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Demarcating and highlighting in Papuan Malay phrase prosody

Kaland C, Baumann S

J Acoust Soc Am, 2020 04;147(4):2974.
PMID: 32359299 DOI: 10.1121/10.0001008

Phrase-level prosody serves two essential functions in many languages of the world: chunking information into units (demarcating) and marking important information (highlighting). Recent work suggests that prosody has a mainly demarcating function in the Trade Malay language family. That is, the use of pitch accents in these languages is limited or absent, as the main prosodic events occur on the final two syllables in a phrase. The current study investigates the extent to which Papuan Malay phrase prosody is used for demarcating and highlighting, taking into account the potential influence of word stress. This is done by means of acoustic analyses on a corpus of spontaneous speech. Both the form (F0 movement) and the possible functions (demarcating and highlighting) of the final two syllables in Papuan Malay phrases are investigated. Although most results favor the demarcating function of Papuan Malay phrase prosody, a highlighting function cannot be ruled out. The results suggest that Papuan Malay might hold an exceptional position in the typology of prosodic prominence.

Matched MeSH terms: Speech; Speech Acoustics; Speech Perception*
Optimising hearing aid output to paediatric prescriptive targets improves outcomes in children

Amri NA, Quar TK, Chong FY, Bagatto M

Int J Audiol, 2022 11;61(11):924-931.
PMID: 34859745 DOI: 10.1080/14992027.2021.2005832

OBJECTIVE: This study examined the accuracy of hearing aid output to DSL v5.0 Child targets in a group of children who wear hearing aids, and the impact on their auditory outcomes.
DESIGN: For each participant, the output of the initial hearing aid fitting was compared to DSL v5.0 Child prescriptive targets and again after the fitting was adjusted using coupler-based verification and RECD measures. Outcomes for initial and adjusted fittings were examined using the Speech Intelligibility Index (SII), Parent's Evaluation of Aural/Oral Performance of Children (PEACH) rating scale, and speech perception tests in quiet and noise.
STUDY SAMPLE: Sixty-eight children aged 3 months to 17 years with moderate to profound hearing loss participated in the study.
RESULTS: Fit-to-targets improved significantly after hearing aids were adjusted to match targets to within 5 dB RMSE. Adjusted hearing aids provided increased aided audibility compared to initial fittings and resulted in improved speech perception scores and parent-reported hearing performance. Fifty percent of the children aged 6 to 17 years preferred their adjusted fitting compared to 10% who preferred their initial fitting.
CONCLUSIONS: Improvement in fit-to-target to a validated paediatric prescriptive formula using best practice procedures can result in improved auditory outcomes and possible self-reported satisfaction.

Matched MeSH terms: Speech Intelligibility; Speech Perception*
Speech and mastication difficulties following treatment by a "street dentist": A case of oral lipoma

Kamil WNWA, Zainal M, Omar AF, Jamaluddin TIBT, Ahmad MS

Spec Care Dentist, 2021 Jan;41(1):129-134.
PMID: 33128415 DOI: 10.1111/scd.12536

In this report, we present the case of a 68-year-old male patient with a complaint of mastication and speech limitations one year after the prescription of a fixed bridge and the construction of "connected" crowns by a "street dentist." A thorough oral examination revealed a multilobulated swelling in the right buccal mucosa that extended to the buccal sulcus. The lesion, which was first noticed as a small, asymptomatic swelling by the patient one year prior, seemed to have undergone enlargement since the prostheses were prescribed. The lesion was completely removed via surgical excision under general anesthesia. Histopathological examination of the excisional mass revealed mature adipocytes and features consistent with conventional or classic lipoma. This case highlights the importance of receiving dental treatment from a qualified professional, whose responsibilities include performing a thorough examination of the oral cavity during treatment planning and delivery, review appointments, and regular dental visits. Such investigation is important to allow for early disease detection and control, especially for patients with complex treatment needs as well as those who may present with asymptomatic and slow-growing lesions such as lipomas.

Matched MeSH terms: Speech*
Fulltext Particle swarm optimization based feature enhancement and feature selection for improved emotion recognition in speech and glottal signals

Muthusamy H, Polat K, Yaacob S

PLoS One, 2015;10(3):e0120344.
PMID: 25799141 DOI: 10.1371/journal.pone.0120344

In the recent years, many research works have been published using speech related features for speech emotion recognition, however, recent studies show that there is a strong correlation between emotional states and glottal features. In this work, Mel-frequency cepstralcoefficients (MFCCs), linear predictive cepstral coefficients (LPCCs), perceptual linear predictive (PLP) features, gammatone filter outputs, timbral texture features, stationary wavelet transform based timbral texture features and relative wavelet packet energy and entropy features were extracted from the emotional speech (ES) signals and its glottal waveforms(GW). Particle swarm optimization based clustering (PSOC) and wrapper based particle swarm optimization (WPSO) were proposed to enhance the discerning ability of the features and to select the discriminating features respectively. Three different emotional speech databases were utilized to gauge the proposed method. Extreme learning machine (ELM) was employed to classify the different types of emotions. Different experiments were conducted and the results show that the proposed method significantly improves the speech emotion recognition performance compared to previous works published in the literature.

