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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↗
PubMed1996

Speech outcomes of a prolonged-speech treatment for stuttering.

It has been shown that people who stutter can speak with greatly reduced stuttering after treatments that use variations of Goldiamond's (1965) prolonged-speech (PS). However, outcome research to date has not taken account of several important issues. In particular, speech outcome measures in that research have been insufficient to show that lasting relief from stuttering has been achieved by clients outside the clinic for meaningful periods. The present study used extensive speech outcome measures across a variety of situations in evaluating the outcome of an intensive PS treatment (Ingham, 1987). The speech of 12 clients in this treatment was assessed on three occasions prior to treatment and frequently-on eight occasions-after discharge from the residential setting. For 7 clients, a further assessment occurred at 3 years posttreatment. Concurrent dependent measures were percent syllables stuttered, syllables per minute, and speech naturalness. The dependent measures were collected in many speaking situations within and beyond the clinic. Dependent measures were based on speech samples of substantive duration, and covert assessments were included in the study. Detailed data were presented for individual subjects. Results showed that 12 subjects who remained with the entire 2-3-year program achieved zero or near-zero stuttering. The majority of subjects did not show a regression trend in %SS or speech naturalness scores during the posttreatment period, either within or beyond the clinic. Some subjects showed higher posttreatment %SS scores during covert assessment than during overt assessment. Results also showed that stuttering was eliminated without using unusually slow and unnatural speech patterns. This treatment program does not specify a target speech rate range, and many clients maintained stutter-free speech using speech rates that were higher than the range typically specified in intensive PS programs. A significant correlation was found between speech rate and perceived posttreatment speech naturalness.

Adolescent↗
PubMed2006

Speech categorization in context: joint effects of nonspeech and speech precursors.

The extent to which context influences speech categorization can inform theories of pre-lexical speech perception. Across three conditions, listeners categorized speech targets preceded by speech context syllables. These syllables were presented as the sole context or paired with nonspeech tone contexts previously shown to affect speech categorization. Listeners' context-dependent categorization across these conditions provides evidence that speech and nonspeech context stimuli jointly influence speech processing. Specifically, when the spectral characteristics of speech and nonspeech context stimuli are mismatched such that they are expected to produce opposing effects on speech categorization the influence of nonspeech contexts may undermine, or even reverse, the expected effect of adjacent speech context. Likewise, when spectrally matched, the cross-class contexts may collaborate to increase effects of context. Similar effects are observed even when natural speech syllables, matched in source to the speech categorization targets, serve as the speech contexts. Results are well-predicted by spectral characteristics of the context stimuli.

Adult↗
PubMedDate not supplied

The perception of speech naturalness of post-therapeutic and altered auditory feedback speech of adults with mild and severe stuttering.

The effect of therapy and altered auditory feedback (AAF) on the perception of speech naturalness of people who stutter was examined. Thirty-five naive young adult listeners rated speech samples from fluent speakers and individuals who stutter. Samples came from normal adults who spoke Standard American English; adults with mild or severe stuttering who spoke under conditions of non-altered feedback (NAF), delayed auditory feedback (DAF), and frequency-altered feedback (FAF); and adults with mild or severe stuttering prior to and following successful completion of a Precision Fluency Shaping Program. Speech produced under AAF was rated as significantly more natural sounding than speech from the same individuals under NAF (p < 0.0001). Speech produced during FAF was judged to be more natural sounding than that produced during DAF for those with mild (p = 0.003) and severe (p < 0.0001) stuttering. Mild stuttered speech was judged to have more natural-sounding speech than severe stuttered speech during AAF (p < 0.0001). Speech from individuals following therapy was rated significantly less natural sounding than that from individuals during AAF for both mild and severe stuttering (p < 0.0001). The speech of individuals prior to therapy was rated significantly more natural than their speech produced after therapy (p < 0.0001). Speech from normal fluent speakers was rated as significantly more natural sounding than all samples produced from the individuals who stutter (p < 0.0001). These findings support the contention that AAF benefits those who stutter through a reduction of stuttering with a gain in perceived speech naturalness.

