Simone dos Santos Barreto

Medidas de inteligibilidade nos distúrbios da fala: revisão crítica da literatura

Background: the reduction in speech intelligibility is considered one of the main characteristics of individuals with speech disorders, and is an important issue for clinical and research investigation. In spite of its relevance, the literature does not present a consensus on how to measure speech intelligibility. Besides the diversity of existent methods, another important issue refers to the influence of certain variables on these measurements and, consequently, on the interpretation of the results. Aim: to investigate evidence on the agreement between speech intelligibility measurements, obtained through different methods, used in the assessment of speech disorders, and to identify the effect of variables related to assessment procedures or to the listener. A critical review of articles indexed in the databases Medline, Web of Science, Lilacs and Scielo, until October 2007, was carried out. The key-word used to perform the search was speech intelligibility. Conclusion: there was no evidence of agreement between the speech intelligibility measurements obtained through different methods in the investigated literature. This fact limits the comparison between clinic and research results on speech intelligibility of individuals with speech disorders. Besides that, it was observed that some variables can interfere in these measurements, such as: type of task and speech stimulus, signal presentation mode, type of required answer and listeners experience with the speaker. These must be considered when interpreting the results of speech intelligibility tests.

Inteligibilidade: efeitos da análise de transcrição e do estímulo de fala

BACKGROUND: intelligibility measures are limited to providing information on the severity level of clinical cases. A key limitation is that such measures are sensitive to changes in performance only in subjects with a determined severity level of speech disturbance. AIM: to investigate the influence of stimuli type and transcription analysis on intelligibility measures of speakers with no communication disorders. METHOD: an experimental study with no intervention procedures was developed. Two groups of subjects with no communication disorders took part in the research. The group of speakers was composed by 30 adults. Speech samples were recorded by repeating three lists of stimuli (sentences, words and non-words) equally distributed according to parameters of frequency of phonemes, syllabic structures and word length. The group of listeners was composed by 60 young adults who orthographically transcribed the speech samples. Two transcription intelligibility measures were obtained for each list of stimuli: percentage of correct answers per syllable unit and per item (for each sentence, word and non-word). RESULTS: intelligibility scores were statistically higher for syllable units than for the other items. Regarding intelligibility scores per syllables, a statistical difference was observed amongst scores for sentences, words and non-words. CONCLUSION: both transcription analysis and stimulus type influenced the intelligibility scores of the studied population, especially when non-words were used as speech material. The handling of these variables can help to improve intelligibility tests.

Heart Rate Variability During Sleep in Patients with Vasovagal Syncope

Background: There are a few studies showing no significant heart rate variability (HRV) over a 24‐hour period in vasovagal syncope (VVS) patients, but no research has examined HRV and its sympathetic and parasympathetic components during rapid eye movement (REM) and non‐REM sleep. The authors hypothesized that REM sleep might be a critical state in which VVS patients would show abnormal responses.

Influência da velocidade articulatória e da intensidade na inteligibilidade de fala

BACKGROUND: contextual cues intrinsic to speech stimuli can have an influence on speech intelligibility measurements; however, the influence of cues that depend on the acoustic signal, such as speech rate and vocal loudness, need further investigation. AIM: to examine whether possible reductions in the articulatory rate and increase in vocal loudness, associated to the production of different speech stimuli, can have an influence on speech intelligibility measurements. METHOD: participants of this study were thirty normal speakers and sixty normal listeners. Speakers were recorded during the repetition of three lists of speech stimuli (sentences, words and pseudo words). The averages of the articulatory rate (syllables per second) and of the vocal loudness (decibel) were calculated for each speaker according to their performance in each repetition task. Speech intelligibility was measured based on the orthographic transcription of the speech samples; the score was calculated in terms of percentage of correctly transcribed words. RESULTS: it was observed that articulatory rates were statistically different between the three types of stimuli; however, the stimuli produced with the lowest articulatory rate (pseudo words followed by words) did not present higher speech intelligibility scores. Vocal loudness was statistically higher during the repetition of pseudo words; however, this increase did not have an influence on the speech intelligibility scores. CONCLUSION: the reduction of the articulatory rate or the increase of vocal loudness did not have an influence on the speech intelligibility measurements, indicating that contextual cues have a greater impact on speech intelligibility than the independent cues given by the acoustic signal.BACKGROUND contextual cues intrinsic to speech stimuli can have an influence on speech intelligibility measurements; however, the influence of cues that depend on the acoustic signal, such as speech rate and vocal loudness, need further investigation. AIM to examine whether possible reductions in the articulatory rate and increase in vocal loudness, associated to the production of different speech stimuli, can have an influence on speech intelligibility measurements. METHOD participants of this study were thirty normal speakers and sixty normal listeners. Speakers were recorded during the repetition of three lists of speech stimuli (sentences, words and pseudo words). The averages of the articulatory rate (syllables per second) and of the vocal loudness (decibel) were calculated for each speaker according to their performance in each repetition task. Speech intelligibility was measured based on the orthographic transcription of the speech samples; the score was calculated in terms of percentage of correctly transcribed words. RESULTS it was observed that articulatory rates were statistically different between the three types of stimuli; however, the stimuli produced with the lowest articulatory rate (pseudo words followed by words) did not present higher speech intelligibility scores. Vocal loudness was statistically higher during the repetition of pseudo words; however, this increase did not have an influence on the speech intelligibility scores. CONCLUSION the reduction of the articulatory rate or the increase of vocal loudness did not have an influence on the speech intelligibility measurements, indicating that contextual cues have a greater impact on speech intelligibility than the independent cues given by the acoustic signal.

