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1.
Front Artif Intell ; 7: 1359094, 2024.
Article in English | MEDLINE | ID: mdl-38800762

ABSTRACT

Perceptual measures, such as intelligibility and speech disorder severity, are widely used in the clinical assessment of speech disorders in patients treated for oral or oropharyngeal cancer. Despite their widespread usage, these measures are known to be subjective and hard to reproduce. Therefore, an M-Health assessment based on an automatic prediction has been seen as a more robust and reliable alternative. Despite recent progress, these automatic approaches still remain somewhat theoretical, and a need to implement them in real clinical practice rises. Hence, in the present work we introduce SAMI, a clinical mobile application used to predict speech intelligibility and disorder severity as well as to monitor patient progress on these measures over time. The first part of this work illustrates the design and development of the systems supported by SAMI. Here, we show how deep neural speaker embeddings are used to automatically regress speech disorder measurements (intelligibility and severity), as well as the training and validation of the system on a French corpus of head and neck cancer. Furthermore, we also test our model on a secondary corpus recorded in real clinical conditions. The second part details the results obtained from the deployment of our system in a real clinical environment, over the course of several weeks. In this section, the results obtained with SAMI are compared to an a posteriori perceptual evaluation, conducted by a set of experts on the new recorded data. The comparison suggests a high correlation and a low error between the perceptual and automatic evaluations, validating the clinical usage of the proposed application.

2.
Article in English | MEDLINE | ID: mdl-38237606

ABSTRACT

BACKGROUND: Perceptual measures such as speech intelligibility are known to be biased, variant and subjective, to which an automatic approach has been seen as a more reliable alternative. On the other hand, automatic approaches tend to lack explainability, an aspect that can prevent the widespread usage of these technologies clinically. AIMS: In the present work, we aim to study the relationship between four perceptual parameters and speech intelligibility by automatically modelling the behaviour of six perceptual judges, in the context of head and neck cancer. From this evaluation we want to assess the different levels of relevance of each parameter as well as the different judge profiles that arise, both perceptually and automatically. METHODS AND PROCEDURES: Based on a passage reading task from the Carcinologic Speech Severity Index (C2SI) corpus, six expert listeners assessed the voice quality, resonance, prosody and phonemic distortions, as well as the speech intelligibility of patients treated for oral or oropharyngeal cancer. A statistical analysis and an ensemble of automatic systems, one per judge, were devised, where speech intelligibility is predicted as a function of the four aforementioned perceptual parameters of voice quality, resonance, prosody and phonemic distortions. OUTCOMES AND RESULTS: The results suggest that we can automatically predict speech intelligibility as a function of the four aforementioned perceptual parameters, achieving a high correlation of 0.775 (Spearman's ρ). Furthermore, different judge profiles were found perceptually that were successfully modelled automatically. CONCLUSIONS AND IMPLICATIONS: The four investigated perceptual parameters influence the global rating of speech intelligibility, showing that different judge profiles emerge. The proposed automatic approach displayed a more uniform profile across all judges, displaying a more reliable, unbiased and objective prediction. The system also adds an extra layer of interpretability, since speech intelligibility is regressed as a direct function of the individual prediction of the four perceptual parameters, an improvement over more black box approaches. WHAT THIS PAPER ADDS: What is already known on this subject Speech intelligibility is a clinical measure typically used in the post-treatment assessment of speech affecting disorders, such as head and neck cancer. Their perceptual assessment is currently the main method of evaluation; however, it is known to be quite subjective since intelligibility can be seen as a combination of other perceptual parameters (voice quality, resonance, etc.). Given this, automatic approaches have been seen as a more viable alternative to the traditionally used perceptual assessments. What this study adds to existing knowledge The present work introduces a study based on the relationship between four perceptual parameters (voice quality, resonance, prosody and phonemic distortions) and speech intelligibility, by automatically modelling the behaviour of six perceptual judges. The results suggest that different judge profiles arise, both in the perceptual case as well as in the automatic models. These different profiles found showcase the different schools of thought that perceptual judges have, in comparison to the automatic judges, that display more uniform levels of relevance across all the four perceptual parameters. This aspect shows that an automatic approach promotes unbiased, reliable and more objective predictions. What are the clinical implications of this work? The automatic prediction of speech intelligibility, using a combination of four perceptual parameters, show that these approaches can achieve high correlations with the reference scores while maintaining a certain degree of explainability. The more uniform judge profiles found on the automatic case also display less biased results towards the four perceptual parameters. This aspect facilitates the clinical implementation of this class of systems, as opposed to the more subjective and harder to reproduce perceptual assessments.

