Characteristics of the lax vowel space in dysarthria.

It has been hypothesized that lax vowels may be relatively unaffected by dysarthria, owing to the reduced vocal tract shapes required for these phonetic events (G. S. Turner, K. Tjaden, & G. Weismer, 1995). It also has been suggested that lax vowels may be especially susceptible to speech mode effects (M. A. Picheny, N. I. Durlach, & L. D. Braida, 1986). Studies evaluating these suggestions are lacking, however. The present study was an initial investigation of the vowel space area formed by the lax vowels /Iota/, /varepsilon/, and /upsilon/, occurring in a passage read in habitual, fast, and slow conditions by speakers with amyotrophic lateral sclerosis (ALS), speakers with Parkinson's disease (PD), and healthy controls. Vowel space areas for speakers with ALS but not speakers with PD differed from those for the appropriate control group. Thus, only the results for the PD group support the hypothesis that lax vowel space areas for speakers with dysarthria should be similar to those for neurologically normal talkers. Compared with the habitual condition, rate reduction was associated with an expanded vowel space area for all of the healthy talkers but for only about half of the speakers with dysarthria. In addition, about half of the speakers in each group demonstrated a reduced vowel space area for the fast condition relative to the habitual condition, although the statistical analyses indicated no difference in vowel space areas for the fast and habitual conditions. The current study therefore provides only limited support for the idea that lax vowels are highly susceptible to speech mode effects, at least when the speech modes under consideration include faster-than-normal and slower-than normal rates. Clinical implications are discussed.     

Intelligibility characteristics of superior esophageal speech presented under various levels of masking noise.

Broad-band masking of speech was used to assess the effects that broad-band masking noise had upon the recognition of consonants and vowels produced by esophageal speakers. Procedures were developed to compare the articulation functions of superior esophageal speech with those of normal speech under comparable levels of masking noise. Within the range of speech-to-noise ratios studied, articulation functions for vowels were essentially the same for esophageal and normal talkers (4% per dB). With respect to consonants, the intelligibility scores for esophageal speech were 12 to 14% lower than for normal speech under adverse noise conditions. Gains in the consonant articulation functions were 2.5%/dB and 4%/dB for normal and esophageal talkers, respectively. For adverse noise conditions, the lowered consonant scores for esophageal speakers were the result of poorer than normal intelligibility for liquid-glides and nasal and, secondarily, for stop consonants. Additional differences between the intelligibility characteristics of esophageal and normal speech were found in work-position and voicing features.     

Cervical lymphnode metastasis of early or late T2 tongue carcinoma

Between 1986 and 1997, 72 patients (47 males, 25 females) with previously untreated tongue cancer were treated at our institution (surgery: 67, interstitial radiotherapy: 3, palliative therapy: 2). These patients, especially T2 tongue cancer, were classified into two groups (early T2: < or = 3 cm, late T2: > 3 cm) according to the maximum diameter of the primary lesion, and were analyzed for treatment outcome and cervical lymphnode metastasis. (1) The cumulative 5-year survival rates were 65.9% for all cases, 95.0% for T1 cases, 77.5% (94.1% for early T2, 59.7% for late T2) for T2 cases, 24.3% for T3 cases (4-year survival rate), and 0% for T4 cases. (2) The cumulative 5-year survival rates were 90.8% for pN- patients and 21.7% for pN+ patients and the difference was statistically significant (p < 0.05%). In prognosis, pN- patients were better than pN+ patients. Since the N factor was related to the cause of death in 87.5% (7/8) of T2 tongue cancer, control of regional lymph node involvement was the most important prognostic factor. (3) The overall incidence of cervical lymph node metastasis (pN+ or secondary nodal metastasis) was 35.3% for early T2 and 750% for late T2. The control rate of secondary nodal metastasis was 75.0% for early T2 and 33.3% for late T2. Partial glossectomy only (observation for occult lymphnode metastasis) is recommended for treatment of T2N0, whereas glossectomy with selective neck dissection by the pull-through method is recommended for treatment of late T2.     

Talker discrimination in preschool children with and without specific language impairment

Variability inherently present between multiple talkers can prove beneficial in the context of learning. However, the performance during learning paradigms by children with specific language impairment (SLI) remains below typically developing peers, even when multiple talkers are used. Preschool children with typically developing language (n = 17) and SLI (n = 17) participated in a talker discrimination task. Five different pairings of talkers (same male, different males, same female, different females, male + female) were used to present 50 spoken words. Children with SLI were significantly poorer in discriminating same and different male speakers compared to their typical peers. The present findings demonstrate that preschool children with SLI can experience difficulty distinguishing between talkers. Poor sensitivity to variation in talkers may contribute to poor learning in SLI for contexts where multiple talker input should benefit the learner.     

