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PubMed2005

Effect of slow-acting wide dynamic range compression on measures of intelligibility and ratings of speech quality in simulated-loss listeners.

The purpose of this study was twofold: (a) to determine the extent to which 4-channel, slow-acting wide dynamic range amplitude compression (WDRC) can counteract the perceptual effects of reduced auditory dynamic range and (b) to examine the relation between objective measures of speech intelligibility and categorical ratings of speech quality for sentences processed with slow-acting WDRC. Multiband expansion was used to simulate the effects of elevated thresholds and loudness recruitment in normal hearing listeners. While some previous studies have shown that WDRC can improve both speech intelligibility and quality, others have found no benefit. The current experiment shows that moderate amounts of compression can provide a small but significant improvement in speech intelligibility, relative to linear amplification, for simulated-loss listeners with small dynamic ranges (i.e., flat, moderate hearing loss). This benefit was found for speech at conversational levels, both in quiet and in a background of babble. Simulated-loss listeners with large dynamic ranges (i.e., sloping, mild-to-moderate hearing loss) did not show any improvement. Comparison of speech intelligibility scores and subjective ratings of intelligibility showed that listeners with simulated hearing loss could accurately judge the overall intelligibility of speech. However, in all listeners, ratings of pleasantness decreased as the compression ratio increased. These findings suggest that subjective measures of speech quality should be used in conjunction with either objective or subjective measures of speech intelligibility to ensure that participant-selected hearing aid parameters optimize both comfort and intelligibility.

Acoustic Stimulation↗
PubMed2003

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

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

Adult↗
PubMed2003

Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue.

OBJECTIVE: Numerous patients in Taiwan with tongue carcinoma require tongue reconstruction. We compared the abilities of 2 methods of tongue reconstruction to reserve tongue function. STUDY DESIGN AND SETTING: Sixty patients underwent resection of the tumors and reconstruction with a pectoralis major flap or a radial forearm flap. The Chinese articulation test was used to evaluate the place and manner of error production, and a questionnaire on dietary habits was used to evaluate deglutition 6 months to 10 years after reconstruction. RESULTS: Patients with the free flap had more intelligible speech. The questionnaire study showed no significant difference between the 2 groups in swallowing rating. Motility caused by flap pliability increased speech intelligibility more than it did on swallowing function. CONCLUSION: Our experience in a few selected patients shows that the functional outcome of tongue surgery is related to the reconstruction methods used (for speech) and to the extent of tongue resection (for swallowing).

Deglutition↗
PubMed2003

Beginning to communicate after cochlear implantation: oral language development in a young child.

This longitudinal case study examined the emergence of a wide range of oral language skills in a deaf child whose cochlear implant was activated at 20 months. The main purposes of this study were to determine "Hannah's" rate of spoken language development during her second to fourth year of implant experience and to estimate the efficiency of her progress by comparing her performance to that of typically developing children. Mother-child interactions were also examined to determine changes in Hannah's communication competence. Normal or above-normal rates of development were observed in the following areas: (a) decreased production of nonwords, (b) increased receptive vocabulary, (c) type-token ratio, (d) regular use of word combinations, and (e) comprehension of phrases. Below-normal rates of development were observed in the following areas: (a) speech intelligibility, (b) number of word types and tokens, and (c) mean length of utterance in morphemes. Analysis of parent-child interactions showed a large increase in responses to questions during the third year of implant use. Data from Hannah's first post-implantation year (D. J. Ertmer & J. A. Mellon, 2001) indicated that some early language milestones were attained quite rapidly (e.g., canonical vocalizations and emergence of first word combinations). In contrast, the current study revealed that progress had slowed for related, but more advanced skills (e.g., production of intelligible speech and consistent use of word combinations). These changes in rate of development suggest that any advantages for language learning due to Hannah's advanced maturity (or other unknown factors) decreased with time and increasing linguistic complexity.

Child, Preschool↗
PubMed2001

Retrospective case series of primary and secondary microvascular free tissue transfer reconstruction of midfacial defects.

