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Purpose: The goal of this study was to examine the effects of increases in vocal effort, without changing speech intensity, on respiratory and articulatory kinematics in young adults with typical voices. Method: A total of 10 participants completed a reading task under three speaking conditions: baseline, mild vocal effort, and maximum vocal effort. Respiratory inductance plethysmography bands around the chest and abdomen were used to estimate lung volumes during speech, and sensor coils for electromagnetic articulography were used to transduce articulatory movements, resulting in the following outcome measures: lung volume at speech initiation (LVSI) and at speech termination (LVST), articulatory kinematic vowel space (AKVS) of two points on the tongue dorsum (body and blade), and lip aperture. Results: With increases in vocal effort, and no statistical changes in speech intensity, speakers showed: (a) no statistically significant differences in LVST, (b) statistically significant increases in LVSI, (c) no statistically significant differences in AKVS measures, and (d) statistically significant reductions in lip aperture. Conclusions: Speakers with typical voices exhibited larger lung volumes at speech initiation during increases in vocal effort, paired with reduced lip displacements. To our knowledge, this is the first study to demonstrate evidence that articulatory kinematics are impacted by modulations in vocal effort. However, the mechanisms underlying vocal effort may differ between speakers with and without voice disorders. Thus, future work should examine the relationship between articulatory kinematics, respiratory kinematics, and laryngeal-level changes during vocal effort in speakers with and without voice disorders.

Purpose: Unexpected and sustained manipulations of auditory feedback during speech production result in "reflexive" and "adaptive" responses, which can shed light on feedback and feedforward auditory-motor control processes, respectively. Persons with Parkinson's disease (PwPD) have shown aberrant reflexive and adaptive responses, but responses appear to differ for control of vocal and articulatory features. However, these responses have not been examined for both voice and articulation in the same speakers and with respect to auditory acuity and functional speech outcomes (speech intelligibility and naturalness). Method: Here, 28 PwPD on their typical dopaminergic medication schedule and 28 age-, sex-, and hearing-matched controls completed tasks yielding reflexive and adaptive responses as well as auditory acuity for both vocal and articulatory features. Results: No group differences were found for any measures of auditory-motor control, conflicting with prior findings in PwPD while off medication. Auditory-motor measures were also compared with listener ratings of speech function: first formant frequency acuity was related to speech intelligibility, whereas adaptive responses to vocal fundamental frequency manipulations were related to speech naturalness. Conclusions: These results support that auditory-motor processes for both voice and articulatory features are intact for PwPD receiving medication. This work is also the first to suggest associations between measures of auditory-motor control and speech intelligibility and naturalness.

Purpose: The purpose of this study was to explore the relationship between feedback and feedforward control of articulation and voice by measuring reflexive and adaptive responses to first formant (F[subscript 1]) and fundamental frequency (f[subscript o]) perturbations. In addition, perception of F[subscript 1] and f[subscript o] perturbation was estimated using passive (listening) and active (speaking) just noticeable difference paradigms to assess the relation of auditory acuity to reflexive and adaptive responses. Method: Twenty healthy women produced single words and sustained vowels while the F[subscript 1] or f[subscript o] of their auditory feedback was suddenly and unpredictably perturbed to assess reflexive responses or gradually and predictably perturbed to assess adaptive responses. Results: Typical speakers' reflexive responses to sudden perturbation of F[subscript 1] were related to their adaptive responses to gradual perturbation of F[subscript 1]. Specifically, speakers with larger reflexive responses to sudden perturbation of F[subscript 1] had larger adaptive responses to gradual perturbation of F[subscript 1]. Furthermore, their reflexive responses to sudden perturbation of F[subscript 1] were associated with their passive auditory acuity to F[subscript 1] such that speakers with better auditory acuity to F[subscript 1] produced larger reflexive responses to sudden perturbations of F[subscript 1]. Typical speakers' adaptive responses to gradual perturbation of F[subscript 1] were not associated with their auditory acuity to F[subscript 1]. Speakers' reflexive and adaptive responses to perturbation of f[subscript o] were not related, nor were their responses related to either measure of auditory acuity to f[subscript o]. Conclusion: These findings indicate that there may be disparate feedback and feedforward control mechanisms for articulatory and vocal error correction based on auditory feedback.

