were found in few occurrences, but in all of the studied groups. Speech alterations presence was identified in the vocable and phrase repetition as well as in the counting of numbers. A smaller Percentage of Correct Consonants value was observed for the linguodental phonemes, in groups B and C, therefore with a larger alteration occurrence, followed by the alveolar phonemes. There was a prevalence of occurrences without alterations in group A, contrarily to groups B and C, in the two speech samples studied, with the lisp and tongue projection being the most occurred alteration types. The comparison among groups, in relation to alteration frequency, showed no significant differences in the vocable and phrase repetition and counting of numbers. Dental evaluation showed that the majority of group B subjects had an unsatisfactory mandibular prosthesis, but an association could not be observed between speech alteration and unsatisfactory maxillary and mandibular prosthesis. There were no significant statistical differences in duration and frequency of the phoneme /s/ among groups. Comparison between alteration presence or absence in /s/ production and duration and frequency showed no significant statistical differences. In conclusion, despite the small sample, it appears that prosthesis type as well as stability does not interfere in speech production.

Estudou-se a fala de idosos submetidos a diferentes modalidades de reabilitação oral para verificar se o tipo de modalidade interferiu na produção da fala. Após aprovação do Comitê de Ética em Pesquisa, 36 idosos (média=68 anos) foram avaliados, formando-se 3 grupos: 13 com dentes naturais no mínimo até o 2º pré-molar (A) e outros dois grupos de desdentados reabilitados, sendo um com 13 usuários de prótese total mucosossuportada superior e inferior (B) e outro com 10 usuários de prótese total mucosossuportada superior e implantossuportada inferior (C). Excluíram-se casos com histórico de doenças neurológica, oncológica da região da cabeça e pescoço e psiquiátrica; realização de cirurgia laríngea; etilismo; usuários de medicamentos que causasse xerostomia; malformação craniofacial, má oclusão e disfunção velofaríngea; dificuldade auditiva ou usuário de Aparelho de Amplificação Sonora Individual e alteração cognitiva. A estabilidade das próteses foi avaliada por um cirurgião-dentista e amostras de fala foram registradas e analisadas por 5 fonoaudiólogos, orientados a: identificar articulação exagerada ou fechada, redução dos movimentos labiais e falta de controle salivar na fala espontânea; determinar a freqüência de alteração dos fones na análise da repetição de vocábulos e frases para o cálculo da Porcentagem de Consoantes Corretas (PCC); e a detectar troca de ponto articulatório, projeção lingual, ceceio, desvio mandibular ou distorção acústica na repetição de vocábulos e frases e na contagem de números. Análise acústica do fone [s] também foi realizada pela gravação digital das palavras-chave sapo, suco, siga, inseridas na frase-veículo: Digo ____ aqui, considerando-se os parâmetros: duração e freqüência do fone [s]. Segundo a opinião da maioria dos juízes observaram-se em todos os grupos poucos casos com alguma alteração de fala, com maior freqüência no grupo C, sendo a articulação travada verificada em todos os grupos, a redução dos movimentos labiais em dois grupos (A e B) e a articulação exagerada e a falta de controle salivar em um dos grupos (C e B). A concordância quanto à PCC entre os juízes foi verificada pela Estatística Kappa, observando-se variação entre concordância regular a quase perfeita. Verificou-se menor valor da PCC para os fonemas linguodentais nos grupos B e C, portanto com maior ocorrência de alteração, seguido dos fonemas alveolares. Houve predomínio de casos sem alteração no grupo A, contrariamente aos grupos B e C, nas duas amostras de fala estudadas, sendo a projeção lingual e o ceceio os tipos de alteração que mais ocorreram. A comparação entre os grupos não mostrou diferença. Quanto às próteses, a maioria do grupo B estava com a prótese inferior insatisfatória, não havendo associação entre alteração de fala e prótese insatisfatória. Em relação à análise acústica, a comparação dos valores da duração e da freqüência do fone [s] entre os grupos não mostrou diferença e, quando comparada à presença ou ausência de alteração na produção do [s] com a duração e a freqüência, também não se observou diferença. Apesar da amostra estudada ser pequena, pode-se concluir que o tipo de prótese, bem como a estabilidade desta parece não interferir na produção da fala. / In order to study the speech production of subjects submitted to different oral rehabilitation modalities, and to verify whether the modality type used would interfere in speech production, 36 elderly (average age = 68 years), both gender, were evaluated after the Research Ethics Committees approval. The sample was divided into 3 groups: group A, composed by 13 subjects with natural teeth, at least up to second premolar; group B, with 13 edentate subjects using maxillary and mandibular conventional denture; and group C, with 10 edentate subjects using maxillary conventional denture and mandibular implant-supported prosthesis. Exclusion criteria were medical history of neurological diseases, head and neck oncologic disease, psychiatric disease; laryngeal surgery; alcoholism; users of any drugs whose side effects could cause xerostomia; craniofacial malformation, malocclusion, and velopharyngeal dysfunction; hearing disorders or hearing aid users and cognitive alteration. A dentist evaluated the prosthesis stability. Recorded speech samples were obtained through spontaneous speech, vocable and sentences repetition, and counting of numbers. The analysis was executed by 5 speech pathologists. They were guided to perform a general impression of the spontaneous speech, identifying articulation, labial movements, and saliva control alterations. Besides that, they had to identify the frequency of phonemes alterations through the vocable and phrase repetition sample, and to detect the phonemes alterations types such as: articulation point changes, tongue projection, lisp or mandibular deviation, in the vocable and phrase repetition as well as in the counting of numbers. Analysis of the alterations frequency involved the calculation of Percentage of Correct Consonants (PCC), to verify the agreement among the observers, besides the comparison among groups, and between the association of alteration presence or absence, in the spontaneous speech, and the prosthesis stability. Acoustic analysis of the phoneme /s/ was also performed, throug h digital record of the speech. For that, a sentence-vehicle (Digo ____ aqui) reading or repetition was used, where Portuguese language key-words were inserted (sapo, suco, siga). Duration and frequency parameters of the phoneme /s/ were considered and compared among groups. Also, the alteration presence or absence in the /s/ production was compared to the duration and frequency of this phoneme. The results showed that, in spontaneous speech, there was a large speech alteration in group C. However, the alterations types were found in few occurrences, but in all of the studied groups. Speech alterations presence was identified in the vocable and phrase repetition as well as in the counting of numbers. A smaller Percentage of Correct Consonants value was observed for the linguodental phonemes, in groups B and C, therefore with a larger alteration occurrence, followed by the alveolar phonemes. There was a prevalence of occurrences without alterations in group A, contrarily to groups B and C, in the two speech samples studied, with the lisp and tongue projection being the most occurred alteration types. The comparison among groups, in relation to alteration frequency, showed no significant differences in the vocable and phrase repetition and counting of numbers. Dental evaluation showed that the majority of group B subjects had an unsatisfactory mandibular prosthesis, but an association could not be observed between speech alteration and unsatisfactory maxillary and mandibular prosthesis. There were no significant statistical differences in duration and frequency of the phoneme /s/ among groups. Comparison between alteration presence or absence in /s/ production and duration and frequency showed no significant statistical differences. In conclusion, despite the small sample, it appears that prosthesis type as well as stability does not interfere in speech production.

