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Towards Understanding Intelligibility of Velopharyngeal Insufficiency (VPI) Speech

Hashemi Hosseinabad, Hedieh
http://orcid.org/0000-0002-2134-9813
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544100340591276

Abstract Details

2018, PhD, University of Cincinnati, Allied Health Sciences: Communication Sciences and Disorders.
The most important speech outcome of clinical intervention for children with cleft palate is improvement in intelligibility. Currently, intelligibility is evaluated indirectly as deviations from normal speech (e.g. by measuring phonological change, degrees of nasality, or extraneous audible noise) in the clinical setting. Further, although it is well-known that real-world conditions are more challenging than the clinical setting can provide, information that would help clinicians track intelligibility in the real world is lacking. Perhaps the largest unknown aspect of real-world conditions is background noise. This study attempted to provide more comprehensive information to clinicians about intelligibility in real-world contexts for children with cleft palate with a diagnosis of velopharyngeal insufficiency (VPI). The study has three interlocking parts. First, we test the ability of untrained listeners to understand VPI speech in both quiet and noise, which is the “gold standard” test of intelligibility. Second, we relate the results of the first study to clinician judgments. Data from this study will enable us to determine how well clinician judgments match the performance of untrained listeners in real-world conditions. Third, we relate the results of the first study to results from a well-known clinical instrument (Intelligibility Context Scale-ICS) developed specifically for the purpose of evaluating intelligibility in real-world contexts, based on the International Classification of Functioning, Disability, and Health- Child and Youth (ICF-CY) framework. Twenty English speaking children with VPI secondary to cleft palate with/without articulation disorders aged 4-12 years participated in the study. Subjects repeated twenty homogenous sentences from Hearing in Noise Test. In study I, a group of 70 native speakers of English participated as naive listeners and 10 expert clinicians in the craniofacial field served as judges in a perceptual task of intelligibility. Judges listened to the recorded speech samples both in quiet and noise. Naive listeners were asked to write what they heard orthographically. Scores of intelligibility were awarded to each speaker based on the number of correct responses by each listener in quiet and noise. Clinicians rated intelligibility on a 5-point scale. Results of study I suggested that intelligibility of VPI is reduced when presented in noise. In addition, the high correlations between scores per naive listener’s transcriptions and per clinician’s ratings suggests that the intelligibility of speech in children with VPI could be predicted by ratings done in clinic by expert clinicians. In study II, the parents of subjects were asked to complete the ICS questionnaire. The 7-item questionnaire asks parents to identify the degree to which they and other six communication partners understood their child on a 5-point Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = usually, 5 = always. In order to evaluate how much ICS scores are valid in reporting intelligibility deficits in individuals with VPI, data collected from ICS was related to nasalance scores, articulation performance (percent consonants correct [PCC], percent vowel correct [PVC], percent phonemes correct [PPC]), and orthographic transcriptions of listeners. Results showed high correspondence of the ICS data with intelligibility scores, PCC, PPC, and PVC.
Suzanne Boyce, Ph.D. (Committee Chair)
Noah Silbert, Ph.D. (Committee Member)
Karla Washington, Ph.D. (Committee Member)
98 p.
Speech Therapy
Intelligibility; Velopharyngeal Insufficiency; Intelligibility in Context Scale; ICF-CY; Naive listener; Expert Clinician

Recommended Citations

Citations

  • Hashemi Hosseinabad, H. (2018). Towards Understanding Intelligibility of Velopharyngeal Insufficiency (VPI) Speech [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544100340591276

    APA Style (7th edition)

  • Hashemi Hosseinabad, Hedieh. Towards Understanding Intelligibility of Velopharyngeal Insufficiency (VPI) Speech. 2018. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544100340591276.

    MLA Style (8th edition)

  • Hashemi Hosseinabad, Hedieh. "Towards Understanding Intelligibility of Velopharyngeal Insufficiency (VPI) Speech." Doctoral dissertation, University of Cincinnati, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544100340591276

    Chicago Manual of Style (17th edition)

ucin1544100340591276
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This open access ETD is published by University of Cincinnati and OhioLINK.