Montreal–Toulouse Language Assessment Battery: Evidence of criterion validity from patients with aphasia

BACKGROUND The Montreal-Toulouse Language Assessment Battery - Brazilian version (MTL-BR) provides a general description of language processing and related components in adults with brain injury. OBJECTIVE The present study aimed at verifying the criterion-related validity of the Montreal-Toulouse Language Assessment Battery - Brazilian version (MTL-BR) by assessing its ability to discriminate between individuals with unilateral brain damage with and without aphasia. METHODS The investigation was carried out in a Brazilian community-based sample of 104 adults, divided into four groups: 26 participants with left hemisphere damage (LHD) with aphasia, 25 participants with right hemisphere damage (RHD), 28 with LHD non-aphasic, and 25 healthy adults. RESULTS There were significant differences between patients with aphasia and the other groups on most total and subtotal scores on MTL-BR tasks. CONCLUSIONS The results showed strong criterion-related validity evidence for the MTL-BR Battery, and provided important information regarding hemispheric specialization and interhemispheric cooperation. Future research is required to search for additional evidence of sensitivity, specificity and validity of the MTL-BR in samples with different types of aphasia and degrees of language impairment.

Ataxia espinocerebelar: análise perceptivo-auditiva e acústica da fala em três casos

BACKGROUND: dysarthrias are commonly found in patients with spinocerebellar ataxias (SCA). AIM: to characterize perceptual and acoustic features of speech in three patients with spinocerebellar ataxia and to verify the presence of similar features among these patients. METHOD: speech samples of two males with SCA3 and one male with SCA2 were obtained. Both perceptual and acoustic analyses were done. RESULTS: It was observed strain-strangled and breathiness phonation, vocal instability, increased noise-to-harmonics ratio and low alternate motion rate (AMR) and speech rate in all three patients. Deviated resonance and s/z ratio were also observed. CONCLUSION: phonatory disorders and altered temporal patterns of speech seem to be typical in dysarthric patients with spinocerebellar ataxia.

Carta ao editor

Purpose: To analyze the predictability of sentences used in the protocol for the assessment of intelligibility of dysarthric speech. Methods: A cross-sectional study was conducted in 120 volunteers divided randomly into four groups of 30 individuals. Based on the list of 25 sentences from the protocol, four versions of lists were elaborated. In each version, a different target word was omitted from the sentences. Each group of participants completed a different list version by graphically filling in the blanks with the first word that came to mind, while keeping the sentences coherent. Statistical analyses were carried out to classify sentences according to their predictability, to compare predictability of the words in each sentence, and to compare the different list versions. Results: Three sentences presented high predictability; seven, average predictability; and fifte en, low predictability. Differences in the predictability of target words were found in 84% of the sentences (p≤0.0054). The comparison of list versions revealed that version 1 differed from the others (p≤0.002), and was less predictable. Conclusion: Low predictability sentences predominated in the protocol for assessment of speech intelligibility used in this study, suggesting that these sentences can be used reliably for assessing intelligibility. Analysis of intelligibility in sentences based on target words can be used in clinical practice, especially when the predictability of the sentences is known.

Disartria na doença de Wilson: análise de dois casos em fases distintas

TEMA: disartria na Doenca de Wilson. PROCEDIMENTOS: estudo de caso de dois pacientes com o diagnostico da doenca, ambos adultos jovens, do sexo feminino e com seis anos de escolaridade. Quatro fonoaudiologas realizaram a avaliacao perceptivo-auditiva de modo independente, na qual foram investigados os seguintes parâmetros: tipo de voz, loudness, pitch, ataque vocal, instabilidade fonatoria e ressonância. O grau de alteracao de cada parâmetro foi mensurado atraves de uma escala analogico-visual. Alem disso, foram obtidas medidas de inteligibilidade por transcricao ortografica. A analise acustica foi realizada por meio do programa Praat, com a obtencao de medidas de frequencia fundamental, de perturbacao e ruido e medidas temporais. RESULTADOS: a fala de ambos os pacientes foi caracterizada por: reducao do tempo maximo de fonacao, voz soprosa e tensa, ataques vocais aspirados, instabilidade vocal, aumento de shimmer e proporcao ruido-harmonico, hipernasalidade, reducao da diadococinesia oral, da inteligibilidade e da velocidade da fala. Os resultados obtidos sugeriram que o paciente que cursa com a Doenca de Wilson ha mais tempo, apresentou prejuizo mais acentuado na maioria dos parâmetros perceptuais e acusticos analisados. CONCLUSAO: foram identificadas manifestacoes comuns entre os casos, as quais podem constituir-se em tracos caracteristicos da fala de pacientes disartricos com Doenca de Wilson. Todavia, diferencas tambem foram evidenciadas, as quais podem estar relacionadas ao tempo de evolucao da doenca.