The purpose of this study was to examine the bidirectional effects of simulated driving and conversations using different speaking modalities. Participants included 30 males and 30 females with no history of speech, language or hearing disorders. The participants were divided into three age groups: 20s, 40s, and 60s. They completed a driving simulation task in isolation and also while speaking on a hand-held or hands-free cell phone or with a passenger in the car. Speech measures included speaking time ratio, mean, and standard deviation of intensity, as well as mean and standard deviation of fundamental frequency in semitones. Driving measures included standard deviation of lane position, mean, and standard deviation of speed, standard deviation of steering wheel position, and the average number of steering wheel turns. There were significant effects of speaking while driving on mean intensity, speaking time ratio, standard deviation of steering wheel position, and the number of steering wheel turns. There were significant gender effects for speaking time ratio, standard deviation of intensity, and mean intensity, with the females having higher speaking time ratios, and the males having a higher standard deviation and mean of intensity. There was a significant age effect for mean fundamental frequency, standard deviation of lane position, and the standard deviation of steering wheel position. For mean fundamental frequency, the 60s group were lower than the 20s group. The 60s group had a higher standard deviation of lane position and standard deviation of steering wheel position. These findings reveal effects on both speaking and driving performance when speaking and driving concurrently. This has potential clinical implications for planning therapy activities that will help individuals generalize their learned skills from quiet, distraction-free clinic rooms to more realistic situations with distractions and background noise.

