A Clinical Advantage: Experience Informs Recognition and Adaptation to a Novel Talker with Dysarthria

• Published in: Journal of speech, language, and hearing research Vol. 64; no. 5; pp. 1503 - 1514
• Main Authors: Borrie, Stephanie A, Lansford, Kaitlin L, Barrett, Tyson S
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association 01.05.2021
• Subjects: Adaptation; Allied Health Personnel; Articulation disorders; Articulation Impairments; Auditory Perception; Behavior Change; Care and treatment; Clinical Experience; Dysarthria; Experience; Familiarity; Generalization; Group Membership; Intelligibility; Knowledge; Listening; Listening Comprehension; Literary characters; Medical personnel; Methods; Neurological Impairments; Opportunities; Perceptual learning; Pretests Posttests; Recognition; Speaking; Speech; Speech disorders; Speech Language Pathology; Speech perception; Speech therapists; Speech-language pathologists; Stimuli; Students; Training; United States
• ISSN: 1092-4388; 1558-9102
• DOI: 10.1044/2021_JSLHR-20-00663

Purpose: Perceptual training paradigms, which leverage the mechanism of perceptual learning, show that naïve listeners, those with no prior experience with dysarthria, benefit from explicit familiarization with a talker with dysarthria. It is theorized that familiarization affords listeners an opportunity to acquire distributional knowledge of the degraded speech signal. Here, we extend investigations to clinically experienced listeners, speech-language pathologists (SLPs), and advance models of listener recognition and adaptation to dysarthric speech. Method: Forty-seven SLPs completed a standard three-phase perceptual training protocol (pretest, familiarization, and posttest) with a novel talker with dysarthria. Intelligibility scores were compared with historical data from naïve listeners. Potential relationships between intelligibility scores and characteristics of clinical experience were examined. Results: Intelligibility scores of SLPs improved by an average of 19% from pretest to posttest. This intelligibility improvement was lower than naïve listeners, although the difference was small. Moreover, clinical characteristics related to level of dysarthria experience (e.g., percent of caseload composed of dysarthria) predicted pretest/initial intelligibility. No predictive relationships between clinical characteristics and intelligibility improvement were revealed. Conclusions: As a group, SLPs benefitted from perceptual training, suggesting that, despite prior experience, the opportunity to acquire knowledge of talker-specific cue distributions is crucial for optimal adaptation. However, SLPs with greater dysarthria experience were better at initially understanding the talker with dysarthria. This suggests that, through regular interaction with individuals with dysarthria, clinicians acquire knowledge of the cue distributions of dysarthric speech more generally and can generalize this group-specific knowledge to aid in understanding other talkers with dysarthria. Consistent with theoretical models of perceptual learning, both talker- and group-specific knowledge informed recognition and adaptation to dysarthric speech.