Adult↗
PubMed1975

Simple reaction-times to speech and non-speech stimuli.

Two experiments were carried out involving the measurement of simple reaction-time when subjects responded to speech and to non-speech stimuli. In the first, subjects were required to make a speech response (uttering the vowel [a: ]) to one speech stimulus (the vowel [a: ]) and three non-speech stimuli (a complex tone, a telephone bell and a click). The click stimulus gave significantly longer reaction-times than the other three stimuli; since all stimuli were equated for peak intensity delivered to the subjects' ears, this was due to the short duration of the click (25 msec). There was no evidence that compatibility between the speech stimulus and the speech response had any influence on reaction-time. The second experiment employed a 2 X 2 design with 2 stimuli and 2 response modes. The stimuli were the vowel [a: ] and the telephone bell; the response modes were key-pressing and uttering the vowel [a: ]. The speech stimulus and the speech response gave significantly longer reaction-times than the non-speech simtulus and response. The minimum time for a reaction requiring speech reception is of the order of 180 msec. and the use of the motor speech mechanism adds about 30 msec. to reaction-time. Again no interaction was found between stimulus and response and this is probably due to the extremely simple nature of the speech tasks imposed.

Adolescent↗
PubMed2004

[200 years testing hearing disorders with speech, 50 years german speech audiometry -- a review].

FROM THE BEGINNIGS TO CLASSICAL SPEECH TESTS: The need for classification of different degrees of hearing disorders first arose when it seemed possible to treat deafness. Grapengiesser in Berlin 1801 had applied galvanic current to the ears of deaf children and reported some success. Pfingsten in Kiel in 1804 using this method was the first to use speech in diagnosing different degrees of deafness. He divided speech sounds into three classes: vowels, voiced consonants and voiceless consonants. Itard in Paris in 1821 gave a classification of five classes according to which sounds could be perceived, starting from normal speech to thunder and the bang of a gun. Schmalz in Dresden 1846 noted the range within which speech was understood thus introducing the concept of hearing distance. Helmholtz in 1863 had demonstrated that vowels are composed of pure tones. Wolf in Frankfurt 1871 tried to align all speech sounds from the lowest frequency (tongue-R = 16 Hz) to the highest (sh = 4096 Hz) and measured the hearing distance for each sound. Following these suggestions word lists based on the predominant frequencies were compiled in a number of languages including Japanese. SPEECH AUDIOMETRY: This chapter is devoted to Karl Heinz HahIbrock, Freiburg, who was the founder of the German speech audiometry. Hahlbrock followed the American authors of the Psycho-acoustic Laboratory at Harvard, in particular J. P. Egan (1948), using statistical methods for composing lists of words based on the relative frequency of speech sounds and phonetically balanced between the different groups. He finally presented a test comprising groups of two-digit numbers and monosyllabic words. Hahlbrock died in 2003 exactly fifty years after the presentation of his test. A short account of his life is given. THE FOLLOWING DEVELOPMENT: In the following years various other types of speech tests were elaborated using sentences, distorted speech, diotic and dichotic presentation partly aimed at fitting hearing aids, partly with the aim to diagnose central hearing disorders. Hahlbrock's test, however, remained the standard for evaluating speech reception and discrimination. DISCUSSION: One of the fundamental problems in testing speech discrimination is that there is no catalogue of phonemes common to all languages or regional accents. Untrained not native speakers often do no perceive certain sounds having a partial auditory agnosia. They cannot distinguish between e. g. 'hand' and 'and' or 'end' and 'ant', but the examiner must decide if the word presented was repeated correctly or not.

Audiometry, Speech↗
PubMed1992

[Dependence of 'audio-phonatoric coupling' of speech rate and speech loudness].