Purpose: Gradual and sudden perturbations of vocal fundamental frequency (f[subscript o]), also known as adaptive and reflexive f[subscript o] perturbations, are techniques to study the influence of auditory feedback on voice f[subscript o] control mechanisms. Previous vocal f[subscript o] perturbations have incorporated varied setup-specific feedback delays and amplifications. Here, we investigated the effects of feedback delays (10--100 ms) and amplifications on both adaptive and reflexive f[subscript o] perturbation paradigms, encapsulating the variability in equipment-specific delays (3--45 ms) and amplifications utilized in previous experiments. Method: Responses to adaptive and reflexive f[subscript o] perturbations were recorded in 24 typical speakers for four delay conditions (10, 40, 70, and 100 ms) or three amplification conditions (-10, +5, and +10 dB relative to microphone) in a counterbalanced order. Repeated-measures analyses of variance were carried out on the magnitude of f[subscript o] responses to determine the effect of feedback condition. Results: There was a statistically significant effect of the level of auditory feedback amplification on the response magnitude during adaptive f[subscript o] perturbations, driven by the difference between +10- and -10-dB amplification conditions (hold phase difference: M = 38.3 cents, SD = 51.2 cents; after-effect phase: M = 66.1 cents, SD = 84.6 cents). No other statistically significant effects of condition were found for either paradigm. Conclusions: Experimental equipment delays below 100 ms in behavioral paradigms do not affect the results of f[subscript o] perturbation paradigms. As there is no statistically significant difference between the response magnitudes elicited by +5- and +10-dB auditory amplification conditions, this study is a confirmation that an auditory feedback amplification of +5 dB relative to microphone is sufficient to elicit robust compensatory responses for f[subscript o] perturbation paradigms.

Purpose: Given the role of auditory perception in voice production, studies have investigated whether impairments in auditory perception may underlie the noted disruptions in speech in Parkinson's disease (PD). Studies of loudness perception in PD show impairments in the perception of self-generated speech, but not external tones. Studies of pitch perception in PD have only examined external tones, but these studies differed in terms of the interstimulus intervals (ISIs) that were used, did not examine the impact of cognition, and report conflicting results. To clarify pitch perception in PD, this work investigated perception of self-generated vocal pitch, controlling for cognition and ISI. Method: A total of 30 individuals with and without PD completed (a) hearing threshold testing, (b) the Montreal Cognitive Assessment, and (c) an adaptive just-noticeable-difference paradigm under two separate ISIs (100 ms and 1,000 ms) to assess acuity to self-generated vocal pitch. Results: There was no significant difference in acuity between individuals with and without PD. Both groups demonstrated significantly worse acuity for longer compared to shorter ISIs. Montreal Cognitive Assessment scores were not a significant predictor of acuity. Conclusions: The results suggest that acuity to self-generated vocal pitch does not differ between individuals with and without PD.

Purpose: Reduced intensity is a hallmark of speech production in Parkinson's disease (PD). Previous work has examined the perception of intensity in PD to explain these speech deficits. This study reports loudness ratings of pure tones by individuals with PD and controls, all with normal thresholds for older adults. Method: Twenty individuals with PD and 23 age- and sex-matched controls rated the loudness of pure tones from 1 ("very soft") to 7 ("uncomfortably loud"). Tones at 500, 750, 1000, 2000, and 4000 Hz were presented from 35 to 80 dB HL (or until a rating of 7 was given). A mixed-model analysis of variance was performed on ratings to assess the effects of group, frequency, sound intensity, and ear. Loudness growth slopes were determined for each participant and analyzed by group. Results: The mean loudness growth slopes of the control and PD groups did not significantly differ. Conclusions: No difference was found in loudness growth slopes in response to externally generated tones in PD. This is in contrast with the findings of previous studies of self-generated speech and externally presented speech. The underlying causes for impaired perception and production of loudness in PD require further investigation.