The speech of an individual conveys a great deal of information about how their central nervous system (CNS) is performing. Whether they are tired, distressed or suffering from a degenerative disease affecting the brainstem, speech can change as a function of an individual’s condition. Yet, when assessing the speech in an individual on the first occasion, it is often difficult to determine whether their performance is different from a pre-morbid level. Therefore, the repeated acquisition and analysis of a set of brief and simple speech measures could provide information on changes in a patient’s performance over time. This could ultimately lead to the inclusion of objective markers of change in trials of conditions and disorders that currently rely of subjective, clinician derived measures of severity or patient self report, such as pain, depression or fatigue. Furthermore, the information could be used to track patient performance in treatment trials for degenerative disorders, such as Friedreich ataxia or Huntington’s disease. / This thesis aimed to evaluate the practical, experimental and statistical requirements of speech assessment protocols designed to monitor patient performance over time. The research involved a number of studies evaluating methods for acquiring and analysing data, studies examining the stability and sensitivity of speech stimuli, and finally, the functionality of these findings in an experimental model known to induce change in CNS function (i.e., sustained wakefulness). / Methods for acquiring and analysing speech data were designed to provide a balance between the concurrent demands for precision and useability inherent in repeated assessment protocols. Data from these studies provided evidence that techniques offering high levels of useability (e.g., easy to use, automated) are capable of offering adequate precision on broad acoustic measures of timing and frequency. Moreover, these methods could be standardised and automated, allowing non-expert users to collect and analyse data in a controlled and time efficient manner. The second series of experiments systematically documented the stability and responsiveness of speech stimuli within a variety of experimental conditions. These studies were designed to establish the suitability of select speech measures for monitoring change in individuals over time, as stimuli that proved to be both stable (across several re-test intervals) and sensitive to change or impairment were ideal candidates. Finally, a proof of concept study designed to evaluate the efficiency and sensitivity of the proposed methodology was initiated in an experimental model known to induce changes in psychomotor functioning in healthy adults (sustained wakefulness). Significant changes from baseline were observed in speech production as a function of increasing levels of fatigue. These findings are important as they demonstrate the potential of speech as a valid, reliable and sensitive marker of change in conditions where the CNS is subject to stress.

The speech of an individual conveys a great deal of information about how their central nervous system (CNS) is performing. Whether they are tired, distressed or suffering from a degenerative disease affecting the brainstem, speech can change as a function of an individual’s condition. Yet, when assessing the speech in an individual on the first occasion, it is often difficult to determine whether their performance is different from a pre-morbid level. Therefore, the repeated acquisition and analysis of a set of brief and simple speech measures could provide information on changes in a patient’s performance over time. This could ultimately lead to the inclusion of objective markers of change in trials of conditions and disorders that currently rely of subjective, clinician derived measures of severity or patient self report, such as pain, depression or fatigue. Furthermore, the information could be used to track patient performance in treatment trials for degenerative disorders, such as Friedreich ataxia or Huntington’s disease. / This thesis aimed to evaluate the practical, experimental and statistical requirements of speech assessment protocols designed to monitor patient performance over time. The research involved a number of studies evaluating methods for acquiring and analysing data, studies examining the stability and sensitivity of speech stimuli, and finally, the functionality of these findings in an experimental model known to induce change in CNS function (i.e., sustained wakefulness). / Methods for acquiring and analysing speech data were designed to provide a balance between the concurrent demands for precision and useability inherent in repeated assessment protocols. Data from these studies provided evidence that techniques offering high levels of useability (e.g., easy to use, automated) are capable of offering adequate precision on broad acoustic measures of timing and frequency. Moreover, these methods could be standardised and automated, allowing non-expert users to collect and analyse data in a controlled and time efficient manner. The second series of experiments systematically documented the stability and responsiveness of speech stimuli within a variety of experimental conditions. These studies were designed to establish the suitability of select speech measures for monitoring change in individuals over time, as stimuli that proved to be both stable (across several re-test intervals) and sensitive to change or impairment were ideal candidates. Finally, a proof of concept study designed to evaluate the efficiency and sensitivity of the proposed methodology was initiated in an experimental model known to induce changes in psychomotor functioning in healthy adults (sustained wakefulness). Significant changes from baseline were observed in speech production as a function of increasing levels of fatigue. These findings are important as they demonstrate the potential of speech as a valid, reliable and sensitive marker of change in conditions where the CNS is subject to stress.