The 'audio-phonatoric coupling' (APC) was investigated in two independent experiments. Slightly delayed auditory feedback (delay time 40 ms) of the subjects' own speech was used as experimental method. The first experiment was conducted to examine whether the strength of the APC depends on the speech rate. In this experiment 16 male Subjects (Ss) were required to utter the testword/tatatas/either with stress placing on the first or second syllable at two different speech rates (fast and slow). In 16% of the randomly chosen speech trials, the delayed auditory feedback (DAF; 40 ms delay) was introduced. It could be shown that the stressed phonation was significantly lengthened under the DAF condition. This lengthening was greater when Ss spoke slowly. The unstressed phonations were not influenced by the DAF condition. The second experiment was conducted to examine whether or not speech intensity effects APC. Nine male Ss were required to utter the testword/tatatas/either with stress placing on the first or second syllable using three different speech intensities (30 dB, 50 dB and 70 dB). In 16% of the randomly chosen speech trials DAF condition was introduced. It could be shown that speech intensity does not influence the DAF effect (lengthening of stressed phonation). These findings were taken as evidence that the auditory feedback of the subjects' own speech can be incorporated into speech control during ongoing speech. Obviously, this feedback information is efficient only during the production of stressed syllables, and varies as a function of speech rate. In addition, the significance of stressed syllables for the structuring of speech is discussed.

Adult↗
PubMed1995

Speech perception in children using the advanced Speak speech-processing strategy.

The Speak speech-processing strategy, developed by the University of Melbourne and commercialized by Cochlear Pty Limited for use in the new Spectra 22 speech processor, has been shown to provide improved speech perception for adults in both quiet and noisy situations. The present study evaluated the ability of children experienced in the use of the Multipeak (Mpeak) speech-processing strategy (implemented in the Nucleus Minisystem-22 cochlear implant) to adapt to and benefit from the advanced Speak speech-processing strategy (implemented in the Nucleus Spectra 22 speech processor). Twelve children were assessed using Mpeak and Speak over a period of 8 months. All of the children had over 1 year's previous experience with Mpeak, and all were able to score significantly on open-set word and sentence tests using the cochlear implant alone. Children were assessed with both live-voice and recorded speech materials, including Consonant-Nucleus-Consonant monosyllabic words and Speech Intelligibility Test sentences. Assessments were made in both quiet and in noise. Assessments were made at 3-week intervals to investigate the ability of the children to adapt to the new speech-processing strategy. For most of the children, a significant advantage was evident when using the Speak strategy as compared with Mpeak. For 4 of the children, there was no decrement in speech perception scores immediately following fitting with Speak. Eight of the children showed a small (10% to 20%) decrement in speech perception scores for between 3 and 6 weeks following the changeover to Speak. After 24 weeks' experience with Speak, 11 of the children had shown a steady increase in speech perception scores, with final Speak scores higher than for Mpeak. Only 1 child showed a significant decrement in speech perception with Speak, which did not recover to original Mpeak levels.

Adolescent↗
PubMed2006

Monaural speech segregation using synthetic speech signals.

When listening to natural speech, listeners are fairly adept at using cues such as pitch, vocal tract length, prosody, and level differences to extract a target speech signal from an interfering speech masker. However, little is known about the cues that listeners might use to segregate synthetic speech signals that retain the intelligibility characteristics of speech but lack many of the features that listeners normally use to segregate competing talkers. In this experiment, intelligibility was measured in a diotic listening task that required the segregation of two simultaneously presented synthetic sentences. Three types of synthetic signals were created: (1) sine-wave speech (SWS); (2) modulated noise-band speech (MNB); and (3) modulated sine-band speech (MSB). The listeners performed worse for all three types of synthetic signals than they did with natural speech signals, particularly at low signal-to-noise ratio (SNR) values. Of the three synthetic signals, the results indicate that SWS signals preserve more of the voice characteristics used for speech segregation than MNB and MSB signals. These findings have implications for cochlear implant users, who rely on signals very similar to MNB speech and thus are likely to have difficulty understanding speech in cocktail-party listening environments.