Purpose: The vocal auditory-motor control of individuals with hyperfunctional voice disorders was examined using a sensorimotor adaptation paradigm. Method: Nine individuals with hyperfunctional voice disorders and 9 individuals with typical voices produced sustained vowels over 160 trials in 2 separate conditions: (a) while experiencing gradual upward perturbations in the fundamental frequency ("f[subscript o]") of their auditory feedback (shift-up) and (b) under no auditory perturbation (control). The shift-up condition consisted of 4 ordered (fixed) phases: baseline (no perturbation), ramp (gradual increases in heard "f[subscript o]"), hold (a consistently higher heard "f[subscript o]"), and after-effect (no perturbation). Adaptive responses were defined as the difference in produced "f[subscript o]" during control and shift-up conditions. Results: Adaptive responses were significantly different between groups. Individuals with typical voices generally showed compensatory adaptive responses, with decreased "f[subscript o]" during the ramp and hold phases. Conversely, many individuals with hyperfunctional voice disorders instead displayed the opposite effect by following the direction of the perturbation. When "f[subscript o]" was experimentally increased, speakers further increased their "f[subscript o]". Conclusion: Results indicate that some individuals diagnosed with hyperfunctional voice disorders have disrupted auditory-motor control, suggesting atypical neurological function. These findings may eventually allow for the development of new interventions for hyperfunctional voice disorders.

Camera Mouse is a freely available software program that visually tracks the movement of facial features to allow individuals with motor impairments to control a computer mouse. The goal of this case study was to provide an evaluation of Camera Mouse as a computer access method as part of a multiple modality communication system for an individual with cerebral palsy. The participant was asked to reproduce sentences and respond to ethical dilemmas for language sampling. Tasks were completed using natural speech and an AAC solution consisting of Camera Mouse paired with an orthographic selection interface and speech synthesis. The participant completed a questionnaire for satisfaction with the introduced assistive technology. Camera Mouse resulted in higher intelligibility than natural speech, while natural speech had a higher rate. She used more complex language with her natural speech. The participant rated Camera Mouse as at least 3/5 on all measures, including 5/5 on weight and safety. The results of this case study suggest Camera Mouse is a promising computer access system for communication supported by the participant's satisfaction rating, expressive language, and synthesized speech production capabilities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to quantify sentence-level articulatory kinematics in individuals treated for oral squamous cell carcinoma (ITOC) compared to control speakers while also assessing the effect of treatment site (jaw vs. tongue). Furthermore, this study aimed to assess the relation between articulatory-kinematic measures and self-reported speech problems. Method: Articulatory-kinematic data from the tongue tip, tongue back, and jaw were collected using electromagnetic articulography in nine Dutch ITOC and eight control speakers. To quantify articulatory kinematics, the two-dimensional articulatory working space (AWS; in mm² ), one-dimensional anteroposterior range of motion (AP-ROM; in mm), and superior-inferior range of motion (SIROM in mm) were calculated and examined. Self-reported speech problems were assessed with the Speech Handicap Index (SHI). Results: Compared to a sex-matched control group, ITOC showed significantly smaller AWS, AP-ROM, and SI-ROM for both the tongue tip and tongue back sensor, but no significant differences were observed for the jaw sensor. This pattern was found for both individuals treated for tongue and jaw tumors. Moderate nonsignificant correlations were found between the SHI and the AWS of the tongue back and jaw sensors. Conclusions: Despite large individual variation, ITOC showed reduced one- and two-dimensional tongue, but not jaw, movements compared to control speakers and treatment for tongue and jaw tumors resulted in smaller tongue movements. A larger sample size is needed to establish a more generalizable connection between the AWS and the SHI. Further research should explore how these kinematic changes in ITOC are related to acoustic and perceptual measures of speech. [ABSTRACT FROM AUTHOR]

