Toward phonetic intelligibility testing in dysarthria.

The measurement of intelligibility in dysarthric individuals is a major concern in clinical assessment and management and in research on dysarthria. The measurement objective is complicated by the fact that intelligibility is not an absolute quantity but rather a relative quantity that depends on variables such as test material, personnel, training, test procedures, and state of the speaker. This paper reviews scaling procedures and item identification tests as they have been applied to dysarthric speech. Based in part on previous studies of speech of the hearing impaired, a profile has been designed to direct research on the acoustic or physiologic correlates of dysarthric intelligibility impairment. In addition, a word intelligibility test is proposed for use with dysarthric speakers. This test is designed to examine 19 acoustic-phonetic contrasts that are likely to (a) be sensitive to dysarthric impairment and (b) contribute significantly to speech intelligibility. Preliminary data from a sample of subjects with amyotrophic lateral sclerosis are presented to illustrate the use of this test in the phonetic interpretation of intelligibility impairment.