Segmental timing in amyotrophic lateral sclerosis.

This study describes segmental timing patterns for a passage read by speakers with ALS and a group of age- and gender-matched neurologically healthy speakers. Segment durations for ALS speakers' habitual rates (ALS condition) were compared to segment durations for healthy speakers' habitual and slow reading rates (Control Habitual and Control Slow conditions). Temporal differences for pairs of sound classes (i.e., long-short vowels, voiceless-voiced fricatives, voiceless-voiced stop gaps, high-low vowels) and prepausal lengthening of vowels also were studied. The results of the ALS-Control Habitual comparison suggested that the slowed articulatory rate of ALS influences segmental timing for most phonetic events. The finding that local segmental cues for disordered speakers were broadly consistent with their overall (slow) articulatory rate suggests that duration likely does not contribute in a significant way to intelligibility deficits in ALS. A qualitative analysis further indicated that the slowed rate of ALS is not uniformly distributed across phonetic events, but influences segment durations of particular sound categories in ways consistent with the disease process. The analysis comparing segment durations for the ALS and Control Slow conditions suggested that the overall pattern of segmental timing for speakers with ALS was broadly similar to the pattern for voluntarily slowed speech of healthy talkers. Finally, temporal differences for sound classes (i.e., voiceless-voiced fricatives, long-short vowels) and prepausal lengthening for speakers with ALS typically were similar to healthy speakers' habitual and slow speech. There were substantial variability within speaker groups and reversals of expected effects, however. The implication is that temporal differences for sound classes, such as short and long vowels, are not a particularly reliable perceptual cue for listeners.     

Nasal septal deformities in ear, nose, and throat patients: an international study

PURPOSE: The purpose of this study was to investigate the incidence and characteristics of nasal septum deformities in ear, nose, and throat (ENT) patients in various geographic regions in the world. MATERIALS AND METHODS: Anterior rhinoscopy without nasal decongestion was performed in 17 ENT centers in 14 countries. The septal deformities were classified according to the classification system proposed by Mladina. RESULTS: A total of 2589 adult ENT patients (1500 males and 1089 females) were examined. Septal deformities were found in 89.2% of subjects. Left-sided deformities were slightly more prevalent than right-sided deformities (51.6% and 48.4%, respectively). The most frequent type of deformity was type 3 (20.4%). Straight septum was found in 15.4% of females and 7.5% of males. CONCLUSIONS: Almost 90% of the subjects showed 1 of the 7 types of septal deformity. There were no statistically significant differences in the incidence of their appearance among particular geographic regions. Type 3 was the most frequent type. Straight septum was twice as frequent in females than in males.     

Vowel category dependence of the relationship between palate height, tongue height, and oral area.

This article evaluates intertalker variance of oral area, logarithm of the oral area, tongue height, and formant frequencies as a function of vowel category. The data consist of coronal magnetic resonance imaging (MRI) sequences and acoustic recordings of 5 talkers, each producing 11 different vowels. Tongue height (left, right, and midsagittal), palate height, and oral area were measured in 3 coronal sections anterior to the oropharyngeal bend and were subjected to multivariate analysis of variance, variance ratio analysis, and regression analysis. The primary finding of this article is that oral area (between palate and tongue) showed less intertalker variance during production of vowels with an oral place of articulation (palatal and velar vowels) than during production of vowels with a uvular or pharyngeal place of articulation. Although oral area variance is place dependent, percentage variance (log area variance) is not place dependent. Midsagittal tongue height in the molar region was positively correlated with palate height during production of palatal vowels, but not during production of nonpalatal vowels. Taken together, these results suggest that small oral areas are characterized by relatively talker-independent vowel targets and that meeting these talker-independent targets is important enough that each talker adjusts his or her own tongue height to compensate for talker-dependent differences in constriction anatomy. Computer simulation results are presented to demonstrate that these results may be explained by an acoustic control strategy: When talkers with very different anatomical characteristics try to match talker-independent formant targets, the resulting area variances are minimized near the primary vocal tract constriction.     

Language and reading outcomes to age 9 in late-talking toddlers.

