MGH Institute of Health Professions, Boston, MA.
Department of Communicative Disorders and Sciences, The State University of New York at Buffalo.
J Speech Lang Hear Res. 2021 Dec 13;64(12):4736-4753. doi: 10.1044/2021_JSLHR-21-00201. Epub 2021 Nov 4.
This study investigated the criterion (analytical and clinical) and construct (divergent) validity of a novel, acoustic-based framework composed of five key components of motor control: Coordination, Consistency, Speed, Precision, and Rate.
Acoustic and kinematic analyses were performed on audio recordings from 22 subjects with amyotrophic lateral sclerosis during a sequential motion rate task. Perceptual analyses were completed by two licensed speech-language pathologists, who rated each subject's speech on the five framework components and their overall severity. Analytical and clinical validity were assessed by comparing performance on the acoustic features to their kinematic correlates and to clinician ratings of the five components, respectively. Divergent validity of the acoustic-based framework was then assessed by comparing performance on each pair of acoustic features to determine whether the features represent distinct articulatory constructs. Bivariate correlations and partial correlations with severity as a covariate were conducted for each comparison.
Results revealed moderate-to-strong analytical validity for every acoustic feature, both with and without controlling for severity, and moderate-to-strong clinical validity for all acoustic features except Coordination, without controlling for severity. When severity was included as a covariate, the strong associations for Speed and Precision became weak. Divergent validity was supported by weak-to-moderate pairwise associations between all acoustic features except Speed (second-formant [F2] slope of consonant transition) and Precision (between-consonant variability in F2 slope).
This study demonstrated that the acoustic-based framework has potential as an objective, valid, and clinically useful tool for profiling articulatory deficits in individuals with speech motor disorders. The findings also suggest that compared to clinician ratings, instrumental measures are more sensitive to subtle differences in articulatory function. With further research, this framework could provide more accurate and reliable characterizations of articulatory impairment, which may eventually increase clinical confidence in the diagnosis and treatment of patients with different articulatory phenotypes.
本研究旨在探讨一种新的基于声学的框架的准则（分析和临床）和结构（发散）有效性，该框架由运动控制的五个关键组成部分组成：协调、一致性、速度、精度和速度。
对 22 名肌萎缩侧索硬化症患者在进行顺序运动速度任务时的音频记录进行了声学和运动学分析。两名持照言语语言病理学家完成了感知分析，他们根据框架的五个组成部分及其整体严重程度对每个受试者的言语进行了评分。通过将声学特征与运动学相关特征以及临床医生对五个组成部分的评分进行比较，分别评估了分析和临床有效性。然后通过比较每个声学特征对的性能来评估基于声学的框架的发散有效性，以确定这些特征是否代表不同的发音结构。对于每个比较，都进行了双变量相关性和偏相关性分析，以严重程度为协变量。
结果表明，在不考虑严重程度的情况下，每个声学特征都具有中度到高度的分析有效性，而在不考虑严重程度的情况下，除协调外，所有声学特征都具有中度到高度的临床有效性。当将严重程度作为协变量时，速度和精度的强关联变为弱关联。除速度（辅音过渡第二共振峰斜率）和精度（第二共振峰斜率之间辅音变异性）之间的弱到中度相关性外，除速度外，所有声学特征之间都存在弱到中度的发散相关性。
本研究表明，基于声学的框架具有作为一种客观、有效且临床有用的工具来分析言语运动障碍患者发音缺陷的潜力。研究结果还表明，与临床医生的评估相比，仪器测量更能敏感地反映发音功能的细微差异。随着进一步的研究，该框架可以提供更准确和可靠的发音障碍特征描述，最终可能会增加临床医生对不同发音表型患者的诊断和治疗的信心。
