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Cox SR, McNicholl K, Shadle CH, Chen WR. Variability of Electrolaryngeal Speech Intelligibility in Multitalker Babble. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2012-2022. [PMID: 32870708 PMCID: PMC8740568 DOI: 10.1044/2020_ajslp-20-00092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/08/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this study was to report the variability of electrolarynx (EL) users' speech intelligibility in quiet and in multitalker babble. Method Ten EL users (five Servox® Digital, five TruTone™) who were at least 2 years postlaryngectomy provided recordings of five sentences from the 1965 Revised List of Phonetically Balanced Sentences. Recordings were judged by two groups of naïve listeners in quiet and in the presence of multitalker babble. Fifteen listeners orthographically transcribed a total of 750 sentences containing 3,750 key words in quiet, and another 15 listeners orthographically transcribed the same sentences mixed with multitalker babble. Results Significant differences in speech intelligibility were observed between listening conditions; 17.9% more key words were correctly identified in quiet compared to multitalker babble. Significant differences in fundamental frequency (F0) standard deviation and range but not speech intelligibility were observed between EL device types. A positive correlation of moderate significance was observed between F0 standard deviation and intelligibility for TruTone users in multitalker babble. Conclusions Findings suggest that listeners are able to identify a significantly higher percentage of EL users' speech in quiet compared to multitalker babble, but a large variability in EL users' speech intelligibility exists. Continued investigation involving a larger number of EL users is necessary to confirm this study's findings. Future research should explore the relationships among F0 measures, speaker characteristics (e.g., rate of speech, articulatory precision), and speech intelligibility, in addition to improving alaryngeal rehabilitation training protocols for EL users.
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Affiliation(s)
- Steven R. Cox
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY
| | - Kimberly McNicholl
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY
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Cox SR, Raphael LJ, Doyle PC. Production of Vowels by Electrolaryngeal Speakers Using Clear Speech. Folia Phoniatr Logop 2019; 72:250-256. [PMID: 31121594 DOI: 10.1159/000499928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study examined the effect of clear speech on vowel productions by electrolaryngeal speakers. METHOD Ten electrolaryngeal speakers produced eighteen words containing /i/, /ɪ/, /ɛ/, /æ/, /eɪ/, and /oʊ/ using habitual speech and clear speech. Twelve listeners transcribed 360 words, and a total of 4,320 vowel stimuli across speaking conditions, speakers, and listeners were analyzed. Analyses included listeners' identifications of vowels, vowel duration, and vowel formant relationships. RESULTS No significant effect of speaking condition was found on vowel identification. Specifically, 85.4% of the vowels were identified in habitual speech, and 82.7% of the vowels were identified in clear speech. However, clear speech was found to have a significant effect on vowel durations. The mean vowel duration in the 17 consonant-vowel-consonant words was 333 ms in habitual speech and 354 ms in clear speech. The mean vowel duration in the single consonant-vowel words was 551 ms in habitual speech and 629 ms in clear speech. CONCLUSION Finding suggests that, although clear speech facilitates longer vowel durations, electrolaryngeal speakers may not gain a clear speech benefit relative to listeners' vowel identifications.