3.
Clin Linguist Phon ; 37(8): 722-741, 2023 08 03.
Article in English | MEDLINE | ID: mdl-35694961

ABSTRACT

Standard reading passages allow for the study of the integrated functions of speech and voice components in contextual, running speech, with target stimuli in a controlled environment. In both clinical practice and research, these texts provide rapid insight into the characteristics of the patient's speech, with fewer hesitations than in conversational speech and better predictability by the evaluator. Although a plethora of texts exist in different languages, they present various limitations. A specifically created standardised text in each language allowing for an ecological assessment of speech and voice functions, meeting most required criteria for standard speech and voice assessment and adapted to the target language's cultural and linguistic specificities, would therefore be an interesting option. However, no guidelines exist for the creation of such a reading passage. This article describes the international Delphi consensus study carried out to identify a minimal set of criteria to take into account when creating standard reading passages for an overall speech and voice assessment in adolescents and adults. This survey was conducted in three consecutive rounds; forty experts participated in the first round, with a total dropout of 17% from round 1 to round 3. It results in a minimal set of ten criteria which were selected by a majority of the experts and were rated as most important. This set contains five phoneme-level, two word-level, two sentence-level criteria and one global-level criterion. It can be used as a general guideline for the creation of standard reading passages in Indo-European Romance and Germanic languages such as English, French and German. The construction of a new reading passage in French following this guideline is briefly described.


Subject(s)
Speech , Voice , Adult , Adolescent , Humans , Reading , Delphi Technique , Language
4.
Folia Phoniatr Logop ; 75(1): 52-66, 2023.
Article in English | MEDLINE | ID: mdl-35665696

ABSTRACT

PURPOSE: The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity. METHODS: The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts. Structural validity was analyzed using inter-item correlations. The scores of a group of patients treated for UADT cancer were compared with those of a group of healthy subjects (clinical validity). For criterion validity, the ECSC scores were compared to those from various questionnaires that assess social functioning (QFS), psychological status (HAD), perceived speech impairment (PHI), and QOL (EORTC QLQ-H&N35) in patients. RESULTS: Structural validity shows low to moderate inter-item correlations which is consistent with the construction of the questionnaire not assessing underlying concepts. Clinical validity was satisfactory regarding the frequency of contact (p = 0.01), satisfaction with the frequency of contact in the private circle (p = 0.03), and the size of the social circles of family and friends (p ≤ 0.01). Criterion validity was adequate with moderate correlations between the ECSC scores and the QFS sub-scores of interest (rs > 0.56, p < 0.05). Anxiety (HAD) had a low correlation (|rs| = 0.46, p < 0.05) with satisfaction with exchanges and the frequency of contact with family. Satisfaction with exchanges with the private circle was moderately correlated with the EORTC QLQ-H&N35 score (rs = 0.56, p = 0.01) and showed a negative trend on the PHI (rs < -0.39, p ≥ 0.05). CONCLUSION: While the test-retest reliability is yet to be evaluated and the sample size should be increased, this preliminary study shows that the ECSC is a valid tool for assessing the constitution of social circles in patients treated for UADT cancer. It highlights the links between social circles and their functional impact on communication and QOL.