Adult↗
PubMedDate not supplied

Blinded speech evaluation following pharyngeal flap surgery by speech pathologists and lay people in children with cleft palate.

METHODS: In order to assess intermediate-term speech outcome after pharyngeal flap surgery for velopharyngeal dysfunction in children with cleft palate between 1980 and 1998, their pre- and postoperative speech performance was analyzed in a blinded fashion by speech pathologists and adult lay people. Speech was evaluated on the basis of tape recordings with regard to resonance, intelligibility, articulation, voice and secondary speech disorders. RESULTS: Twenty-three patients could be evaluated. Both lay assessors and speech pathologists noted a significant improvement in speech performance after pharyngeal flap surgery. The percentage of children who improved was 83% (19/23, 95% confidence interval: 0.68-0.98, p = 0.002) when rated by lay people, and 87% (20/23, CI 0.73-1.01, p < 0.0001) when rated by professionals. Rated on a 5-point scale, the mean improvement per speech characteristic was 0.52 +/- 0.32 scale points when judged by lay people, and 0.75 +/- 0.8 points when judged by experts. Experts considered none of the children to have normal speech after surgery. Agreement with regard to outcome between lay people and speech pathologists occurred in 87% of the patients. CONCLUSION: The cranially based pharyngeal flap can improve speech performance in cleft palate children with chronic velopharyngeal insufficiency. However, it cannot be expected that this type of surgery will result in normal speech.

Child↗
PubMed1996

Speech outcome following palatoplasty in primary school children: do lay peer observers agree with speech pathologists?

The aim of this study was twofold: (1) to test the ability of normal children to discriminate the speech of children with repaired cleft palate from the speech of unaffected peers and (2) to compare these naive assessments of speech acceptability with the sophisticated assessments of speech pathologists. The study group (subjects) was composed of 21 children of school age (aged 8 to 12 years) who had undergone palatoplasty at a single cleft center and 16 matched controls. The listening team (student raters) was composed of 20 children who were matched to the subjects for age, sex, and other variables. Randomized master audio-tape recordings of the children who had undergone palatoplasty were presented in blinded fashion and random order to student raters who were inexperienced in the evaluation of patients with speech dysfunction. The same sound recordings were evaluated by an experienced panel of extramural speech pathologists whose intrarater and interrater reliabilities were known; they were not direct care providers. Additionally, the master tape was presented in blinded fashion and random order to the velopharyngeal staff at the cleft center for intramural assessment. Comparison of these assessment methodologies forms the basis of this report. Naive raters were insensitive to speech differences in the control and cleft palate groups. Differences in the mean scores for the groups never approached statistical significance, and there was adequate power to discern a difference of 0.75 on a 7-point scale. Expert raters were sensitive to differences in resonance and intelligibility in the control and cleft palate groups but not to other aspects of speech. The expert raters recommended further evaluation of cleft palate patients more often than control patients. Speech pathologists discern differences that the laity does not. Consideration should be given to the utilization of untrained listeners to add real-life significance to clinical speech assessments. Peer group evaluations of speech acceptability may define the morbidity of cleft palate speech in terms that are most relevant to the patients themselves and may safeguard against the possibility of offering treatment that may be unnecessary.

Child↗
PubMed2004

[Acoustic analysis of tracheoesophageal speech in comparison to esophageal speech after total laryngectomy].

In order to evaluate the vocal quality of tracheo-oesophageal (TE) and oesophageal (E) speech, several acoustic parameters were measured in the acoustic waveform (fundamental frequency, maximum phonation time, maximum intensity) and in the frequency spectrum: harmonicity-to-noise ratio [HNR], pitch perturbation [Jitter], Shimmer. Thirteen patients using tracheo-oesophageal speech (Provox 2 valve) and 11 good oesophageal speakers were evaluated. The control group consisted of 10 healthy men with normal speech. Digital recordings were obtained from examined subjects as they sustained the vowel "a". Maximum phonation time in TE samples was significantly longer than in E speech recordings and similar to the normal speech. The tracheo-oesophageal voices more often showed a detectable fundamental frequency which was fairly stable and lower than in oesophageal and normal speech. In our cohort of patients maximum voice intensity in both groups of alaryngeal speakers was similar and lower than in control group. The Jitter and Shimmer results of TE speech were similar to those of E speech and higher than in controls. HNR was significantly higher in TE speech than in E voice and three times lower in comparison to normal speech. The results of this investigation indicate that TE speech is more like normal speech than is E voice.

