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The term 'speech usage' refers to what people want or need to do with their speech to fulfil the communication demands in their life roles. Speech-language pathologists (SLPs) need to know about clients' speech usage to plan appropriate interventions to meet their life participation goals. The Levels of Speech Usage is a categorical scale intended for client self-report of speech usage, but SLPs may want the option to use it as a proxy-report tool. The relationship between self-report and clinician ratings should be examined before the instrument is used in a proxy format.The primary purpose of this study was to compare client self-ratings with SLP ratings on the Levels of Speech Usage scale. The secondary purpose was to determine if the SLP ratings differed depending on whether or not the SLPs knew about the clients' medical condition.Self-ratings of adults with communication disorders on the Levels of Speech Usage scale were available from prior research. Vignettes about these individuals were created from existing data. Two sets of vignettes were created. One set contained information about demographic information, living situation, occupational status and hobbies or social activities. The second set was identical to the first with the addition of information about the clients' medical conditions and communication disorders. Various communication disorders were represented including dysarthria, voice disorders, laryngectomy, and mild cognitive and language disorders. Sixty SLPs were randomly divided into two groups with each group rating one set of vignettes. The task was completed online. While this does not replicate typical in-person clinical interactions, it was a feasible method for this study. For data analysis, the client self-ratings were considered fixed points and the percentage of SLP ratings in agreement with the self-ratings was calculated.The percentage of SLP ratings in exact agreement with client self-ratings was 44.9%. Agreement was lowest for the less-demanding speech usage categories and highest for the most demanding usage category. There was no significant difference between the two groups of SLPs based on knowledge of medical condition.SLPs often need to document the speech usage levels of clients. This study suggests the potential for SLPs to misjudge how clients see their own speech demands. Further research is needed to determine if similar results would be found in actual clinical interactions. Until then, SLPs should seek the input of their clients when using this instrument.

People use speech in a variety of ways to fulfill life roles and responsibilities. Documenting speech usage is critical in clinical work to plan relevant intervention goals for individual clients, and in clinical research to better describe participant characteristics. A few voice-use classification scales exist; however, they are limited in scope (e.g., focus almost exclusively on occupation) and in applicability beyond voice-disordered populations. The Levels of Speech Usage is a self-report categorical rating scale intended for use with adults across a wide range of communication disorders and life situations. This article presents data from the initial analysis of this scale in a sample of 200 people with spasmodic dysphonia (SD). Speech usage was significantly associated with age, education level, and work status (full time, part time, no paid work). Speech usage was not significantly associated with gender, SD duration, self-rating of voice, treatment status, presence of other medical conditions, Voice Handicap Index, or a measure of communicative participation. Further research is needed to explore the function of this scale in other populations.

Conference on Motor Speech, Albuquerque, NM, MAR, 2004; International audience; Audiomotor and visuomotor tracking paradigms were used to evaluate differences in oral and upper limb motor deficits in Parkinson disease (PD). Ten PD subjects and 10 normal controls (NC) used their jaw and index finger to track visual targets and auditory targets. Tracking tasks included (1) stationary target tracking, (2) step tracking, and (3) predictable sinusoidal (.3, .5, .8, 1.1 Hz) tracking. Maximum rates of repetition were also examined. Performance measures included response time, repetition rate, and average tracking error. PD subjects showed a significant impairment on most of the tasks and measures that were examined. None of the primary interactions were significant. These interaction results indicate that PD oral and limb movements showed (1) equivalent reductions in the speed of repetitive movements, (2) equivalent increases in visual and auditory response times, (3) equivalent difficulty in maintaining visual and auditory guided postures, and (4) equivalent difficulty in tracking predictable auditory and visual targets. In general, these results support the hypothesis that speech/oral motor deficits are similar to limb motor deficits in PD. These results also emphasize the importance of equating motor tasks when comparing across different systems (i.e., limb vs. speech/oral, gait vs. upper limb).