br All such perceptual tests however have
All such perceptual tests, however, have a drawback: reliabil-ity and reproducibility are listener-dependent . The listener’s familiarity with the patient or with the task increases predictabil-ity, and results may differ between panels of experts and of naïve observers. Reproducibility is likewise subject to variation. Even so, these are the most widely used clinical tests, mainly for reasons of ease of use.
We therefore sought to identify the most useful tests, feasible in everyday clinical practice, for perceptual evaluation of speech to provide reference values for progression assessment.
The aim was to compare results on perceptual tests of disor-der severity and intelligibility impairment between two situations: reading, and semi-spontaneous speech.
The study N,N-Dimethylsphingosine was that severity assessed on semi-spontaneous picture description is more clinically relevant than intelligibility assessed on reading.
2. Material and methods
The study protocol was designed as part of the Carcinologic Speech Severity Index (C2SI) project , the aim of which is to measure the impact of head and neck (oral and pharyngeal) cancer treatment on speech production by automated speech processing compared to perceptual methods.
The corpus was built up from patients seen in follow-up after oral cavity or oropharyngeal cancer treatment in 2015 and 2016 at the Institut Universitaire du Cancer Oncopole cancer center in Toulouse, France.
Inclusion criteria comprised: 6 months post-treatment, and clinical remission so that speech disorder would be as stable as pos-sible, whether perceptible to the naked ear or not (so as to include the mildest deficits). The study was thus conducted in a context of chronic speech disorder.
Exclusion criteria comprised speech disorder potentially associ-ated with some other pathology such as stroke or fluency disorder (stammering).
Patients’ speech was recorded on a reading task (READ) and a picture description task (DESC).
All recordings were made in the oncorehabilitation unit of the Institut Universitaire du Cancer Toulouse – Oncopole. During follow-up consultation, patients entered a soundproof recording booth for speech assessment tasks. Audio files were recorded in WAVE format on a digital recorder with microphone and popshield filter, to optimizer recording quality and minimize measurement bias (misassessment due to recording issues).
Patients read aloud the first paragraph of La chèvre de Monsieur Seguin by Alphone Daudet:
“Monsieur Seguin n’avait jamais eu de bonheur avec ses chèvres. Il les perdait toutes de la même fac¸ on. Un beau matin, elles cas-saient leur corde, s’en allaient dans la montagne, et là-haut le loup les mangeait. Ni les caresses de leur maître, ni la peur du
loup, rien ne les retenait. C’était, paraît-il, des chèvres indépen-dantes voulant à tout prix le grand air et la liberté”.
This text was chosen for its length and balanced phonetic make-up; extracellular digestion is widely used in clinical assessment in France .
Patients randomly chose one out of several photographs, all showing a sea-front with boats.
They were asked to describe the picture so that a listener some distance away could copy it. The description task lasted at least 1 minute, to give the listening panel sufficient material.
184.108.40.206. Listening panel. The completed corpus of recordings was analyzed by a listening panel comprising 6 speech therapists, work-ing in the ENT department and thus considered to be experts.
2.3. DESC task analysis
Individual recordings were rendered anonymous and presented to the panel, who listened to them via headphones in a calm setting.
Panelists were informed that they would hear recordings of sub-jects describing a photograph related to the sea. After listening, they were to make two assessments:
• impairment of intelligibility and of speech signal, on a 0–10 scale (the lower the score, the greater the perceived disorder) by unit steps (discrete scoring). The two terms were defined in the instructions as follows: “Intelligibility is the comprehensibility of the message carried by the signal; signal impairment severity is the degree of overall vocal signal impairment.”;