Language and reading outcomes at 6 to 9 years of age were examined in a sample of 34 children who were late talkers as toddlers. The late talkers, who all had normal nonverbal ability and age-adequate receptive language at intake, were compared to a group of 25 typically developing children matched at intake (24 to 31 months) on age, socioeconomic status, and nonverbal ability. Late talkers performed in the average range on most language tasks by age 5. However, they had significantly poorer scores on most language measures through age 9. The groups did not differ in reading skills at age 6 or 7, but the late talkers were slightly less skilled in reading at ages 8 and 9. Findings suggest that slow early language development reflects a predisposition for slower acquisition and lower asymptotic performance in a wide range of language-related skills into middle childhood.     

A novel fixed-target task to determine articulatory speed constraints in persons with amyotrophic lateral sclerosis

PurposeThe goal of this study was to determine if talkers with ALS are limited in their ability to increase lower lip and jaw speed at an early stage of the disease when their speaking rate and intelligibility are only minimally or not affected.MethodA novel metronome paced fixed-target task was used to assess movement speed capacities during lower lip and jaw oscillations in seven talkers with ALS and seven age and gender matched controls.ResultsLower lip peak speeds were significantly lower in talkers with mild ALS than in healthy talkers suggesting a lower lip speed constraint in talkers with mild ALS. Jaw peak speeds tended to be lower, but jaw displacements tended to be larger in talkers with mild ALS than in healthy talkers. Because greater speeds are typically expected for larger displacements, outcomes also suggest a jaw speed constraint in talkers with mild ALS.ConclusionsLower lip and jaw peak speeds may be sensitive measures to identify bulbar motor performance decline at an early stage of the disease when speaking rate and intelligibility are only minimally affected.Learning Outcomes: The reader will be able to explain two different articulatory strategies to increase speaking rate and understand why fast speech tasks and diadochokinetic pseudo-speech tasks are not suited to assess articulatory speed capacity in healthy and impaired talkers. The reader will also be able to explain how orofacial movement speed capacity can be tested using a fixed-target task and how ALS affects lower lip and jaw speed capacities during the early stages of the disease.     

Articulation rate and vowel space characteristics of young males with fragile X syndrome: preliminary acoustic findings.

PURPOSE: Increased speaking rate is a commonly reported perceptual characteristic among males with fragile X syndrome (FXS). The objective of this preliminary study was to determine articulation rate-one component of perceived speaking rate-and vowel space characteristics of young males with FXS. METHOD: Young males with FXS (n = 38), developmental age (DA)-matched males (n = 21), and chronological age (CA)-matched males (n = 16) were audiotaped while engaged in spontaneous conversation and a picture-naming task. Articulation rate in syllables per second during intelligible utterances and vowel space area/dispersion measures were acoustically determined for each speaker. RESULTS: Males with FXS did not articulate significantly faster than CA-matched males. Area and dispersion of the acoustic vowel space also were similar between the 2 groups. Males with FXS, however, used significantly shorter utterances and had a tendency to pause less often than CA-matched males. In addition, males with FXS exhibited greater intraspeaker variability of formants associated with the vowel /a/. CONCLUSIONS: These preliminary findings suggest that articulation rate may not be a primary factor contributing to perceived speaking rate of males with FXS. Limitations of the study relative to speech production tasks and utterance intelligibility are discussed.     

Sex-related acoustic changes in voiceless English fricatives.

This investigation is a comprehensive acoustic study of 4 voiceless fricatives (/f theta s /) in English produced by adults and pre- and postpubescent children aged 6-14 years. Vowel duration, amplitude, and several different spectral measures (including spectral tilt and spectral moments) were examined. Of specific interest was the pattern of normal development of the acoustic properties of fricatives and the nature of sex-specific patterns of fricative articulation in prepubescent children. Little evidence of amplitude or duration differences was found between speakers that was related to sex of the speaker. However, significant sex-specific differences in fricative articulation were found in all groups of speakers-even in the youngest children (ages 6-7 years)-although there was an indication that some of the acoustic differences between females and males is reduced or absent in the youngest children. Results from discriminant analysis demonstrated that a discriminant function based on the adult male tokens was generally better at classifying fricatives produced by male speakers than female speakers, regardless of age. This showed that sex-related differences (presumably a function of sex-linked vocal tract variation) were present even in the youngest speaker group. However, the classification accuracy of the female model showed a steady improvement with the increased age of the female speakers and may provide support for the claim that sex-related developmental differences may just be emerging in the youngest age group.     