Subject(s)
Neoplasms , Quality of Life , Humans , Reproducibility of Results , Social Adjustment , Surveys and Questionnaires , Speech Disorders , Psychometrics
5.
Int J Lang Commun Disord ; 58(1): 39-51, 2023 01.
Article in English | MEDLINE | ID: mdl-36043497

ABSTRACT

BACKGROUND: In head and neck cancer, many tools exist to measure speech impairment, but few evaluate the impact on communication abilities. Some self-administered questionnaires are available to assess general activity limitations including communication. Others are not validated in oncology. These different tools result in scores that does not provide an accurate measure of the communication limitations perceived by the patients. AIM: To develop a holistic score measuring the functional impact of speech disorders on communication in patients treated for oral or oropharyngeal cancer, in two steps: its construction and its validation. METHODS & PROCEDURES: Patients treated for oral/oropharyngeal cancer filled six self-questionnaires: two about communicative dynamics (ECVB and DIP), two assessing speech function (PHI and CHI) and two relating to quality of life (EORTC QLQ-C30 and EORTC QLQ-H&N35). A total of 174 items were initially collected. A dimensionality reduction methodology was then applied. Face validity analysis led to eliminate non-relevant items by surveying a panel of nine experts from communication-related disciplines (linguistics, medicine, speech pathology, computer science). Construct validity analysis led to eliminate redundant and insufficiently variable items. Finally, the holistic communication score was elaborated by principal component factor and validated using cross-validation and latent profile analysis. OUTCOMES & RESULTS: A total of 25 patients filled the questionnaires (median age = 67 years, EIQ = 12; 15 men, 10 women; oral cavity = 14, oropharynx = 10, two locations = 1). After face validity analysis, 44 items were retained (κ > 0.80). Four additional items were excluded because of a very high correlation (r > 0.90) with other items presenting a better dispersion. A total of 40 items were finally included in the factor analysis. A post-analysis score prediction was performed (mean = 100; SD = 10). A total of 24 items are finally retained for the construction of the holistic communication score (HoCoS): 19 items from questionnaires assessing communicative dynamics (13 from the ECVB and six from the DIP), four items from a perceived speech impairment questionnaire (PHI) and one from a quality-of-life questionnaire (EORTC QLQ-H&N35). The reliability is good (five-fold cross-validation: rs = 0.91) and the complementary latent profile analysis shows a good validity of the HoCoS, clustering subjects by level of communication performance. CONCLUSIONS & IMPLICATIONS: A global score allowing a measure of the impact of the speech disorder on communication was developed. It fills the lack of this type of score in head and neck oncology and allows the better understanding of the functional and psychosocial consequences of the pathology in the patients' follow-up. WHAT THIS PAPER ADDS: What is already known on the subject Because of their anatomical location, head and neck cancer degrades the speech abilities. Few tools currently allow the assessment of the impact of the speech disorder on communication abilities. In ENT oncology, self-administered questionnaires are available to assess activity limitations and participation restrictions (International Classification of Functioning (ICF)-WHO). Other tools from the field of neurology allow an evaluation of communication dynamics. But these different tools, constructed by items, give global additive or averaged scores. This implies an identical weighting of each item, resulting in global scores that are not very representative of the communication limitations really perceived by the patients. What this paper adds to existing knowledge A new global holistic score allowing a measurement of the impact of speech impairment on communication after treatment of oral or oropharyngeal cancer has been developed. The methodology of its construction allows a better reflection of the symptomatological, pragmatic and psychosocial elements leading to a degradation of communication abilities. What are the potential or actual clinical implications of this work? The developed HoCoS score fills the gap in the absence of this type of tool in head and neck oncology. It may allow a better understanding of the factors involved in the functional and psychosocial limitations of these patients, and better customize their follow-up.


Subject(s)
Head and Neck Neoplasms , Oropharyngeal Neoplasms , Male , Humans , Female , Aged , Quality of Life , Reproducibility of Results , Oropharyngeal Neoplasms/therapy , Speech Disorders/diagnosis , Speech Disorders/etiology , Speech , Surveys and Questionnaires
6.
Front Neurosci ; 16: 779062, 2022.
Article in English | MEDLINE | ID: mdl-35368250

