Association between objective measurement of the speech intelligibility of young people with dysarthria and listener ratings of ease of understanding.

PURPOSE: This study aimed to investigate the association between listeners' ratings of how much effort it took to understand the speech of young people with cerebral palsy and the percentage of words listeners actually understood. METHOD: Thirty-one young people with dysarthria and cerebral palsy (16 males, 15 females; mean age = 11 years, SD = 3) were audio recorded repeating single words and producing speech. Objective measures of intelligibility were calculated for multiple familiar and unfamiliar listeners using a forced choice paradigm for single words and verbatim orthographic transcriptions for connected speech. Listeners rated how much effort it took to understand speech in each condition using a 5-point ordinal ease of listening (EOL) scale. RESULTS: Agreement on EOL within rater groups was high (ICC > 0.71). An effect of listener was observed for familiar listeners, but not for unfamiliar listeners. EOL agreement between familiar and unfamiliar listeners was weak-moderate (ICC = 0.46). EOL predicted the percentage of speech actually understood by familiar and unfamiliar listeners (r > 0.56, p < 0.001 for all predictions). Strongest associations between EOL and intelligibility were observed for speakers with mild and profound impairments. CONCLUSIONS: The findings of this study demonstrate that listeners can judge how well they have understood dysarthric speech. EOL is associated with listener familiarity, speech task and speech impairment severity. EOL is appropriate for use in clinical practice as a measure of communication activity.

Letters from ainsworth: contesting the 'organization' of attachment.

As Main (1999) noted in her obituary for Mary Ainsworth, 'she was interacting weekly by letter and manuscript with her mentor and friend, John Bowlby, and their academic correspondence formed an important part of her, and implicitly our, life.' These letters of Ainsworth to John Bowlby during the 1980s, available in the Wellcome Trust Library in London, contain valuable reflections on the work of her pupils to extend her system of classifying infant behaviour in the Strange Situation Procedure. Mary Main proposed a D classification and interpreted such behaviour as a breakdown in an ABC strategy caused by a conflict between a disposition to approach and flee from the caregiver. Patricia Crittenden extended the subtypes of A and C, using a developmental model of information processing, and observed that they could be used together in A/C combinations. These letters offer insight into Ainsworth's intellectual rationale for encouraging both Main and Crittenden in their conflicting endeavours.

Comme l'a noté Main (1999) dans son article nécrologique sur Mary Ainsworth: « Elle communiquait chaque semaine par lettre et manuscrit avec son mentor et ami, John Bowlby, et leur correspondance scientifique a constitué une part importante de sa vie, et implicitement, de la nôtre. ¼ Ces lettres d'Ainsworth à John Bowlby durant les années 1980, qu'on peut consulter à la Wellcome Trust Library de Londres, renferment des réflexions valables sur le travail de ses élèves visant à étendre son système de classification du comportement des bébés à la procédure de la situation étrange. Mary Main a proposé une catégorie D et interprété ce comportement comme étant une rupture de la stratégie ABC causée par un conflit entre la propension à s'approcher de la personne soignante et à l'éviter. Patricia Crittenden a étoffé les sous-types A et C, à l'aide d'un modèle développemental de traitement de l'information, et observé qu'ils pouvaient être utilisés ensemble dans des combinaisons A/C. Ces lettres offrent des aperçus du raisonnement intellectuel d'Ainsworth qui la poussait à encourager Main et Crittenden dans leurs entreprises conflictuelles.