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The objective measurement of alaryngeal speech is desirable so that results between different centres can be compared. We examined several phonatory parameters of alaryngeal speech with the Visi-pitch and correlated these with the subjective assessment of voice quality. Amplitude, percentage voiced and perturbation correlated extremely well with the subjective assessment of voice quality.
BACKGROUND: We compared 4 kinds of alaryngeal speech available in Taiwan in the performance of daily-life tasks. The speech methods included pneumatic device (Taiwan tube), electrolaryngeal speech, esophageal speech, and tracheoesophageal prosthesis. METHODS: Questionnaires covering various communication situations in daily-life tasks as well as subjective feelings about using alaryngeal speech were distributed to members of The Taiwan Laryngectomees' Association and were collected mostly in April 2000 in their annual meeting. RESULTS: A total of 108 members responded to the questionnaire (totally 160 were questionnaires distributed). The mean age of respondents was 68.6 years, and the average time after surgery was 14.5 years. A pneumatic device was used by 58.8% of the responders, esophageal speech was used by 24.7%, an electrolarynx by 10.3%, and a tracheoesophageal prosthesis by 6.2%. No statistical difference was noted among patients using any of the 4 devices in terms of 13 communication tasks in daily life, except 4 questions such as the convenience of alaryngeal speech, embarrassment in face of strangers, the effort required to speak, and the discomfort in throat/neck/mouth when speaking. No statistical differences were noted among the 4 devices in terms of intelligibility. CONCLUSIONS: All 4 alaryngeal speech methods can serve most of the communication functions in daily life tasks with no differences in intelligibility. Limitations in loudness and tone were common problems. It is crucial for surgeons to understand the performance of various alaryngeal speeches in daily life during rehabilitation consultations with patients.
This project was a perceptual investigation of lexical stress in alaryngeal speech. The ability of alaryngeal speakers to signal lexical stress in American English was assessed by obtaining high-quality tape recordings of noun-verb oppositions (e.g., 'insult vs. in'sult) from four normal and 16 laryngectomized speakers using four different types of alaryngeal speech. The recordings of these words were presented to 30 listeners for perceptual evaluation using a two-interval-forced-choice procedure. As expected, the four normal speakers achieved high (93% or above) levels of stress contrast. Lexical stress contrasts were also achieved at a high level of proficiency (88% or above) by all four esophageal speakers, all four tracheoesophageal speakers, one of four users of the Western Electric electrolarynx, and two of four users of the Servox electrolarynx. Lexical stress contrasts were realized in a less (82-86%) but reasonably effective manner by one Western Electric user and two Servox users. The findings were interpreted to highlight the contributions that study of clinical samples may make to investigations of speech production and speech perception.
The speech productions of 8 male alaryngeal speakers were used to identify four perceptual measures and five durational measures which were significant for identifying intelligibility of alaryngeal speech. The acoustic variable of duration was a key factor in relating perceptual and acoustic measures.
This investigation supports the notion that audio-visual presentations of esophageal speech to 32 university student judges yield a relative increase in rated intelligibility in contrast with esophageal speech presented auditorily. Implications suggest that to construct realistic therapeutic goals of an esophageal speaker more effectively, the audio-visual component should be included in the clinical assessment.
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Highly proficient alaryngeal speakers are known to convey prosody successfully. The present study investigated whether alaryngeal speakers not selected on grounds of proficiency were able to convey pitch accent (a pitch accent is realized on the word that is in focus, cf. Bolinger, 1958). The participating speakers (10 tracheoesophageal, 9 esophageal, and 10 laryngeal [control] speakers) produced sentences in which accent was cued by the preceding context. For each utterance, a group of listeners identified which word conveyed accent. All speakers were able to convey accent. Acoustic analyses showed that some alaryngeal speakers had little or no control over fundamental frequency. Contrary to expectation, these speakers did not compensate by using nonmelodic cues, whereas speakers using F0 did use nonmelodic cues. Thus, temporal and intensity cues are concomitant with the use of F0; if F0 is affected, these nonmelodic cues will be as well. A pitch perception experiment confirmed that alaryngeal speakers who had no control over F0 and who did not use nonmelodic cues were nevertheless able to produce pitch movements. Speakers with no control over F0 apparently relied on an alternative pitch system to convey accents and other pitch movements.