ABSTRACT

Automatic speech recognition (ASR), when combined with hearing-aid (HA) and hearing-loss (HL) simulations, can predict aided speech-identification performances of persons with age-related hearing loss. ASR can thus be used to evaluate different HA configurations, such as combinations of insertion-gain functions and compression thresholds, in order to optimize HA fitting for a given person. The present study investigated whether, after fixing compression thresholds and insertion gains, a random-search algorithm could be used to optimize time constants (i.e., attack and release times) for 12 audiometric profiles. The insertion gains were either those recommended by the CAM2 prescription rule or those optimized using ASR, while compression thresholds were always optimized using ASR. For each audiometric profile, the random-search algorithm was used to vary time constants with the aim to maximize ASR performance. A HA simulator and a HL simulator simulator were used, respectively, to amplify and to degrade speech stimuli according to the input audiogram. The resulting speech signals were fed to an ASR system for recognition. For each audiogram, 1,000 iterations of the random-search algorithm were used to find the time-constant configuration yielding the highest ASR score. To assess the reproducibility of the results, the random search algorithm was run twice. Optimizing the time constants significantly improved the ASR scores when CAM2 insertion gains were used, but not when using ASR-based gains. Repeating the random search yielded similar ASR scores, but different time-constant configurations.

7.
Front Neurosci ; 16: 779048, 2022.
Article in English | MEDLINE | ID: mdl-35264922

ABSTRACT

Hearing-aid (HA) prescription rules (such as NAL-NL2, DSL-v5, and CAM2) are used by HA audiologists to define initial HA settings (e.g., insertion gains, IGs) for patients. This initial fitting is later individually adjusted for each patient to improve clinical outcomes in terms of speech intelligibility and listening comfort. During this fine-tuning stage, speech-intelligibility tests are often carried out with the patient to assess the benefits associated with different HA settings. As these tests tend to be time-consuming and performance on them depends on the patient's level of fatigue and familiarity with the test material, only a limited number of HA settings can be explored. Consequently, it is likely that a suboptimal fitting is used for the patient. Recent studies have shown that automatic speech recognition (ASR) can be used to predict the effects of IGs on speech intelligibility for patients with age-related hearing loss (ARHL). The aim of the present study was to extend this approach by optimizing, in addition to IGs, compression thresholds (CTs). However, increasing the number of parameters to be fitted increases exponentially the number of configurations to be assessed. To limit the number of HA settings to be tested, three random-search (RS) genetic algorithms were used. The resulting new HA fitting method, combining ASR and RS, is referred to as "objective prescription rule based on ASR and random search" (OPRA-RS). Optimal HA settings were computed for 12 audiograms, representing average and individual audiometric profiles typical for various levels of ARHL severity, and associated ASR performances were compared to those obtained with the settings recommended by CAM2. Each RS algorithm was run twice to assess its reliability. For all RS algorithms, ASR scores obtained with OPRA-RS were significantly higher than those associated with CAM2. Each RS algorithm converged on similar optimal HA settings across repetitions. However, significant differences were observed between RS algorithms in terms of maximum ASR performance and processing costs. These promising results open the way to the use of ASR and RS algorithms for the fine-tuning of HAs with potential speech-intelligibility benefits for the patient.

8.
Logoped Phoniatr Vocol ; 47(2): 92-108, 2022 Jul.
Article in English | MEDLINE | ID: mdl-33423572

ABSTRACT

INTRODUCTION: Speech assessment methods used in clinical practice are varied and mainly perceptual and motor. Reliable assessment of speech disorders is essential for the tailoring of the patient's treatment plan. OBJECTIVE: To describe current clinical practices and identify the shortcomings and needs reported by French-speaking clinicians regarding the assessment of speech disorders in adult patients. METHODS: Data were collected using an online questionnaire for French-speaking speech and language pathologists (SLPs) in Belgium, France, Switzerland, Luxembourg, and Maghreb. Forty-nine questions were grouped into six domains: participant data, educational and occupational background, experience with speech disorders, patient population, tools and tasks for speech assessment, and possible lacks regarding the current assessment of speech disorders. RESULTS: Responses from 119 clinicians were included in the analyses. SLPs generally use "à la carte" assessment with a large variety of tasks and speech samples. About one quarter of them do not use existing assessment batteries. Those who do mostly use them partially. Pseudo-words are rarely used and are absent from standardized batteries, in contrast to the major use of words and sentences. Perceptual evaluation largely prevails (mainly overall ratings of speech "intelligibility", "severity," and "comprehensibility" and percent-correct phonemes), whereas the recording equipment for acoustic measures is not standardized and only scarcely described by the SLPs. The most commonly used questionnaire to assess the functional impact of the speech disorder is the Voice Handicap Index; one quarter of the SLPs does not use any questionnaire. Overall, the available tools are considered only moderately satisfactory. The main reported shortcomings are a lack of objectivity and reproducibility of speech measures; exhaustiveness and consideration of specific speech parameters (prosody, speech rate, and nasality); practicality of the assessment tools. CONCLUSION: This study highlights a lack of standardization of the speech assessment in French-speaking adults and the need to offer new reliable tools for an optimized, accurate speech assessment. The automation of these tools would allow for rapid, reproducible, and accurate measures.


