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Purpose: The purpose of this study was to report the variability of electrolarynx (EL) users’ speech intelligibility in quiet and in multitalker babble. Method: Ten EL users (five Servox® Digital, five TruTone™) who were at least 2 years postlaryngectomy provided recordings of five sentences from the 1965 Revised List of Phonetically Balanced Sentences. Recordings were judged by two groups of naïve listeners in quiet and in the presence of multitalker babble. Fifteen listeners orthographically transcribed a total of 750 sentences containing 3,750 key words in quiet, and another 15 listeners orthographically transcribed the same sentences mixed with multitalker babble. Results: Significant differences in speech intelligibility were observed between listening conditions; 17.9% more key words were correctly identified in quiet compared to multitalker babble. Significant differences in fundamental frequency (F0) standard deviation and range but not speech intelligibility were observed between EL device types. A positive correlation of moderate significance was observed between F0 standard deviation and intelligibility for TruTone users in multitalker babble. Conclusions: Findings suggest that listeners are able to identify a significantly higher percentage of EL users’ speech in quiet compared to multitalker babble, but a large variability in EL users’ speech intelligibility exists. Continued investigation involving a larger number of EL users is necessary to confirm this study’s findings. Future research should explore the relationships among F0 measures, speaker characteristics (e.g., rate of speech, articulatory precision), and speech intelligibility, in addition to improving alaryngeal rehabilitation training protocols for EL users. [ABSTRACT FROM AUTHOR]

Purpose: Sense of effort and fatigue associated with talking was compared in individuals with and without a total laryngectomy. Method: An online survey of individuals using tracheoesophageal speech (TES; n = 222), electrolaryngeal speech (ELS; n = 132), esophageal speech (n = 41), and laryngeal speech (LS; n = 112) asked about 3 domains of effort when talking: frequency of occurrence, withdrawal from talking, and location in the body. Three aspects of fatigue were explored: frequency of occurrence, fatigue type, and duration of talking before fatigue. Results: Alaryngeal groups reported significantly more talking-related effort and fatigue than the LS group. Sixty-three percent of all respondents indicated that effort caused them to talk less, with no group differences on this item. Significantly more effort was localized to the lips and tongue by ELS compared with TES and LS groups. Both the ELS and TES groups had higher shoulder/arm effort when talking compared with the esophageal speech and LS groups. ELS respondents reported less fatigue than the TES group. When fatigue was present, the TES group had more physical and less mental fatigue than the ELS group. The duration of talking before experiencing fatigue was significantly shorter for the alaryngeal groups compared with the LS group. Conclusions: Effort and fatigue associated with talking are a common report for individuals using alaryngeal speech. The location of effort within the body and the type of fatigue experienced vary to some extent across alaryngeal speaking methods. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the acoustic properties of 6 Taiwan Southern Min vowels produced by 10 laryngeal speakers (LA), 10 speakers with a pneumatic artificial larynx (PA), and 8 esophageal speakers (ES). Method: Each of the 6 monophthongs of Taiwan Southern Min (/i, e, a, ɔ, u, ə/) was represented by a Taiwan Southern Min character and appeared randomly on a list 3 times (6 Taiwan Southern Min characters × 3 repetitions = 18 tokens). Each Taiwan Southern Min character in this study has the same syllable structure, /V/, and all were read with tone 1 (high and level). Acoustic measurements of the 1st formant, 2nd formant, and 3rd formant were taken for each vowel. Then, vowel space areas (VSAs) enclosed by /i, a, u/ were calculated for each group of speakers. The Euclidean distance between vowels in the pairs /i, a /, /i, u/, and /a, u / was also calculated and compared across the groups. Results: PA and ES have higher 1st or 2nd formant values than LA for each vowel. The distance is significantly shorter between vowels in the corner vowel pairs /i, a/ and /i, u/. PA and ES have a significantly smaller VSA compared with LA. Conclusions: In accordance with previous studies, alaryngeal speakers have higher formant frequency values than LA because they have a shortened vocal tract as a result of their total laryngectomy. Furthermore, the resonance frequencies are inversely related to the length of the vocal tract (on the basis of the assumption of the source filter theory). PA and ES have a smaller VSA and shorter distances between corner vowels compared with LA, which may be related to speech intelligibility. This hypothesis needs further support from future study. [ABSTRACT FROM AUTHOR]

Purpose: The construct validity of the Voice-Related Quality of Life (V-RQOL; Hogikyan & Sethuraman, 1999) measure was evaluated in a sample of 109 individuals who have undergone total laryngectomy. Method: A principal components factor analysis was performed on participant responses to the 10-question V-RQOL measure. Results: Factor analysis of the V-RQOL in our alaryngeal sample confirmed the presence of two factors (physical and social-emotional), which is consistent with the identified domains in the current V-RQOL. However, the current data indicate that some of the questions proposed by the original authors of the V-RQOL (Questions 7 and 9) do not align with their proposed domains in this postlaryngectomy sample. Conclusion: The results indicate that some V-RQOL questions do not align with their proposed domains. Consequently, an alternative scoring algorithm may be warranted for alaryngeal populations, and the authors make suggestions for this change that are simple and efficient. Based on the findings of the present factor analysis, use of this modified scoring procedure may serve to increase the sensitivity of the V-RQOL for those who are laryngectomized and use alaryngeal methods of voice and speech. Consequently, the value and application of the V-RQOL may be expanded in the clinical setting. [ABSTRACT FROM AUTHOR]

Purpose: To determine (a) the effect of fundamental frequency (f0) on speech intelligibility, acceptability, and perceived gender in electrolaryngeal (EL) speakers, and (b) the effect of known gender on speech acceptability in EL speakers. Method: A 2-part study was conducted. In Part 1, 34 healthy adults provided speech recordings using electrolarynges set at 75 Hz, 130 Hz, and 175 Hz, and 36 listeners transcribed the recordings. In Part 2, 22 speech samples were presented to 16 listeners. First, listeners identified the gender of each speaker and judged his or her speech acceptability using rating scales. Second, listeners judged the same samples for speech acceptability when gender information was provided. Results: In Part 1, speakers were significantly more intelligible when using 75-Hz devices. In Part 2, the f0 of the speech signal significantly impacted listeners' accuracy in perceiving the speaker's gender: In gender-incongruent conditions (males using 175-Hz devices, females using 75-Hz devices), listeners were unable to identify female speakers. Speech acceptability judgments were directly related to intelligibility. Finally, listeners differentially penalized female speakers who used 75-Hz devices when gender information was known. Conclusion: Low f0 facilitated speech intelligibility. However, at low f0, listeners were unable to identify females as female, and females were differentially penalized for speech acceptability. Results may have implications for rehabilitation. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability and Health (ICF) provides a conceptual framework and common language for describing human functioning and disability (World Health Organization, 2001). The ICF provides direction for comprehensive rehabilitation by classifying individual functioning at the levels of (a) body functions and structures and (b) activities and participation. Consequently, the purpose of this article is (a) to summarize the ICF; (b) to apply a case example to the framework of the ICF, involving individuals who have undergone total laryngectomy; and (c) to examine implications for both research and clinical practice. This article demonstrates how speech-language pathologists may apply the ICF framework and endorses the adoption of the framework by the American Speech-Language-Hearing Association in the 2001 Scope of Practice in Speech-Language Pathology. [ABSTRACT FROM AUTHOR]