Abstract
Introduction: The purpose of the current study was to evaluate speech intelligibility and speech rate in individuals with Parkinson’s disease using altered auditory feedback (AAF) in comparison to age-matched healthy controls. Based on prior research, it is hypothesized that the use of AAF will improve participants’ speech intelligibility. Methods: Five individuals with Parkinson’s disease (clinical group) and five age-matched healthy controls aged 50 years and above participated in this pre-/post-group experiment. All participants completed reading and monologue tasks with and without AAF. The AAF delayed the participants’ auditory feedback by 150 ms and altered it by 1/20 octave. Thirty-two naïve listeners listened to the recorded participants’ speech samples (with and without AAF) randomly and rated the participants’ speech intelligibility. Results: Results of the mixed model ANOVA revealed that participants in the control group had significantly higher speech intelligibility scores than the participants in the clinical group. Post hoc tests indicated that only participants in the clinical group were more intelligible with AAF than without AAF. Participants in the clinical group had better speech intelligibility when reading the passage than speaking the monologue. With regards to speech rate, participants spoke more slowly with AAF than without. Finally, there was a negative correlation between speech rate and speech intelligibility. Discussion: The current findings support our hypothesis that AAF improves speech intelligibility in people with Parkinson’s disease, though not in healthy controls. Future research should evaluate the long-term effect of AAF use on speech intelligibility in people with Parkinson’s disease.
Journal Section:
Research Article
References
1.
Jankovic
J
. Parkinson’s disease: clinical features and diagnosis
. J Neurol Neurosurg Psychiatry
. 2008
;79
(4
):368
–76
.2.
Liotti
M
, Ramig
LO
, Vogel
D
, New
P
, Cook
CI
, Ingham
RJ
et al. Hypophonia in Parkinson’s disease: neural correlates of voice treatment revealed by PET
. Neurology
. 2003
;60
(3
):432
–40
.3.
Duffy
JR
Motor speech disorders: substrates, differential diagnosis, and management
3rd edSt. Louis (MO)
Elsevier Mosby
. 2013
.4.
Blanchet
PG
, Snyder
GJ
. Speech rate treatments for individuals with dysarthria: a tutorial
. Percept Mot Skills
. 2010
110
3 Pt 1
965
82
.5.
Yorkston
KM
, Hammen
VL
, Beukelman
DR
, Traynor
CD
. The effect of rate control on the intelligibility and naturalness of dysarthric speech
. J Speech Hear Disord
. 1990
;55
(3
):550
–60
.6.
Van Nuffelen
G
, De Bodt
M
, Wuyts
F
, Van de Heyning
P
. The effect of rate control on speech rate and intelligibility of dysarthric speech
. Folia Phoniatr Logop
. 2009
;61
(2
):69
–75
.7.
Hammen
VL
, Yorkston
KM
. Speech and pause characteristics following speech rate reduction in hypokinetic dysarthria
. J Commun Disord
. 1996
;29
(6
):429
–44
; quiz 444-5.8.
Tjaden
K
, Wilding
G
. The impact of rate reduction and increased loudness on fundamental frequency characteristics in dysarthria
. Folia Phoniatr Logop
. 2011
;63
(4
):178
–86
.9.
Lowit
A
, Dobinson
C
, Timmins
C
, Howell
P
, Kröger
B
. The effectiveness of traditional methods and altered auditory feedback in improving speech rate and intelligibility in speakers with Parkinson’s disease
. Int J Speech Lang Pathol
. 2010
;12
(5
):426
–36
.10.
Van Nuffelen
G
, De Bodt
M
, Vanderwegen
J
, Van de Heyning
P
, Wuyts
F
. Effect of rate control on speech production and intelligibility in dysarthria
. Folia Phoniatr Logop
. 2010
;62
(3
):110
–9
.11.
Natke
U
, Grosser
J
, Kalveram
KT
. Fluency, fundamental frequency, and speech rate under frequency-shifted auditory feedback in stuttering and nonstuttering persons
. J Fluen Disord
. 2001
;26
(3
):227
–41
.12.
Van Borsel
J
, Reunes
G
, Van den Bergh
N
. Delayed auditory feedback in the treatment of stuttering: clients as consumers
. Int J Lang Commun Disord
. 2003
;38
(2
):119
–29
.13.
Sparks
G
, Grant
DE
, Millay
K
, Walker-Batson
D
, Hynan
LS
. The effect of fast speech rate on stuttering frequency during delayed auditory feedback
. J Fluency Disord
. 2002
;27
(3
):187
–200
; quiz 200-1, III.14.
Downie
AW
, Low
JM
, Lindsay
DD
. Speech disorder in parkinsonism-usefulness of delayed auditory feedback in selected cases
. Br J Disord Commun
. 1981
;16
(2
):135
–9
.15.
Rousseau
B
, Watts
CR
. Susceptibility of speakers with Parkinson disease to delayed feedback
. J Med Speech Lang Pathol
. 2002
;10
(1
):41
–50
.16.
Brendel
B
, Lowit
A
, Howell
P
. The effects of delayed and frequency shifted feedback on speakers with Parkinson’s Disease
. J Med Speech Lang Pathol
. 2004
;12
:131
–8
.17.