Subject(s)
Communication Disorders , Speech-Language Pathology , Adult , Humans , Reproducibility of Results , Speech , Speech Disorders/diagnosis , Speech Intelligibility , Speech-Language Pathology/methods , Voice Quality
9.
Int J Lang Commun Disord ; 57(1): 21-41, 2022 01.
Article in English | MEDLINE | ID: mdl-34558145

ABSTRACT

BACKGROUND: Intelligibility and comprehensibility in speech disorders can be assessed both perceptually and instrumentally, but a lack of consensus exists regarding the terminology and related speech measures in both the clinical and scientific fields. AIMS: To draw up a more consensual definition of intelligibility and comprehensibility and to define which assessment methods relate to both concepts, as part of their definition. METHODS & PROCEDURES: A three-round modified Delphi consensus study was carried out among clinicians, researchers and lecturers engaged in activities in speech disorders. OUTCOMES & RESULTS: Forty international experts from different fields (mainly clinicians, linguists and computer scientists) participated in the elaboration of a comprehensive definition of intelligibility and comprehensibility and their assessment. While both concepts are linked and contribute to functional human communication, they relate to two different reconstruction levels of the transmitted speech material. Intelligibility refers to the acoustic-phonetic decoding of the utterance, while comprehensibility relates to the reconstruction of the meaning of the message. Consequently, the perceptual assessment of intelligibility requires the use of unpredictable speech material (pseudo-words, minimal word pairs, unpredictable sentences), whereas comprehensibility assessment is meaning and context related and entails more functional speech stimuli and tasks. CONCLUSION & IMPLICATIONS: This consensus study provides the scientific and clinical communities with a better understanding of intelligibility and comprehensibility. A comprehensive definition was drafted, including specifications regarding the tasks that best fit their assessment. The outcome has implications for both clinical practice and scientific research, as the disambiguation improves communication between professionals and thereby increases the efficiency of patient assessment and care and benefits the progress of research as well as research translation. WHAT THIS PAPER ADDS: What is already known on the subject Intelligibility and comprehensibility in speech disorders can be assessed both perceptually and instrumentally, but a lack of consensus exists regarding the terminology and related speech measures in both the clinical and scientific fields. What this paper adds to existing knowledge This consensus study allowed for a more consensual and comprehensive definition of intelligibility and comprehensibility and their assessment, for clinicians and researchers. The terminological disambiguation helps to improve communication between experts in the field of speech disorders and thereby benefits the progress of research as well as research translation. What are the potential or actual clinical implications of this work? Unambiguous communication between professionals, for example, in a multidisciplinary team, allows for the improvement in the efficiency of patient care. Furthermore, this study allowed the assessment tasks that best fit the definition of both intelligibility and comprehensibility to be specified, thereby providing valuable information to improve speech disorder assessment and its standardization.


Subject(s)
Phonetics , Speech Intelligibility , Delphi Technique , Humans , Speech Disorders , Speech Production Measurement
10.
Head Neck ; 44(1): 71-88, 2022 01.
Article in English | MEDLINE | ID: mdl-34729847