High click stimulus repetition rate in the auditory evoked potentials in multiple sclerosis patients with normal MRI. Does it improve diagnosis?

OBJECTIVE: The purpose of this study was to evaluate whether auditory brainstem responses (ABR) in multiple sclerosis (MS) patients were qualitatively different from a normal population. MATERIAL AND METHOD: This study analysed 69 subjects, separated into two groups; a control group composed of 20 females and 20 males; and an MS group composed of 20 females and 9 males. The controls had no history of neurological or otorhinolaryngological disorders. All MS patients presented a normal magnetic resonance imaging of the brainstem. A definite diagnosis of MS was given according to Poser's criteria for MS research protocols (1983). The following parameters were used in the study of the ABR of each subject: 2000 clicks of 100 ms at 60 dB equivalent peak of sou nd pressure level (pe SPL) above the psycho-acoustic threshold, obtained with the subject's response to clicks. Both ears were initially stimulated at 11 clicks/s, and then with clicks of same intensity, but with a progressive increase of the stimulus rate to 31, 51, 61 and 71 clicks/s. The analysis of variance with independent factors and repeated measures was used in the statistical analysis of the comparison between group results. RESULTS: The absolute latency of wave III was statistically greater, with a stimulus rate of 51 and 61 clicks/s, in the MS group. The males in the MS group presented a statistically greater absolute latency of wave V with the use of 51 and 61 clicks/s. With stimulus rates above 30 clicks/s, the absolute latency of wave V was also greater for MS females. There were statistically significant differences in the interpeak interval I - III of the control group compared to the MS group, for stimulus rates of 51 and 61 clicks/s, in females and for the stimulus rate of 61 clicks/s in males. This interval was higher in the MS group with these stimulus rates. CONCLUSION: The results suggest the inclusion of stimulus rates of 51 and 61 clicks/s in the ABR tests of subjects with clinical suspicion of demyelinating diseases like MS.     

Patterns of orofacial movement velocity across variations in speech rate.

To understand the clinical aspects of speech rate control, a clearer picture is needed of how orofacial structures are coordinated across variations in speech rate. To address this problem, patterns of orofacial tangential velocity or speed were analyzed in a group of 9 normal speakers as they produced the utterance "a bad daba" at fast, normal, and slow speech rates. An electromagnetic system was used to record the movements of the upper lip, lower lip, jaw, and tongue. Measures of the magnitude of peak tangential velocities were obtained across the four structures. Orofacial velocities consistently decreased at slow rates relative to normal rates, whereas at fast rates increased and decreased velocities were observed in an equivalent number of cases. Significant correlations frequently were obtained across speech rate between lip, tongue, and jaw velocities. Upper and lower lip velocities showed consistent positive correlations with one another, whereas marked intersubject differences were observed in the sign of jaw-related correlations. Repeated testing on 3 subjects indicated a high degree of consistency within subjects in the overall patterns of mean velocity for the different structures. Results are discussed in relation to possible motor control differences underlying fast and slow speech, neural coupling of muscle systems, and jaw-related individual differences in speech motor coordination.     

The epidemiology of malignant neoplasia of the larynx in Canada: 1931-1984

Canadian patterns of morbidity and mortality from laryngeal carcinoma were examined for the periods 1970-1980 and 1931-1984, respectively. Age-standardized morbidity rates had risen significantly in both males and females (P = 0.0001 and 0.0116) during 1970-1980 with rates for males increasing by more than 0.28 additional cases per 100,000 population per year since 1970. Analysis of age-specific rates over time indicates that the rise in standardized rates is attributable to significant increases in rates for males aged 45-54, 55-64 and 65-74 (P less than 0.006) and females aged 45-54, 55-64, and 75-84 (P less than 0.045). Rates for males aged 55-64 demonstrated the most dramatic rate of change of any age group at over 1.8 additional new cases per 100,000 population per year since 1970. Analysis of age-standardized mortality rates reveals that rates for males have risen significantly during the period 1931-1984 whereas rates for females have declined significantly (P = 0.0001 and 0.005, respectively). The rise in age-standardized mortality rates for males is associated with corresponding significant rates of increase in age-specific rates for males aged 45-54, 55-64, 65-74, 75-84 and 85 + (P less than 0.02) whereas the decline in rates for females is associated with significant declines in rates for women aged 35-44, 45-54, and 75-84 (P less than 0.05). Males aged 75-84 had the greatest rate of change at 0.20 additional new deaths per 100,000 population per year since 1931.     