Adult↗
PubMed2006

The cleft audit protocol for speech-augmented: A validated and reliable measure for auditing cleft speech.

OBJECTIVES: To develop an assessment tool for use in intercenter audit studies of cleft speech and to test its acceptability, validity, and reliability. The tool is to be used systematically to record and report speech outcomes, providing an indication of treatment needs and continuing burden of care. SETTING: Regional Cleft Center, U.K. METHODS: The Cleft Audit Protocol for Speech-Augmented (CAPS-A) was developed by three cleft speech experts who identified the key features required from existing assessment measures. Criterion validity was assessed by comparing the Cleft Audit Protocol for Speech-Augmented outcomes reported for 20 cases with clinical assessment results and other investigations. Intra- and interrater reliability were tested following the training of specialist speech and language therapists who used the Cleft Audit Protocol for Speech-Augmented on two occasions to assess 10 cases. The raters evaluated acceptability and ease of using a questionnaire. RESULTS: The mean percentage agreement for criterion validity in each section was 87% (range 70% to 100%). Both intra- and interexaminer reliability were rated as good/very good (Kappa 0.61 to 1.00) for seven sections and moderate (Kappa 0.41 to 0.60) for three sections. Raters reported that the Cleft Audit Protocol for Speech-Augmented was acceptable and easy to use with appropriate training. CONCLUSION: An acceptable, valid, and reliable cleft speech audit tool has been developed based on a small sample. The Cleft Audit Protocol for Speech-Augmented is recommended for use in intercenter audit studies in the U.K. and Ireland and could be used in other English-speaking countries. In addition, it has wider applicability for use in reporting speech outcomes of surgical procedures.

Adult↗
PubMed1992

[Speech production and speech comprehension of dysgrammatic speech of preschool children].

The language comprehension and production abilities of 15 preschool children with developmental language disorders (LD) (4;11 yrs.-7;1 yrs.) and 15 control children (3;8 yrs.-4;7 yrs.) were investigated. For this purpose a test consisting of 135 picture cards was devised. On the production task (plural and comparative forms) the majority of the LD children performed significantly poorer than the control children. The results of the comprehension tests (plural and comparative forms and short sentences) showed marked deficits for the majority of the LD children (11 of 15), especially (but not only) in the identification of single forms. These combined expressive-receptive deficits should be considered in an etiological concept of developmental dysphasia. It is discussed whether these deficits are indicative of far-reaching disorders in the processing of language.

Aphasia, Broca↗
PubMed1992

Speech naturalness and prolonged-speech treatments for stuttering: further variables and data.

It is well known that unusual speech quality may result from stuttering treatments that are based on prolonged speech. However, empirical information concerning the speech quality associated with those treatments is lacking. The present study was designed to contribute such empirical information. Results indicated that speech quality assessments of posttreatment clients, using Martin, Haroldson, and Triden's (1984) speech naturalness scale, gave similar results regardless of whether they were based on monologues or conversations. The speech quality of those clients remained stable at the conclusion of their treatment program. Further, there was a significant, positive correlation between pretreatment speech measures and measures of speech naturalness made after the establishment of stutter-free speech. The subjects whose pretreatment stuttering was the most severe had posttreatment speech naturalness scores that were more than two scale values worse than the subjects whose pretreatment stuttering was the least severe. Speech naturalness scale scores are presented for nonstutterers and posttreatment stutterers and these data are compared with existing findings.

Adolescent↗