STATEMENT OF PROBLEM: Midfacial defects arising from tumor extirpation or trauma may involve any portion of the central area of the face, including the palate, maxilla, orbit, lip, and/or nose. Speech, mastication, swallowing, and cosmesis are significantly impaired and present a unique challenge to the reconstructive surgeon. PURPOSE: This study evaluated the functional and cosmetic success of both soft tissue and osteocutaneous free flap reconstruction of the midface. MATERIAL AND METHODS: A retrospective chart review of 34 patients who underwent primary and secondary free flap reconstruction of the midface was conducted. The main outcome measures were perioperative complications, diet, speech intelligibility, type of dental restoration, and cosmetic result. RESULTS: Fifteen patients underwent soft tissue free flap reconstruction of the midface. Six of these patients also had additional nonvascularized free cranial bone grafts to improve restoration of the orbitozygomatic region. Nineteen patients who might have required osseointegrated implants to anchor a dental prosthesis underwent osteocutaneous free flap reconstruction. Thirty-three of 34 free flaps survived, and wound complications were minimal. After surgery, 20 patients were able to eat a regular diet and 14 a soft diet. All patients had intelligible speech over the telephone. Ten patients used a dental prosthesis (5 conventional and 5 implant-borne). Cosmesis was judged to be excellent in 12 patients, good in 15 patients, fair in 5 patients, and poor in 2 patients. CONCLUSION: In the patients reviewed, free flap reconstruction of the midface was completed in a single stage and created a reproducible, permanent separation of the oral and sinonasal cavities with adequate speech and swallowing.

Adolescent↗
PubMed2006

Measuring the intelligibility of conversational speech in children.

Conversational speech is the most socially-valid context for evaluating speech intelligibility, but it is not routinely examined. This may be because it is difficult to reliably count the number of words in the unintelligible portions of the sample. In this study four different approaches to dealing with this problem are examined. Each is based on the assumption that it is possible to perceive syllables in unintelligible strings even when the target words are unknown; these unintelligible syllables can then be used to estimate the number of unintelligible words in these samples using at least four different approaches. Preliminary data are presented for each of the four approaches based on conversational speech from two convenience samples including 320 children with normal (or normalized) speech and 202 children with speech delay. Differences among the four approaches are discussed.

Case-Control Studies↗
PubMed2006

The intelligibility of tracheoesophageal speech, with an emphasis on the voiced-voiceless distinction.

Total laryngectomy has far-reaching effects on vocal tract anatomy and physiology. The preferred method for restoring postlaryngectomy oral communication is prosthetic tracheoesophageal (TE) speech, which like laryngeal speech is pulmonary driven. TE speech quality is better than esophageal or electrolarynx speech quality, but still very deviant from laryngeal speech. For a better understanding of neoglottis physiology and for improving rehabilitation results, study of TE speech intelligibility remains important. Methods used were perceptual evaluation, acoustic analyses, and digital high-speed imaging. First results show large variations between speakers and especially difficulty in producing voiced-voiceless distinction. This paper discusses first results of our experiment.

Adult↗
PubMedDate not supplied

Evaluation of speech in people with head and neck cancer: a pilot study.

BACKGROUND: A paucity of information exists on the effects of cancer on speech, with what little literature exists focussing on the effects of treatment. Baseline assessment of speech in head and neck cancer patients before treatment is important to distinguish accurately the effects of treatment from the effects of the cancer itself. AIMS: This prospective study had four major foci: (1) to determine if speech intelligibility and motor speech functions of patients with head and neck cancer before treatment differed from the normal population; (2) to determine if impairments in speech intelligibility and motor speech functions were specific to the original site of cancer; (3) to determine which motor speech functions were most related to overall speech intelligibility; and (4) to determine whether there was a relationship between self-report of speech intelligibility, motor speech functions and the clinical assessment thereof. This study aimed incidentally to determine whether the Frenchay Dysarthria Assessment is a practicable, valid and reliable tool for assessing speech functions in the head and neck cancer population. METHODS & PROCEDURES: Twenty participants, between 47 and 76 years of age and all newly diagnosed with a cancer of the head and neck, participated in the pilot study. In examining speech, participants completed a self-report questionnaire pertaining to speech intelligibility and motor speech functions and were then assessed clinically using subscales of the Frenchay Dysarthria Assessment before the start of cancer treatment. The motor speech functions examined included: respiratory ability and functions of the lip, soft palate, larynx and tongue. OUTCOMES & RESULTS: Results indicated that participants with head and neck cancer had a greater reduction in both speech intelligibility and in almost all aspects of speech when compared with the normal population. Results further demonstrated that the site of the cancer dictated the type of impairment experienced with respect to speech function. Not all motor speech characteristics correlated with overall speech intelligibility and, lastly, self-report and clinical assessment were significantly correlated with respect to motor speech characteristics, but they differed slightly in the assessment of speech intelligibility. CONCLUSIONS: This pilot study has highlighted the critical importance of collecting baseline measures and reporting functional results according to the cancer site in future research. It has also shown the usefulness of the Frenchay Dysarthria Assessment as a practicable, valid and reliable protocol of motor speech assessment for the head and neck cancer population.