The perception and production of voicing contrast was investigated in utterances spoken by Thai alaryngeal speakers. Thai exhibits a three-category voicing distinction for bilabial /b, p, ph/ and alveolar /d, t, th/ stops and a two-category distinction for velar [k, kh] stops. Voice onset time (VOT) was measured in word-initial stops of words produced in isolation by 2 Thai esophageal speakers and 1 Thai user of an electronic artificial larynx. These measurements were compared with published VOT values for the same words spoken by 5 normal Thai speakers. Both esophageal speakers were capable of signaling voicing distinctions for /b, d/ and /p, t, k/. The electrolaryngeal speaker was able to signal /p, t, k/ only. Thai alaryngeal speakers were generally unsuccessful in signaling /ph, th, kh/. A cross-linguistic comparison to VOT in English suggests that no more than two voicing categories can be distinguished in these two forms of alaryngeal speech. Findings are interpreted to illustrate that the realization of stop voicing contrasts in alaryngeal speech depends on the number of voicing categories in a language, the relative positions of the voicing categories on the VOT continuum, and the form of alaryngeal speech.
The intelligibility measures and listener preference rankings of pulmonary esophageal speech following tracheo-esophageal puncture (TEP) surgery were assessed relative to traditional esophageal speech, artificial laryngeal speech, and normal laryngeal speech. Intelligibility rankings were obtained with sentence length stimuli i the presence of a background competing message at varying message-to-competition ratios. Results for 20 normal-hearing adult subjects showed that although pulmonary esophageal speech was the most preferred of the alaryngeal speech modes, it was the least intelligible in the two most difficult listening conditions (-5-dB and -10-dB message-to-competition ratios).
We developed and evaluated an intra-oral electrolaryngeal speech aid system for those who could not acquire common alaryngeal speech or for early post-surgery speech rehabilitation. Our system consisted of a denture-base intra-oral vibrator, a wireless miniature fingertip switch and a controller. To produce natural speech, the fingertip switch produced binary commands of voicing and accent and the controller implemented the pitch generation model using the commands. We first estimated the intelligibility of consonant-vowel syllables produced by our system. We then obtained the feedback about the system from the Japanese users on the basis of their daily life use, and evaluated the possibility and acceptability as an alaryngeal speech aid. Although the users were less satisfied at the intra-oral electrolarynx, the intelligibility of the intra-oral electrolarygeal speech was comparable to that of transcervical electrolaryngeal speech, and most of them were willing to employ it if they lost their current electrolaryngeal speech. According to the feedbacks from the users, a completely wire-free system and less eye-catching designs would make the prosthesis more acceptable. These results placed the intra-oral electrolarynx as a useful option of alaryngeal speech aids and encouraged the further development of the intra-oral electrolarynx.
The perception and production of linguistic tone was investigated in utterances spoken by Thai alaryngeal speakers. Thai is a tone language with five phonemic tones. High-quality tape recordings of five monosyllabic words produced by 2 esophageal, 1 electrolaryngeal, and 5 normal, native Thai speakers were subjected to perceptual and acoustic analysis. Results from the phonemic identification tests indicated that tones produced by alaryngeal speakers were not only perceived at much lower levels of accuracy than those produced by normal speakers, but the patterns of tonal confusions for alaryngeal speakers were also dissimilar to those for normal speakers. Results from fundamental frequency (Fo) analysis revealed that the performance deficit of alaryngeal speakers could be related to specific characteristics of their Fo contours. Findings are interpreted to highlight the importance of (a) language, (b) type of prosody, (c) form of alaryngeal speech, and (d) Fo level and direction on linguistic assessments of Fo control in alaryngeal speech.
Preference ratings of a laryngectomized client's production of three types of alaryngeal speech--Tokyo pneumatic aid speech, Servox electro-larynx speech, and poor esophageal speech were composed. Judges rated the three methods from an audiovisual recording. Ratings were obtained for voice quality, loudness, intelligibility, rate, pitch, visual appearance and overall preference. Speech produced using the Tokyo aid was preferred by by majority of judges, although the visual appearance of the Tokyo usage was least preferred. The findings were interpreted to highlight the need to offer a range of communication alternatives to laryngectomized clients.
Past investigations of alaryngeal speech intelligibility have focused on comparative intelligibility as perceived by young normally hearing adults. However, the spouses and social companions of laryngectomees may have significantly different auditory capabilities compared to young listeners. This report presents a comparison of alaryngeal and laryngeal speech identification performance for a group of young normally hearing listeners and a group of older adult listeners representative of the age of the laryngectomee's social companions. The speech signals investigated included normal laryngeal speech, artificial larynx speech, traditional esophageal speech, and tracheoesophageal speech. The results obtained reveal not only differences in speech signals but also a difference in the proficiency of speech perception for the two groups, favoring the younger listeners. The results of the speech identification measures in the presence of auditory competition revealed greatest intelligibility for the artificial larynx speech signal and poorest for the tracheoesophageal speech signal.
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