ABSTRACT

BACKGROUND: Speech disorders impact quality of life for patients treated with oral cavity and oropharynx cancers. However, there is a lack of uniform and applicable methods for measuring the impact on speech production after treatment in this tumor location. OBJECTIVE: The objective of this work is to (1) model an automatic severity index of speech applicable in clinical practice, that is equivalent or superior to a severity score obtained by human listeners, via several acoustics parameters extracted (a) directly from speech signal and (b) resulting from speech processing and (2) derive an automatic speech intelligibility classification (i.e., mild, moderate, severe) to predict speech disability and handicap by combining the listener comprehension score with self-reported quality of life related to speech. METHODS: Eighty-seven patients treated for cancer of the oral cavity or the oropharynx and 35 controls performed different tasks of speech production and completed questionnaires on speech-related quality of life. The audio recordings were then evaluated by human perception and automatic speech processing. Then, a score was developed through a classic logistic regression model allowing description of the severity of patients' speech disorders. RESULTS: Among the group of parameters subject to extraction from automatic processing of the speech signal, six were retained, producing a correlation at 0.87 with the perceptual reference score, 0.77 with the comprehension score, and 0.5 with speech-related quality of life. The parameters that contributed the most are based on automatic speech recognition systems. These are mainly the automatic average normalized likelihood score on a text reading task and the score of cumulative rankings on pseudowords. The reduced automatic YC2SI is modeled in this way: YC2SIp  = 11.48726 + (1.52926 × Xaveraged normalized likelihood reading ) + (-1.94e-06 × Xscore of cumulative ranks pseudowords ). CONCLUSION: Automatic processing of speech makes it possible to arrive at valid, reliable, and reproducible parameters able to serve as references in the framework of follow-up of patients treated for cancer of the oral cavity or the oropharynx.


Subject(s)
Oropharyngeal Neoplasms , Quality of Life , Humans , Mouth , Oropharyngeal Neoplasms/therapy , Speech Disorders/diagnosis , Speech Disorders/etiology , Speech Intelligibility
11.
Eur Arch Otorhinolaryngol ; 278(4): 1159-1169, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32666294

ABSTRACT

PURPOSE: To validate the upgraded version of the CHI with two new dimensions ("limitation of neck and/or shoulder movements", "changes in physical appearance"). To assess the relationship between CHI scores and patient self-reported management needs. METHODS: 71 patients treated for cancer with ENT complaints and 36 controls were included. Construct validity, internal consistency, criterion validity (using visual analogue scales by dimension), clinical validity (comparison of patient and control scores) and temporal reliability (scores of a second CHI completed after a few days) were studied. A hierarchical ranking of the dimensions according to perceived difficulties was compared to the CHI scores. RESULTS: Correlations were moderate to high between items of the same dimension (0.38 < r<0.73), between scores on the two new dimensions and on the VAS (r > 0.68), and between scores on the two CHI completions (r > 0.67). Cronbach's alphas are greater than 0.72. Patients and controls had significantly different scores in the two new dimensions (Mann-Whitney: p < 0.001). Sensitivity, specificity and AUC calculated between CHI scores and hierarchy ranking determined patient priority cut-off scores for eight of the eleven dimensions. CONCLUSION: The new CHI dimensions have good psychometric qualities. Threshold scores by dimension allow the perceived management needs to be determined.


Subject(s)
Quality of Life , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
12.
Head Neck ; 42(1): 111-130, 2020 01.
Article in English | MEDLINE | ID: mdl-31571334

ABSTRACT

BACKGROUND: The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim of this study is to provide a systematic review of literature describing the effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis. METHODS: Two databases (PubMed and Embase) were surveyed. The selection process, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, led to a final set of 22 articles. RESULTS: Nasalance is studied mainly in oropharyngeal patients. The vowels are mostly studied using formant analysis and vowel space area, the consonants by means of spectral moments with specific parameters according to their phonetic characteristic. Machine learning methods allow classifying "intelligible" or "unintelligible" speech for T3 or T4 tumors. CONCLUSIONS: The development of comprehensive models combining different acoustic measures would allow a better consideration of the functional impact of the speech disorder.


Subject(s)
Oropharyngeal Neoplasms , Speech Intelligibility , Acoustics , Humans , Speech Acoustics , Speech Production Measurement
13.
Folia Phoniatr Logop ; 72(6): 464-477, 2020.
Article in English | MEDLINE | ID: mdl-31734664