Aged↗
PubMed2001

Improvements in intelligibility of noisy reverberant speech using a binaural subband adaptive noise-cancellation processing scheme.

This article reports on the performance of an adaptive subband noise cancellation scheme, which performs binaural preprocessing of speech signals for a hearing-aid application. The multi-microphone subband adaptive (MMSBA) signal processing scheme uses the least mean squares (LMS) algorithm in frequency-limited subbands. The use of subbands enables a diverse processing mechanism to be employed, splitting the two-channel wide-band signal into smaller frequency-limited subbands, which can be processed according to their individual signal characteristics. The frequency delimiting used a linear- or cochlear-spaced subband distribution. The effect of the processing scheme on speech intelligibility was assessed in a trial involving 15 hearing-impaired volunteers with moderate sensorineural hearing loss. The acoustic material consisted of speech and speech-shaped noise signals, generated using simulated and real-room acoustic environments, at signal-to-noise ratios (SNRs) in the range -6 to +3 dB. The results show that the MMSBA scheme delivered average speech intelligibility improvements of 11.5%, with a maximum of 37.25%, in noisy reverberant conditions. There was no significant reduction in mean speech intelligibility due to processing, in any of the test conditions.

Acoustics↗
PubMed2002

Quantifying the intelligibility of speech in noise for non-native talkers.

The intelligibility of speech pronounced by non-native talkers is generally lower than speech pronounced by native talkers, especially under adverse conditions, such as high levels of background noise. The effect of foreign accent on speech intelligibility was investigated quantitatively through a series of experiments involving voices of 15 talkers, differing in language background, age of second-language (L2) acquisition and experience with the target language (Dutch). Overall speech intelligibility of L2 talkers in noise is predicted with a reasonable accuracy from accent ratings by native listeners, as well as from the self-ratings for proficiency of L2 talkers. For non-native speech, unlike native speech, the intelligibility of short messages (sentences) cannot be fully predicted by phoneme-based intelligibility tests. Although incorrect recognition of specific phonemes certainly occurs as a result of foreign accent, the effect of reduced phoneme recognition on the intelligibility of sentences may range from severe to virtually absent, depending on (for instance) the speech-to-noise ratio. Objective acoustic-phonetic analyses of accented speech were also carried out, but satisfactory overall predictions of speech intelligibility could not be obtained with relatively simple acoustic-phonetic measures.

Adult↗
PubMed2003

Effects of presentation mode and repeated familiarization on intelligibility of dysarthric speech.

Clinical measures of speech intelligibility are widely used as one means of characterizing the speech of individuals with dysarthria. Many variables associated with both the speaker and the listener contribute to what is actually measured as intelligibility. The present study explored the effects of presentation modality (audiovisual vs. audio-only information) and the effects of speaker-specific familiarization across 4 trials on the intelligibility of speakers with mild and severe dysarthria associated with cerebral palsy. Results revealed that audiovisual information did not enhance intelligibility relative to audio-only information for 4 of the 5 speakers studied. The one speaker whose intelligibility increased when audiovisual information was presented had the most severe dysarthria and concomitant motor impairments. Results for speakerspecific repeated familiarization were relatively homogeneous across speakers, demonstrating significant intelligibility score improvements across 4 trials and, in particular, a significant improvement in intelligibility between the 1st and 4th trials.