Communicative gestures in children with delayed onset of oral expressive vocabulary.

Use of communicative gestures in a group of children with delayed onset of expressive oral vocabulary (late talkers) was compared with such use among normal-language-matched controls and age-matched controls. Analyses revealed that late talkers used significantly more communicative gestures and for a greater variety of communicative functions than did language-matched controls. However, a 1-year follow-up revealed that 4 of the late talkers remained delayed (truly delayed late talkers) and 6 caught up (late bloomers). Reanalyses of Year 1 data based on these follow-up outcomes demonstrated that only late bloomers used more communicative gestures than did language-matched controls. Truly delayed late talkers did not differ from language-matched controls either for number of gestures, type of gestures (symbolic vs. nonsymbolic), or number of different functions for which gestures were used. Late bloomers also used more communicative gestures than did age-matched controls, suggesting that they (the late bloomers) were using gestures to compensate for their small oral expressive vocabulary. Results are discussed in the context of early predictors of risk for language impairment and relationships between language and cognition.     

Specific language impairment in families: evidence for co-occurrence with reading impairments.

Two family aggregation studies report the occurrence and co-occurrence of oral language impairments (LIs) and reading impairments (RIs). Study 1 examined the occurrence (rate) of LI and RI in children with specific language impairment (SLI probands), a matched control group, and all nuclear family members. Study 2 included a larger sample of SLI probands, as well as their nuclear and extended family members. Probands and their family members who met specific criteria were classified as language and/or reading impaired based on current testing. In Study 1, the rates of LI and RI for nuclear family members (excluding probands) were significantly higher than those for control family members. In the SLI families, affected family members were more likely to have both LI and RI than either impairment alone. In Study 2, 68% of the SLI probands also met the diagnostic classification for RI. The language and RI rates for the other family members, excluding probands, were 25% and 23% respectively, with a high degree of co-occurrence of LI and RI (46%) in affected individuals. Significant sex ratio differences were found across generations in the families of SLI probands. There were more male than female offspring in these families, and more males than females were found to have both LIs and RIs. Results demonstrate that when LIs occur within families of SLI probands, these impairments generally co-occur with RIs. Our data are also consistent with prior findings that males show impairments more often than females.     

Dysarthria associated with traumatic brain injury: speaking rate and emphatic stress

Prosodic abnormality is common in the dysarthria associated with traumatic brain injury (TBI), and adjustments of speaking rate and emphatic stress are often used as steps in treating the speech disorder in patients with TBI-induced dysarthria. However, studies to date do not present a clear and detailed picture of how speaking rate and emphatic stress are affected in this speech disorder. This study, based on the acoustic analyses of syllable repetitions and sentence speech samples, reports on speaking rate and emphatic stress for 12 subjects with TBI and 8 healthy controls. For speaking rate, the subjects with TBI had (1) both slow speaking and articulation rates, (2) smaller phonation proportion and larger pause proportion, and (3) larger percentage change in speaking rate and smaller percentage change in articulation rate. For emphatic stress, the subjects with TBI had (1) significant increases in the difference and percentage change between pre-stressed and pre-unstressed pause durations, (2) significantly smaller difference between stressed and unstressed word durations, but not the percentage change between stressed and unstressed word durations, and (3) significantly reduced differences in f(0) movement and f(0) slope between stressed and unstressed words, but not in RMS range. This study demonstrates the multidimensional nature of prosodic deficits in the dysarthria related to TBI and illustrates the ability of acoustic measures to give a picture of the dysprosody related to TBI-induced dysarthria. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe the prosodic disturbances that have been reported in studies of dysarthria associated with TBI; (2) define acoustic measures appropriate to the analysis of changes in speaking rate and emphatic stress; and (3) discuss the importance of prosody to spoken communication.     

Continuous discourse tracking: an analysis of the procedure

The method of continuous discourse tracking was evaluated in terms of the strategies used by the talker and the types of responses elicited from the listener. Talker utterances were classified into four categories: 1. Complete repetition (of the initial utterance); 2. Partial repetition; 3. Repetition with change in emphasis; and 4. A combined strategy using two or more correction strategies. Listener responses were classified into three categories: 1. Correct repetition of intended utterance; 2. Partially correct repetition; and 3. Totally incorrect repetition or no response. The listeners showed small but statistically significant differences in their response patterns. Much larger differences were observed in the pattern of correction strategies used by the talkers. Differences in correction strategy were also observed between the early and later stages of a talker-listener exchange.