Wang
EQ
, Metman
LV
, Bernard
BA
. Treating festinating speech with altered auditory feedback in Parkinson’s disease: a preliminary report
. J Med Speech Lang Pathol
. 2008
;16
(4
):275
–83
.18.
Max
L
, Guenther
FH
, Gracco
VL
, Ghosh
SS
, Wallace
ME
. Unstable or insufficiently activated internal models and feedback-biased motor control as sources of dysfluency: a theoretical model of stuttering
. Contemp Issues Commun Sci Disord
. 2004
;31
:105
–22
.19.
Martin
CD
, Niziolek
CA
, Duñabeitia
JA
, Perez
A
, Hernandez
D
, Carreiras
M
et al. Online adaptation to altered auditory feedback is predicted by auditory acuity and not by domain-general executive control resources
. Front Hum Neurosci
. 2018
;12
:91
.20.
Robey
RR
. A five-phase model for clinical-outcome research
. J Commun Disord
. 2004
;37
(5
):401
–11
.21.
Nasreddine
ZS
, Phillips
NA
, Bédirian
V
, Charbonneau
S
, Whitehead
V
, Collin
I
et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment
. J Am Geriatr Soc
. 2005
;53
(4
):695
–9
.22.
Goetz
CG
, Poewe
W
, Rascol
O
, Sampaio
C
, Stebbins
GT
, Counsell
C
et al. Movement disorder society task force report on the Hoehn and Yahr staging scale: status and recommendations
. Mov Disord
. 2004
;19
(9
):1020
–8
.23.
Davis
DH
, Creavin
ST
, Yip
JL
, Noel-Storr
AH
, Brayne
C
, Cullum
S
. Montreal Cognitive Assessment for the diagnosis of Alzheimer’s disease and other dementias
. Cochrane Database Syst Rev
. 2015
2015
10
CD010775
.24.
Carson
N
, Leach
L
, Murphy
KJ
. A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores
. Int J Geriatr Psychiatry
. 2018
;33
(2
):379
–88
.25.
Chan
KM
, Yiu
EM
. A comparison of two perceptual voice evaluation training programs for naive listeners
. J Voice
. 2006
;20
(2
):229
–41
.26.
Boersma
P
, Weenink
D
. Praat: Doing phonetics by computer [Computer program]. Version 6.3.20, retrieved 24 October 2023. Available from: http://www.praat.org/.27.
Baum
SR
. An acoustic analysis of rate of speech effects on vowel production in aphasia
. Brain Lang
. 1993
;44
(4
):414
–30
.28.
Koo
TK
, Li
MY
. A guideline of selecting and reporting intraclass correlation coefficients for reliability research
. J Chiropr Med
. 2016
;15
(2
):155
–63
.29.
30.
Akoglu
H
. User’s guide to correlation coefficients
. Turk J Emerg Med
. 2018
;18
(3
):91
–3
.31.
Blanchet
PG
, Hoffman
PR
. Factors influencing the effects of delayed auditory feedback on dysarthric speech associated with Parkinson’s disease
. Commun Disord Deaf Stud Hearing Aids
. 2014
;2
(106
):2
.32.
Desmurget
M
, Grafton
S
. Forward modeling allows feedback control for fast reaching movements
. Trends Cogn Sci
. 2000
;4
(11
):423
–31
.33.
Wolpert
DM
, Ghahramani
Z
, Jordan
MI
. An internal model for sensorimotor integration
. Science
. 1995
;269
(5232
):1880
–2
.34.
Wolpert
DM
, Miall
RC
, Kawato
M
. Internal models in the cerebellum
. Trends Cogn Sci
. 1998
;2
(9
):338
–47
.35.
Chon
H
, Kraft
SJ
, Zhang
J
, Loucks
T
, Ambrose
NG
. Individual variability in delayed auditory feedback effects on speech fluency and rate in normally fluent adults
. J Speech Lang Hear Res
. 2013
;56
(2
):489
–504
.36.
Sidtis
D
, Cameron
K
, Bonura
L
, Sidtis
JJ
. Speech intelligibility by listening in Parkinson speech with and without deep brain stimulation: task effects
. J Neurolinguistics
. 2012
;25
(2
):121
–32
.37.
Stolwyk
RJ
, Triggs
TJ
, Charlton
JL
, Iansek
R
, Bradshaw
JL
. Impact of internal versus external cueing on driving performance in people with Parkinson’s disease
. Mov Disord
. 2005
;20
(7
):846
–57
.38.
Shaver
JP
. What statistical significance testing is, and what it is not
. J Exp Educ
. 1993
;61
(4
):293
–316
.39.
Thompson
B
. Statistical significance and effect size reporting: portrait of a possible future
. Res Sch
. 1998
;5
(2
):33
–8
.40.
Robey
RR
. A meta-analysis of clinical outcomes in the treatment of aphasia
. J Speech Lang Hear Res
. 1998
;41
(1
):172
–87
.41.
Schafer
WD
. Interpreting statistical significance and nonsignificance
. J Exp Educ
. 1993
;61
(4
):383
–7
.© 2023 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2023
You do not currently have access to this content.