Adult↗
PubMedDate not supplied

Intelligibility of speech produced during simultaneous communication.

UNLABELLED: This study investigated the overall intelligibility of speech produced during simultaneous communication (SC). Four hearing, experienced sign language users were recorded under SC and speech alone (SA) conditions speaking Boothroyd's (1985) forced-choice phonetic contrast material designed for measurement of speech intelligibility. Twelve hearing-impaired listeners participated, with three of them randomly assigned to audit the speech sample provided by each one of the four speakers under the SC and SA conditions. Although results indicated longer sentence durations for SC than SA, results showed no difference in the overall intelligibility of speech produced during SC versus speech produced during SA, nor any difference in pattern of phonetic contrast recognition errors during SC. This conclusion is consistent with previous research indicating that temporal alterations produced by SC do not produce degradation of temporal or spectral cues in speech or disruption of the perception of specific English phoneme segments. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe simultaneous communication; (2) explain the role of simultaneous communication in communication with children who are deaf; (3) discuss methods of measuring speech intelligibility; and (4) specify the ability of listeners to perceive speech produced during simultaneous communication.

Communication↗
PubMedDate not supplied

Effects of noise and filtering on the intelligibility of speech produced during simultaneous communication.

UNLABELLED: This study investigated the effects of noise and filtering on the intelligibility of speech produced during simultaneous communication (SC). Four normal hearing, experienced sign language users were recorded under SC and speech alone (SA) conditions speaking Boothroyd's forced-choice phonetic contrast material designed for measurement of speech intelligibility. Twenty-four normal hearing listeners audited the speech samples produced by the four speakers under the SC and SA conditions, three listeners in noise and three listeners in filtered listening conditions for each of the four speakers. Although results indicated longer sentence durations for SC than SA, the data showed no difference in the intelligibility of speech produced during SC versus speech produced during SA under either the noise or filtered listening condition, nor any difference in pattern of phonetic contrast recognition errors between the SA and SC speech samples in either listening condition. This conclusion is consistent with previous research indicating that temporal alterations produced by SC do not produce degradation of temporal or spectral cues to speech intelligibility or disruption of the perception of specific English phoneme segments. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe simultaneous communication; (2) explain the role of simultaneous communication in communication with children who are deaf; (3) discuss methods of measuring speech intelligibility under filtered and noise conditions; and (4) specify the ability of listeners to perceive speech produced during simultaneous communication under noise and filtered listening conditions.

Adult↗
PubMed2001

Relations between intelligibility of narrow-band speech and auditory functions, both in the 1-kHz frequency region.

Relations between perception of suprathreshold speech and auditory functions were examined in 24 hearing-impaired listeners and 12 normal-hearing listeners. The speech intelligibility index (SII) was used to account for audibility. The auditory functions included detection efficiency, temporal and spectral resolution, temporal and spectral integration, and discrimination of intensity, frequency, rhythm, and spectro-temporal shape. All auditory functions were measured at 1 kHz. Speech intelligibility was assessed with the speech-reception threshold (SRT) in quiet and in noise, and with the speech-reception bandwidth threshold (SRBT), previously developed for investigating speech perception in a limited frequency region around 1 kHz. The results showed that the elevated SRT in quiet could be explained on the basis of audibility. Audibility could only partly account for the elevated SRT values in noise and the deviant SRBT values, suggesting that suprathreshold deficits affected intelligibility in these conditions. SII predictions for the SRBT improved significantly by including the individually measured upward spread of masking in the SII model. Reduced spectral resolution, reduced temporal resolution, and reduced frequency discrimination appeared to be related to speech perception deficits. Loss of peripheral compression appeared to have the smallest effect on the intelligibility of suprathreshold speech.

Adult↗
PubMed2001

Double hearing protection and speech intelligibility-room for improvement.

