Minimally Detectable Change and Minimal Clinically Important Difference of a Decline in Sentence Intelligibility and Speaking Rate for Individuals With Amyotrophic Lateral Sclerosis

Stipancic, Kaila L.; Yunusova, Yana; Berry, James; Green, Jordan R.

doi:10.1044/2018_jslhr-s-17-0366

Cited by 60 publications

(44 citation statements)

References 76 publications

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“…However, these results suggest that speech treatment also had positive effects in improving intelligibility. Treatment effects on the intelligibility of speakers with dysarthria have been documented reporting a wide range of values for the gains (Stipancic et al, 2018), with some studies reporting statistically significant increases in intelligibility scores of 4% post-treatment (Cannito et al, 2012). Three of the five children in the SIT group in our study evidenced moderate dysarthria, while a fourth presented with a severe motor speech disorder.…”

Section: Intelligibility and Naturalness Changesmentioning

confidence: 50%

Speech Treatment Effects on Narrative Intelligibility in French-Speaking Children With Dysarthria

Moya‐Galé

Keller

Escorial

et al. 2021

J Speech Lang Hear Res

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Purpose This study examined the effects of Speech Intelligibility Treatment (SIT) on intelligibility and naturalness of narrative speech produced by francophone children with dysarthria due to cerebral palsy. Method Ten francophone children with dysarthria were randomized to one of two treatments, SIT or Hand–Arm Bimanual Intensive Therapy Including Lower Extremities, a physical therapy (PT) treatment. Both treatments were conducted in a camp setting and were comparable in dosage. The children were recorded pre- and posttreatment producing a story narrative. Intelligibility was measured by means of 60 blinded listeners' orthographic transcription accuracy (percentage of words transcribed correctly). The listeners also rated the children's naturalness on a visual analogue scale. Results A significant pre- to posttreatment increase in intelligibility was found for the SIT group, but not for the PT group, with great individual variability observed among the children. No significant changes were found for naturalness ratings or sound pressure level in the SIT group or the PT group posttreatment. Articulation rate increased in both treatment groups, although not differentially across treatments. Conclusions Findings from this first treatment study on intelligibility in francophone children with dysarthria suggest that SIT shows promise for increasing narrative intelligibility in this population. Acoustic contributors to the increased intelligibility remain to be explored further. Supplemental Material https://doi.org/10.23641/asha.14161943

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Section: Intelligibility and Naturalness Changesmentioning

confidence: 50%

Speech Treatment Effects on Narrative Intelligibility in French-Speaking Children With Dysarthria

Moya‐Galé

Keller

Escorial

et al. 2021

J Speech Lang Hear Res

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“…For speakers in CS3, for whom dysarthria was severe enough to affect overall intelligibility, sentence intelligibility was approximately 13% higher in 5-word sentences than in 15-word sentences. Prior work suggests that a change in intelligibility of approximately 12% on the SIT is clinically meaningful (Stipancic et al, 2018). Speakers with severe-to-profound dysarthria (i.e., those in CS4) also showed a similar but not statistically significant decline in intelligibility with increased sentence length.…”

Section: Short Sentences Maximized Intelligibility In Persons With Admentioning

confidence: 88%

“…For each speaker, an overall speaking rate was determined by averaging the speaking rates for each sentence. Although intelligibility transcriptions were only completed by one judge for this study, recent research from our lab has demonstrated strong intrajudge reliability for intelligibility (r = .92) and speaking rate (r = .92) measurements from the SIT (Stipancic, Yunusova, Berry, & Green, 2018). Overall intelligibility and overall speaking rate were used to determine communication stage groupings as defined above.…”

Section: Intelligibility and Speaking Ratementioning

confidence: 99%

Shorter Sentence Length Maximizes Intelligibility and Speech Motor Performance in Persons With Dysarthria Due to Amyotrophic Lateral Sclerosis

Allison

Yunusova

Green

2019

Am J Speech Lang Pathol

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Purpose The purpose of this study was to investigate the effect of sentence length on intelligibility and measures of speech motor performance in persons with amyotrophic lateral sclerosis (ALS) and to determine how these effects were influenced by dysarthria severity levels. Method One hundred thirty-one persons with ALS were included in this study, stratified into 4 dysarthria severity groups. All participants produced sentences from 5 to 15 words in length. Intelligibility, speaking rate, and measures of speech pausing behavior (i.e., total speech duration, total pause duration, and mean speech event duration) were measured for each sentence. Linear mixed-effects models were used to determine the effect of sentence length on speech measures for speakers at different dysarthria severity levels. Results Results showed that speech intelligibility significantly declined at longer sentence lengths only for the speakers with ALS who had more advanced dysarthria symptoms; however, speakers with mild-to-severe dysarthria showed significant declines in speaking rate and speech pausing behavior at longer sentence lengths. Conclusions Findings suggest that producing shorter sentences may help maximize intelligibility for speakers with moderate-to-severe dysarthria secondary to ALS and may be a beneficial compensatory strategy for preserving motor effort for all speakers with dysarthria secondary to ALS.

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“…SR was averaged across the 11 sentences to derive each participant's overall SR in words per minute (WPM). Strong intra- and inter-rater reliability has previously been reported for SR with correlations of 0.93 and intraclass correlation coefficients (ICCs) of 0.53 ( 18 , 20 ).…”

Section: Methodsmentioning

confidence: 87%

Two Distinct Clinical Phenotypes of Bulbar Motor Impairment in Amyotrophic Lateral Sclerosis

et al. 2021

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Objective: Understanding clinical variants of motor neuron diseases such as amyotrophic lateral sclerosis (ALS) is critical for discovering disease mechanisms and across-patient differences in therapeutic response. The current work describes two clinical subgroups of patients with ALS that, despite similar levels of bulbar motor involvement, have disparate clinical and functional speech presentations.Methods: Participants included 47 healthy control speakers and 126 speakers with ALS. Participants with ALS were stratified into three clinical subgroups (i.e., bulbar asymptomatic, bulbar symptomatic high speech function, and bulbar symptomatic low speech function) based on clinical metrics of bulbar motor impairment. Acoustic and lip kinematic analytics were derived from each participant's recordings of reading samples and a rapid syllable repetition task. Group differences were reported on clinical scales of ALS and bulbar motor severity and on multiple speech measures.Results: The high and low speech-function subgroups were found to be similar on many of the dependent measures explored. However, these two groups were differentiated on the basis of an acoustic measure used as a proxy for tongue movement.Conclusion: This study supports the hypothesis that high and low speech-function subgroups do not differ solely in overall severity, but rather, constitute two distinct bulbar motor phenotypes. The findings suggest that the low speech-function group exhibited more global involvement of the bulbar muscles than the high speech-function group that had relatively intact lingual function. This work has implications for clinical measures used to grade bulbar motor involvement, suggesting that a single bulbar measure is inadequate for capturing differences among phenotypes.

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Minimally Detectable Change and Minimal Clinically Important Difference of a Decline in Sentence Intelligibility and Speaking Rate for Individuals With Amyotrophic Lateral Sclerosis

Cited by 60 publications

References 76 publications

Speech Treatment Effects on Narrative Intelligibility in French-Speaking Children With Dysarthria

Speech Treatment Effects on Narrative Intelligibility in French-Speaking Children With Dysarthria

Shorter Sentence Length Maximizes Intelligibility and Speech Motor Performance in Persons With Dysarthria Due to Amyotrophic Lateral Sclerosis

Two Distinct Clinical Phenotypes of Bulbar Motor Impairment in Amyotrophic Lateral Sclerosis

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