ABSTRACT

CONTEXT: Nowadays, clinical tools are available to evaluate the functional impact of speech disorders in neurological conditions, but few are validated in oncology. Because of their location, cancers of the upper aerodigestive tract directly impact patients' communication skills. Two questionnaires exist in French, the Speech Handicap Index (SHI) and the Phonation Handicap Index (PHI), but none are specifically validated for the head and neck cancer population. Our aim is to evaluate the validity of these 2 questionnaires in a population of patients treated for oral cavity or oropharyngeal cancer. MATERIAL AND METHOD: Eighty-seven patients treated for cancer of the oral cavity or oropharynx, and 21 controls filled in the questionnaires during a consultation or 1-day hospitalization. Validation was studied by the analysis of convergent and discriminant validity, clinical validity, criterion validity, and internal consistency. RESULTS: The 2 questionnaires present a coherent structure in 2 distinct dimensions for the SHI, and in 3 dimensions for the PHI. Both tools discriminate patients and healthy subjects (p value <0.001, Mann-Whitney test). The comparison of the SHI and PHI scores with the "social role functioning" dimension of the Medical Outcome Study Short Form 36 chosen as a reference shows similar performances for the 2 questionnaires (ρ > 0.42). Lastly, the internal consistency is good (Cronbach's α > 0.71). CONCLUSION: In patients treated for oral cavity or oropharyngeal cancer, the SHI and PHI are 2 valid and reliable tools for the self-assessment of speech disability. A limitation can be found about criterion validity, because a true gold standard does not exist at the moment. However, the reduced number of questions of the PHI, which implies a shorter completion, leads to prefer this tool over the SHI.


Subject(s)
Disability Evaluation , Mouth Neoplasms , Oropharyngeal Neoplasms , Speech Disorders , Humans , Language , Mouth Neoplasms/complications , Mouth Neoplasms/therapy , Oropharyngeal Neoplasms/complications , Oropharyngeal Neoplasms/therapy , Oropharynx/physiopathology , Phonation , Quality of Life , Reproducibility of Results , Speech Disorders/etiology , Surveys and Questionnaires
14.
J Acoust Soc Am ; 142(2): 878, 2017 08.
Article in English | MEDLINE | ID: mdl-28863587

ABSTRACT

Sounds involving liquid sources are part of everyday life. They form a category of sounds easily identified by human listeners in different experimental studies. Unlike acoustic models that focus on bubble vibrations, real life instances of liquid sounds, such as sounds produced by liquids with or without other materials, are very diverse and include water drop sounds, noisy flows, and even solid vibrations. The process that allows listeners to group these different sounds in the same category remains unclear. This article presents a perceptual experiment based on a sorting task of liquid sounds from a household environment. It seeks to reveal the cognitive subcategories of this set of sounds. The clarification of this perceptive process led to the observation of similarities between the perception of liquid sounds and other categories of environmental sounds. Furthermore, the results provide a taxonomy of liquid sounds on which an acoustic analysis was performed that highlights the acoustical properties of the categories, including different rates of air bubble vibration.

15.
J Speech Lang Hear Res ; 60(9): 2394-2405, 2017 09 18.
Article in English | MEDLINE | ID: mdl-28793162

ABSTRACT

Purpose: The purpose of this article is to assess speech processing for listeners with simulated age-related hearing loss (ARHL) and to investigate whether the observed performance can be replicated using an automatic speech recognition (ASR) system. The long-term goal of this research is to develop a system that will assist audiologists/hearing-aid dispensers in the fine-tuning of hearing aids. Method: Sixty young participants with normal hearing listened to speech materials mimicking the perceptual consequences of ARHL at different levels of severity. Two intelligibility tests (repetition of words and sentences) and 1 comprehension test (responding to oral commands by moving virtual objects) were administered. Several language models were developed and used by the ASR system in order to fit human performances. Results: Strong significant positive correlations were observed between human and ASR scores, with coefficients up to .99. However, the spectral smearing used to simulate losses in frequency selectivity caused larger declines in ASR performance than in human performance. Conclusion: Both intelligibility and comprehension scores for listeners with simulated ARHL are highly correlated with the performances of an ASR-based system. In the future, it needs to be determined if the ASR system is similarly successful in predicting speech processing in noise and by older people with ARHL.


Subject(s)
Comprehension , Computer Simulation , Hearing Loss , Pattern Recognition, Automated , Speech Intelligibility , Speech Recognition Software , Adolescent , Adult , Aging , Child , Female , Hearing Aids , Hearing Loss/rehabilitation , Humans , Male , Middle Aged , Pattern Recognition, Automated/methods , Regression Analysis , Young Adult
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