INTRODUCTION: Double hearing protection is used in many air forces around the world for protection in noisy aircraft environments, particularly in helicopters. The usual combination is foam ear plugs under headset or helmet muffs. Much of the research that spurred the introduction of foam earplugs indicated little change in speech intelligibility in persons with normal hearing. However, aircrew often complain about having to maximize intercom volume for speech understanding, causing a situation with no reserve volume and bad sound quality. In recent years, further developments have included so-called hi-fi plugs and custom made ear plugs which are claimed to improve speech communication. The aim of the present project was to investigate different types of ear plugs and their effect on speech intelligibility in helicopter noise. METHODS: Each of nine normal-hearing pilot subjects were placed in an environment of recorded helicopter noise from a BO-105 helicopter. Speech audiometry was performed under four different conditions: headset only, and three different ear plugs worn under the headset. Fitting of the ear plugs was performed by an ear, nose and throat specialist to ensure similar conditions. The sequence of test conditions was randomized and double-blind. In addition, a subjective rating scale was used. RESULTS: Wearing foam ear plugs under the headset decreased speech intelligibility dramatically. The "hi-fi" plug was somewhat better than foam plugs, and the custom made ear plug provided a speech intelligibility close to the headset-only situation. Subjective rating scores coincided with these findings. DISCUSSION: In helicopter noise, custom made ear plugs may provide a much improved speech intelligibility over conventional plugs when worn under a headset, while maintaining improved noise protection over the headset-alone situation. Custom made ear plugs might therefore be a good alternative to other forms of enhanced noise protection in helicopters.

Adult↗
PubMedDate not supplied

Acoustic and intelligibility characteristics of sentence production in neurogenic speech disorders.

The purpose of this study was to examine the relationship between scaled speech intelligibility and selected acoustic variables in persons with dysarthria. Control speakers and speakers with amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD) produced sentences which were analyzed acoustically and perceptually. The acoustic variables included total utterance durations, segment durations, estimates of the acoustic vowel space, and slopes of formant transitions; the perceptual variables included scaled speech intelligibility and severity of speech involvement. Results indicated that the temporal variables typically differentiated the ALS group, but not the PD group, from the controls, and that vowel spaces were smaller for both neurogenic groups as compared to controls, but only significantly so for the ALS speakers. The relation of these acoustic measures to scaled speech intelligibility is shown to be complex, and the composite results are discussed in terms of sentence vs. single-word intelligibility estimates and their underlying acoustic bases.

Aged↗
PubMed1997

Speech perception skills and speech production intelligibility in French children with prelingual deafness and cochlear implants.

OBJECTIVE: To examine speech perception and production intelligibility in French children with prelingual deafness who received multichannel cochlear implants. DESIGN: Within-subject, repeated-measures design for assessing speech perception and a cross-sectional design for assessing overall speech intelligibility. SETTING: A pediatric cochlear implant center. SUBJECTS: Sixty-four French children with prelingual deafness who received multichannel cochlear implants (mean age at time of implantation, 3 years 11 months) underwent assessment for speech perception. A subset of 16 children who received implants by 3 years of age underwent assessment for speech intelligibility. MAIN OUTCOME MEASURES: Speech perception skills were assessed using phoneme detection, closed-set word and sentence recognition, and modified open-set (MOS) recognition. Speech intelligibility was assessed by asking 50 listeners to identify recorded speech samples from the subjects. Dependent variables for the studies consisted of percent of correct items. RESULTS: After implantation, all children were able to detect phonemes by 3 months. Closed-set word and sentence identification reached 100% accuracy by 48 months (7 children with 4 years of implantation experience). Some children (8 of 48) demonstrated some MOS recognition after 1 year. Modified open-set recognition averaged 67.9% by 42 months (12 children available) and 80% by 48 months (7 children available). Overall speech intelligibility was 4.2% after 1 year, 30.7% after 2 years, 55.2% after 3 years, and 74.2% after 4 years. Within-subject comparison of MOS recognition and overall speech intelligibility scores revealed an insignificant trend for high perceptual performance to be associated with higher speech intelligibility scores (P = .17). There also was a tendency for higher performance to be associated with longer implantation experience. CONCLUSIONS: Speech perception scores appear to increase with increased experience using a cochlear implant. Overall speech intelligibility appears to steadily improve with increased experience and appears to be poorly related to perceptual performance on MOS recognition tasks.

Child, Preschool↗