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Affiliation(s)
- Steven R Cox
- Communication Sciences and Disorders, Adelphi University, Garden City, New York, USA,
| | - Lawrence J Raphael
- Communication Sciences and Disorders, Adelphi University, Garden City, New York, USA
| | - Philip C Doyle
- Rehabilitation Sciences, Western University, London, Ontario, Canada
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Cox SR, Doyle PC. The influence of clear speech on auditory-perceptual judgments of electrolaryngeal speech. JOURNAL OF COMMUNICATION DISORDERS 2018; 75:25-36. [PMID: 30005317 DOI: 10.1016/j.jcomdis.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/29/2018] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To determine the influence of clear speech on auditory-perceptual judgments of speech acceptability and listener comfort for electrolaryngeal speech. METHOD Voice recordings were obtained from 10 electrolaryngeal speakers. Each speaker read the Rainbow Passage in two conditions: habitual speech and clear speech. Speakers were encouraged to speak as clearly as possible and over-articulate in the clear speech condition. Auditory-perceptual rating tasks were completed by 20 normal-hearing adults who evaluated 20 randomized voice recordings. Two counterbalanced listening sessions were used to gather ratings of speech acceptability and listener comfort. RESULTS A significant effect of speaking condition was found on listener judgments of speech acceptability, but not listener comfort. However, listener scores for speech acceptability and listener comfort were found to be significantly related. For all speakers, objective temporal measures indicated reduced speaking rates in the clear speech condition. CONCLUSIONS These findings suggest that volitional attempts to improve electrolaryngeal speech using clear speech might negatively impact listener judgments of speech acceptability, but not listener comfort. Further, the data suggest that speech acceptability and listener comfort might address unique perceptual entities. Overall, the strong relationship between these auditory-perceptual dimensions provide support for the use of scaled measurements to assess the impact of speech rehabilitation on individuals who use the electrolarynx.
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Affiliation(s)
- Steven R Cox
- Voice Production and Perception Laboratory, Western University, London, ON, Canada; Rehabilitation Science, Western University, London, ON, Canada; Communication Sciences and Disorders, Adelphi University, Garden City, NY, United States.
| | - Philip C Doyle
- Voice Production and Perception Laboratory, Western University, London, ON, Canada; Rehabilitation Science, Western University, London, ON, Canada; Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Nagle KF, Eadie TL. Perceived listener effort as an outcome measure for disordered speech. JOURNAL OF COMMUNICATION DISORDERS 2018; 73:34-49. [PMID: 29567465 DOI: 10.1016/j.jcomdis.2018.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/05/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Perceived listening effort is a perceptual dimension used to identify the amount of work necessary to understand disordered speech. The purpose of this study was to investigate the utility of perceived listening effort to provide unique information about disordered speech. The relationships between perceived listening effort and two current outcome measures (speech acceptability, intelligibility) were examined for listeners rating electrolaryngeal speech, along with their reliability and intra-rater agreement. METHODS Ten healthy male speakers read low-context sentences using an electrolarynx. Twenty-five inexperienced listeners orthographically transcribed and rated the stimuli for perceived listening effort and speech acceptability using a visual analog scale. Strict reliability and agreement criteria were set. RESULTS Perceived listening effort was moderately to strongly correlated with intelligibility (r = -0.76) and acceptability (r = -0.80), each of which contributed uniquely to ratings of perceived listening effort. However, only 17 listeners met stringent reliability and agreement criteria. CONCLUSIONS Ratings of perceived listening effort may provide unique information about the communicative success of individuals with communication disorders. There is great variability, however, among inexperienced listeners' perceptual ratings of electrolaryngeal speech. Future research should investigate variables that may affect perceived listening effort specifically and auditory-perceptual ratings in general.
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Affiliation(s)
- Kathleen F Nagle
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, 98105, USA.
| | - Tanya L Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, 98105, USA
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Tuttle TG, Erath BD. Design and Evaluation of a Mechanically Driven Artificial Speech Device. J Med Device 2017. [DOI: 10.1115/1.4038222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper presents the design of a mechanically driven artificial speech device to be used by laryngectomees as an affordable alternative to an electrolarynx (EL). Design objectives were based on feedback from potential end users. The device implements a mainspring powered gear train that drives a striker. The striker impacts a suspended drum-like head, producing sound. When pressed against the neck, the head transmits sound into the oral cavity, allowing the user to produce intelligible speech. The dynamics of the vibrating head and sound pressure levels (SPLs) produced at the mouth were measured to compare performance between the device and a common, commercially available EL. The results showed comparable performance and sound output.
