tampereen yliopisto: viestintätieteiden tiedekunta: opiskelu: valinnaiset opinnot: sivuaineet ja muut opintokokonaisuudet: fonetiikka: tutkimus: 25. fonetiikan päivät 2008: abstraktit:
Viestintätieteiden tiedekuntaTampereen yliopistoViestintätieteiden tiedekunta
25. Fonetiikan päivät 2008

Following speech changes in ALS: a call for co-operation

Tanja Makkonen and Anna-Maija Korpijaakko-Huuhka

The purpose of this study is to get more information about how communication and swallowing problems proceed in adults with Amyotrophic Lateral Sclerosis (ALS) during the follow-up and also to find out specific factors that may predict the progression pattern—or patterns—of communication difficulty and swallowing. In this presentation we focus on changes of speech and voice.

ALS, also known by the name motor neuron disease, causes progressive speech and swallowing disorders. As the disease progresses, the patient’s speech becomes less understandable because of dysarthria (mm. DePaul & Brooks, 1993; Dworkin et al. 1980; Kent. et al. 1992; Langmore & Lehman, 1994; Mulligan et al. 1994). Typically dysarthria influences all levels of speech production: phonation, respiration, articulation, resonance and prosody
 Decline in speech rate is often the first symptom of ALS (Watts & Vanryckeghem, 2001; Kent et al.,1991; Mulligan et al., 1994). Speech intelligibility may remain good even if speech rate and maximum repetition rate decline (Nishio & Niimi, 2000). Patients with ALS seem to use slowered speech rate as a compensatory strategy to maintain speech intelligibility when the ability to articulate gets worse. The slowing down of articulatory movements and the increased number and duration of pauses, result in unavoidable decrease of speech intelligibility (Nishio & Niimi, 2000). In addition to slowered movements, changes in articulatory accuracy affect speech intelligibility. This can be also verified acoustically, for example, as reduced vowel space (Weismer et al., 2001).
 Forced vital capacity declines in dysarthric patients with ALS (Mulligan, 1994). The bulbar symptoms and declination of vital capacity may cause phonatory weakness and changes in the quality of voice, for example breathy or stained-strangled voice. Prolonged intervals, prolonged phonemes and inappropriate silences may result from respiratory changes (Yorkston et al., 2004).

Materials and methods
Participants in this study will be 20–30 adult patients with the diagnosis of probable ALS or ALS definitive. The follow-up starts at the first appointment with the speech therapists in the neurological department, and will last about two years for each patient. Data collection is starting during the fall 2007.
 To describe speech changes during the follow-up we are collecting versatile material: Phonatory and speech motor functions are examined with clinical tasks. Articulatory accuracy and speech intelligibility are rated based on word and sentence production tasks and on spontaneous speech samples. The data will mainly be analysed according to clinical criteria but acoustic analyses of speech and voice are also possible in this audiotaped material.
 We call students and researchers within phonetics and vocology for co-operation!

DePaul, R. & Brooks, B.R. (1993).
Multiple orofacial indices in amyotrophic lateral sclerosis. Journal of Speech and Hearing Research; 36:1158–67
Dworkin, J.P., Aronson, A.E. & Mulder, D.W. (1980).
Tongue force in normal and dysarthric patients with amyotrophic lateral sclerosis. Journal of Speech and Hearing Reasearch; 23:828–37.
Kent, J.F., Kent, R.D., Rosenbek, J.C., Weismer, G., Martin, R., Sufit, R. & Brooks, B.R. (1992).
Quantitative description of the dysarthria in women with amyotrophic lateral sclerosis. Journal of Speech and Hearing Reasearch; 35:723–34.
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Speech deterioration in amyotrophic lateral sclerosis: a case study. Journal of Speech and Hearing Reasearch; 34;1269–75.
Langmore, S.E. & Lehman, M.E. (1994).
Physiologic deficits in the orofacial system underlying dysarthria in amyotrophic lateral sclerosis. Journal of Speech and Hearing Research; 37:28-37.
Mulligan, M., Carpenter, J., Riddel, J., Delaney, M.K., Badker, G., Krusinski, P & Tandan, R. (1994).
Intelligibility and the acoustic characteristics of speech in amyotrophic lateral sclerosis (ALS). Journal of Speech and Hearing Research; 37:496–504
Nishio, M. & Niimi, S. (2000).
Changes over time in dysathric patients with amyotrophic lateral sclerosis (ALS): A study of changes in speaking rate and maximum repetition rate (MRR). Clinical Linguistics & Phonetics; 14:485-497.
Watts,C.R. & Vanryckeghem, M. (2001).
Laryngeal dysfunction in amyotrophic lateral sclerosis: a review and case report. Ear, Nose and Throat Disorders; 1:1.
Weismer, G., Jeng, J-Y., Laures, J.S., Kent, R.D. & Kent, J.F. (2001).
Acoustic and Intelligibility Characteristics of Sentence Production in Neurogenic Speech Disorders. Folia Phoniatrica et Logopedica; 53: 1–18.
Yorkston, K.M., Miller, R.M. & Strand, E.A. (2004).
Management of Speech and Swallowing in Degenerative Diseases, 2nd ed. Texas: Pro-ed.
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