Purpose: Behavioral assays of feedforward and feedback auditory–motor control of voice and articulation frequently are used to make inferences about underlying neural mechanisms and to study speech development and disorders. However, no studies have examined the test–retest reliability of such measures, which is critical for rigorous study of auditory–motor control. Thus, the purpose of the present study was to assess the reliability of assays of feedforward and feedback control in voice versus articulation domains. Method: Twenty-eight participants (14 cisgender women, 12 cisgender men, one transgender man, one transmasculine/nonbinary) who denied any history of speech, hearing, or neurological impairment were measured for responses to predictable versus unexpected auditory feedback perturbations of vocal (fundamental frequency, fo) and articulatory (first formant, F1) acoustic parameters twice, with 3–6 weeks between sessions. Reliability was measured with intraclass correlations. Results: Opposite patterns of reliability were observed for fo and F1; fo reflexive responses showed good reliability and fo adaptive responses showed poor reliability, whereas F1 reflexive responses showed poor reliability and F1 adaptive responses showed moderate reliability. However, a criterion-referenced categorical measurement of fo adaptive responses as typical versus atypical showed substantial test–retest agreement. Conclusions: Individual responses to some behavioral assays of auditory–motor control of speech should be interpreted with caution, which has implications for several fields of research. Additional research is needed to establish reliable criterion-referenced measures of F1 adaptive responses as well as fo and F1 reflexive responses. Furthermore, the opposite patterns of test–retest reliability observed for voice versus articulation add to growing evidence for differences in underlying neural control mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the effect of a concurrent working memory task on acoustic measures of speech in individuals with Parkinson's disease (PD). Method: Individuals with PD and age- and sex-matched controls performed a speaking task with and without a Stroop-like concurrent working memory task. Cepstral peak prominence, low-to-high spectral energy ratio, fundamental frequency (fo) standard deviation, articulation rate, pause duration, articulatory-acoustic vowel space, relative fo, mean voice onset time (VOT), and VOT variability were calculated for each condition. Mixed-model analyses of variance were performed to determine the effects of group, condition (presence of the concurrent working memory task), and their interaction on the acoustic measures. Results: All measures except for VOT variability, mean pause duration, and relative fo offset differed between people with and without PD. Cepstral peak prominence, articulation rate, and relative fo offset differed as a function of condition. However, no measures indicated disparate effects of condition as a function of group. Conclusion: Although differentially impactful on limb motor function in PD, here a concurrent working memory task was not found to be differentially disruptive to speech acoustics in PD. [ABSTRACT FROM AUTHOR]

Background: Treatment for oral or oropharyngeal squamous cell carcinoma (O&OSCC) often leads to problems with speech articulation. Articulatory-kinematic data may be especially informative in designing new therapeutic approaches for individuals treated for these tumours., Aims: To provide a systematic review of the literature assessing the articulatory-kinematic consequences of oral and oropharyngeal cancer treatment., Methods & Procedures: Five databases (PubMed, Embase, Scopus, Web of Science and PsycInfo) were used to identify studies that used kinematic methods to characterize the speech of individuals treated for O&OSCC. Risk of bias was assessed using the critical appraisal checklist from the Joanna Briggs Institute. Data were synthesized using the Synthesis Without Meta-Analysis guidelines., Outcomes & Results: In total, 29 studies with a total of 197 individuals treated for O&OSCC were included. In most studies the risk of bias was moderate to high and certainty of evidence was very low to low. Results showed both global changes (i.e., reduced movement and increased asymmetry of the tongue) as well as more local changes (i.e., reduced palatal contact and more centralized productions of consonants) following treatment for O&OSCC. Generally, reported changes were related to tumour size and location. Smaller tumours resulted in better or more typical articulatory-kinematic speech outcomes. Articulatory movements were most reduced in the affected region of the tongue as compared with neighbouring parts. Study findings were limited to small sample sizes with generally minimal descriptions of patient characteristics. No study assessed the influence of primary radiation treatment or adjuvant radiation therapy on kinematic speech outcomes., Conclusions & Implications: Based on the literature to date, surgical treatment for O&OSCC seems to reduce articulatory-kinematics of speech, and post-treatment outcomes may be partially explained by tumour size and location. The absence of studies assessing the effect of primary or adjuvant radiation therapy on articulatory-kinematics limits our knowledge of how these interventions influence post-treatment kinematic speech outcomes. Future studies should provide detailed patient descriptions and develop standardized speech assessment tools in order to further our knowledge regarding articulatory-kinematic speech changes following treatment, and to move towards the development of active rehabilitation strategies for those with O&OSCC., What This Paper Adds: What is already known on this subject Treatment for O&OSCC can result in problems with speech articulation. Speech outcomes for O&OSCC are highly variable. What this paper adds to the existing knowledge We systematically reviewed and synthesized the literature on articulatory-kinematic changes following O&OSCC treatment and identified 29 related studies. Treatment for O&OSCC resulted in global (i.e., more asymmetrical or reduced movement patterns) and local (i.e., reduced palatal contact) articulatory-kinematic changes. In general, smaller tumours resulted in better or more typical articulatory-kinematic speech outcomes as compared with larger tumours. Articulatory movements were most reduced in the affected region of the tongue as compared with neighbouring parts. What are the potential or actual clinical implications of this work? Understanding articulatory-kinematic impacts of surgical intervention for O&OSCC can guide (the development of) tailored speech rehabilitation., (© 2024 The Author(s). International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)