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Affiliation(s)
- Tyler G. Tuttle
- Department of Mechanical Engineering, Michigan State University, 428 South Shaw Ln, East Lansing, MI 48824 e-mail:
| | - Byron D. Erath
- Department of Mechanical and Aeronautical Engineering, Clarkson University, 8 Clarkson Ave, Potsdam, NY 13699 e-mail:
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Eadie TL, Otero DS, Bolt S, Kapsner-Smith M, Sullivan JR. The Effect of Noise on Relationships Between Speech Intelligibility and Self-Reported Communication Measures in Tracheoesophageal Speakers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:393-407. [PMID: 27379754 PMCID: PMC5270639 DOI: 10.1044/2016_ajslp-15-0081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/29/2015] [Accepted: 12/22/2015] [Indexed: 05/29/2023]
Abstract
PURPOSE The purpose of this study was to examine how sentence intelligibility relates to self-reported communication in tracheoesophageal speakers when speech intelligibility is measured in quiet and noise. METHOD Twenty-four tracheoesophageal speakers who were at least 1 year postlaryngectomy provided audio recordings of 5 sentences from the Sentence Intelligibility Test. Speakers also completed self-reported measures of communication-the Voice Handicap Index-10 and the Communicative Participation Item Bank short form. Speech recordings were presented to 2 groups of inexperienced listeners who heard sentences in quiet or noise. Listeners transcribed the sentences to yield speech intelligibility scores. RESULTS Very weak relationships were found between intelligibility in quiet and measures of voice handicap and communicative participation. Slightly stronger, but still weak and nonsignificant, relationships were observed between measures of intelligibility in noise and both self-reported measures. However, 12 speakers who were more than 65% intelligible in noise showed strong and statistically significant relationships with both self-reported measures (R2 = .76-.79). CONCLUSIONS Speech intelligibility in quiet is a weak predictor of self-reported communication measures in tracheoesophageal speakers. Speech intelligibility in noise may be a better metric of self-reported communicative function for speakers who demonstrate higher speech intelligibility in noise.
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Cox SR, Theurer JA, Spaulding SJ, Doyle PC. The multidimensional impact of total laryngectomy on women. JOURNAL OF COMMUNICATION DISORDERS 2015; 56:59-75. [PMID: 26186255 DOI: 10.1016/j.jcomdis.2015.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 03/26/2015] [Accepted: 06/29/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED Based on society's expectations of what defines the norms for what is deemed "masculine" and "feminine", and a propensity for society's members to adhere to these expectations, women may face a unique set of circumstances and pressures following surgical treatment for laryngeal cancer. This is primarily due to the changes that occur to women's physical, psychological, and social functioning when dealing with cancer diagnosis and treatment outcomes. Because of concerns related to physical disfigurement, acoustic and perceptual changes to one's voice, and threat of the psychological sequelae associated with total laryngectomy (TL) (or, the surgical removal of one's voicebox and surrounding structures), there is an increased potential for violation of social expectations that cross these areas of functioning. As such, efforts that seek to better understand the potentially differential impact of TL on women and identify the specific needs they may have leading up to and after such treatment pursuant to contemporary societal expectations are warranted. Thus, this paper provides an examination of the potentially differential impact of TL on women. In addressing this position, this paper examines the unique challenges women may face postlaryngectomy through the framework of the International Classification of Functioning, Disability, and Health (ICF). Through the use of the ICF, this paper will provide an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as facilitators or barriers to women's societal reintegration secondary to TL. LEARNING OUTCOMES Readers will be able to describe the multiple factors that may contribute to the differential impact of total laryngectomy (TL) on women. More specifically, readers will gain an understanding about women's physical, psychological, and social functioning secondary to TL. This paper also provides readers with exposure to the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework. This framework provides readers with an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as either facilitators or barriers to the societal reintegration of women secondary to TL.
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Affiliation(s)
- Steven R Cox
- Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
| | - Julie A Theurer
- Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
| | - Sandi J Spaulding
- Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; School of Occupational Therapy, University of Western Ontario, London, ON, Canada
| | - Philip C Doyle
- Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
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