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

This study examined changes in speech production when distracting background audio is present. Forty typically speaking adults completed a repetitive sentence reading task in the presence of 5 different audio conditions (pink noise, movie dialogue, heated debate, classical music, and contemporary music) and a silent condition. Acoustic parameters measured during the study included vowel space area (VSA), vowel articulation index (VAI), formant transition extent, formant transition rate, and diphthong duration for /ɑɪ/ and /ɑʊ/. It was hypothesized that there would be significant increases in vowel space area and vowel articulation index as well as an increase in formant transition measures in the presence of background noise. There were statistically significant decreases in vowel space are and vowel articulation index in the presence of all noise conditions compared to the silent baseline condition. Results also demonstrated a significant decrease in F2 transition extent for both /ɑɪ/, and /ɑʊ/ diphthongs in all noise conditions except the pink noise condition when compared to the silent condition. These findings were contrary to what was originally hypothesized. It is possible that VAI and VSA decreased in the presence of background noise due to an increase in speaking rate. Formant transition measurements were consistent with the VAI and VSA results. More research is needed to accurately determine the acoustic changes a speaker makes in response to distracting background audio.

This study investigated the effect of hearing six background noise conditions (silent baseline, pink noise, monologue, lively conversation, one-sided phone call, and cocktail noise) on acoustic measures of speech production during story retells in people with aphasia. Eleven individuals with aphasia and 11 age- and gender-matched control participants took part in the study. Participants heard the background noise conditions through open-back headphones while they retold six short stories. The examiner calculated mean and standard deviation of intensity, mean and standard deviation of fundamental frequency (F0), and speech rate in words per minute. A Matlab application that identified pauses (i.e., periods of silence greater than 200 ms) computed a speaking time ratio measure (i.e., time speaking versus time pausing). With the exception of the monologue and one-sided phone call condition, both people with aphasia and control participants significantly increase their intensity and F0 in the presence of background noise. Additionally, participants with aphasia have significantly lower speaking time ratios and speaking rates when compared to control participants. Participants make acoustic changes while hearing background noise; speech intensity rises in an effort to increase the signal-to-noise ratio, while mean F0 increases due to a presumed rise in subglottal pressure. Further research is suggested to investigate other acoustic differences, possibly at the segmental level, between speech produced in informational and energetic background noise.

This study examined the effects of concurrent speech and computer tasks on each other and on measures of physiologic arousal in 30 young adults. Physiologic measures included galvanic skin response, heart rate, and heart rate variability. Participants completed a speech-only task, two computer-based tasks, and combined speech and computer-based tasks. Participants spoke for 60 seconds on a procedural discourse prompt. Acoustic measures included the mean and standard deviation of intensity and fundamental frequency as indices of prosody, speaking time ratio to reflect pausing, and speech rate. The primary computer task (with two levels of difficulty) involved making formatting changes to a paragraph with a word processor. The secondary computer task involved data entry (typing items from a shopping list into categories in a spreadsheet). Errors were tallied for each computer task. Statistical analysis revealed a significant decrease in words per minute in both the data entry and the easier formatting tasks; the proportion of speaking time decreased for all three concurrent computer tasks. Performance on all computer tasks was negatively impacted by speech. There was a significant decrease in the number of words correctly sorted and the number of correct formatting changes. The physiologic changes were limited; it remains unclear whether the heart rate increases during combined computer task and speaking conditions resulted from the addition of cognitive load or the respiratory changes inherent in speaking compared to silent task performance. Findings reflect bidirectional interference between speech and computer-based tasks while multitasking. These findings can help speech-pathologists to create therapy activities that are more like what patients will be experiencing in their everyday lives, such as practicing speech during computer tasks.

This study examined interference between three non-speech tasks and concurrent speech performance. The non-speech activity consisted of computer-based mathematical, language, and visuospatial tasks. The speech tasks included a procedural discourse monologue and a conversation. Participants included 60 adults in two age groups with 30 participants each. The younger adults were aged from 18 to 30 years and older adults from 55 to 82 years. Each participant completed the non-speech tasks in isolation, the speech tasks in isolation, and then each of the speech tasks concurrently with each of the three non-speech tasks. Speech acoustic measures included the mean and standard deviation of intensity and fundamental frequency as indicators of prosody, speaking time ratio to reflect speaking versus pausing time, and speech rate. Non-speech measures included total responses, correct responses, and accuracy. Statistical analysis revealed significant divided attention effects on speech, with increases in fundamental frequency and decreases in speaking time ratio, speech rate, and intensity. Performance on all non-speech tasks was negatively impacted by speech, as there was a significant decrease in total responses and total correct responses overall. There was a significant age effect for intensity and fundamental frequency variability, in that the younger group had less prosodic variation compared to the older group. The present findings provide some evidence that the effects of divided attention increase with age, as older adults gave fewer responses than younger adults overall. However, results indicate older adults prioritize accuracy over speed compared to younger adults. These findings suggest that bidirectional interference occurs between speech and mathematical, language, and visuospatial tasks. The results expand what is known about bidirectional interference between speech and other concurrent tasks, as well as the effects of age on divided attention.