Matched MeSH terms: Speech Recognition Software*
Pseudo-Directive Speech Act in the Javanese Language: Culture-Specific Pragmatic Perspective

Rahardi RK, Rahmat W, Kurniawan Y

J Speech Lang Hear Res, 2023 Dec 11;66(12):5036-5047.
PMID: 37944102 DOI: 10.1044/2023_JSLHR-23-00223

PURPOSE: This study aims to illustrate the diverse modes and implications of pseudo-directive speech acts in Javanese, specifically emphasizing the Jogjakarta area. This field of pragmatics has garnered heightened attention in recent decades. However, it is worth noting that language researchers have not thoroughly examined these pragmatic studies and have not been extensively explored in linguistics.
METHOD: The primary data source of the study consists of excerpts of verbal expressions within the familial context. The provenance of the locational data can be traced to a familial unit with a cultural legacy deeply embedded in Javanese customs. The data were collected using observation and participation methodologies, employing advanced techniques of recording and note taking. The data were categorized and characterized to identify the various data types and formats. The tabulated results of classification and typification are presented to triangulate theory through expert validation and justification of theories. The method of contextual analysis was utilized to conduct the data analysis that relies on the pragmatic context.
RESULTS: The study's findings indicate the following: The Javanese language encompasses various modes of pseudo-directive utterances, such as commanding, ordering, suggesting, insinuating, and recommending. In addition, the Javanese language encompasses pseudo-directive pragmatics such as warning, prohibiting, reminding, suggesting, and commanding.
CONCLUSION: This research will significantly assist in formulating a pragmatic framework that considers cultural factors, as other linguistic phenomena in various regional languages remain unresolved.

Matched MeSH terms: Speech*
Fulltext A normalization model for repeated letters in social media hate speech text based on rules and spelling correction

Mansur Z, Omar N, Tiun S, Alshari EM

PLoS One, 2024;19(3):e0299652.
PMID: 38512966 DOI: 10.1371/journal.pone.0299652

As social media booms, abusive online practices such as hate speech have unfortunately increased as well. As letters are often repeated in words used to construct social media messages, these types of words should be eliminated or reduced in number to enhance the efficacy of hate speech detection. Although multiple models have attempted to normalize out-of-vocabulary (OOV) words with repeated letters, they often fail to determine whether the in-vocabulary (IV) replacement words are correct or incorrect. Therefore, this study developed an improved model for normalizing OOV words with repeated letters by replacing them with correct in-vocabulary (IV) replacement words. The improved normalization model is an unsupervised method that does not require the use of a special dictionary or annotated data. It combines rule-based patterns of words with repeated letters and the SymSpell spelling correction algorithm to remove repeated letters within the words by multiple rules regarding the position of repeated letters in a word, be it at the beginning, middle, or end of the word and the repetition pattern. Two hate speech datasets were then used to assess performance. The proposed normalization model was able to decrease the percentage of OOV words to 8%. Its F1 score was also 9% and 13% higher than the models proposed by two extant studies. Therefore, the proposed normalization model performed better than the benchmark studies in replacing OOV words with the correct IV replacement and improved the performance of the detection model. As such, suitable rule-based patterns can be combined with spelling correction to develop a text normalization model to correctly replace words with repeated letters, which would, in turn, improve hate speech detection in texts.

Matched MeSH terms: Speech*
The effect of dialect on the phonological analysis of Chinese-influenced Malaysian English speaking children

Phoon HS, Abdullah AC, Maclagan M

Int J Speech Lang Pathol, 2012 Dec;14(6):487-98.
PMID: 23039125 DOI: 10.3109/17549507.2012.719549

This study investigates the effect of dialect on phonological analyses in Chinese-influenced Malaysian English (ChME) speaking children. A total of 264 typically-developing ChME speaking children aged 3-7 years participated in this cross-sectional study. A single word naming task consisting of 195 words was used to elicit speech from the children. The samples obtained were transcribed phonetically and analysed descriptively and statistically. Phonological analyses were completed for speech sound accuracy, age of consonant acquisition, percentage of phonological process occurrence, and age of suppression for phonological processes. All these measurements differed based on whether or not ChME dialectal features were considered correct, with children gaining higher scores when ChME dialect features were considered correct. The findings of the present study provide guidelines for Malaysian speech-language pathologists and stress the need to appropriately consider ChME dialectal features in the phonological analysis of ChME speaking children. They also highlight the issues in accurate differential diagnosis of speech impairment for speech-language pathologists working with children from any linguistically diverse background.

Matched MeSH terms: Speech Acoustics*; Speech Disorders/diagnosis; Speech Disorders/physiopathology; Speech Disorders/psychology; Speech-Language Pathology/methods; Speech Production Measurement
Discharging patients: A perspective from speech-language pathologists working in public hospitals in Malaysia

Ahmad K

Int J Speech Lang Pathol, 2010 Aug;12(4):317-9; discussion 329-32.
PMID: 20590514 DOI: 10.3109/17549507.2010.483017

Speech-language pathologists (SLPs) practising in Malaysia face similar dilemmas as their counterparts in more developed countries when it comes to deciding on discharge/termination of services for their patients. Furthermore, discharge dilemmas appear to be a frequent and inevitable part of their everyday practice. In an interview conducted for the purpose of this paper, it was clear that many SLPs found it difficult to articulate or justify the process they took to reach a decision on whether or not to terminate their services or discharge their patients. Much of the difficulty is anchored on the need to be realistic and function within the confines of limited resources. Malaysian SLPs were aware of the ideals that had to be abandoned along the way but had not allowed guilt to dissuade or discourage them from providing what they perceived as the next best available service. The not-so ideal decisions made by these SLPs may be frowned upon by international standards but must be examined within the local historical perspective of the development of the SLP profession in Malaysia. The dilemma will continue until the country produces SLPs in sufficient numbers but the profession is reminded that less-than-ideal practices may perpetuate over time into unhealthy traditions that will require major efforts to be undone.

Matched MeSH terms: Speech-Language Pathology*; Speech Therapy
Fulltext Disyllabic Malay word lists for speech audiometry

Yiap KH

Med J Malaysia, 1984 Sep;39(3):197-204.
PMID: 6544920

A clinical study was undertaken to standardize a set of Malay word lists for speech audiometry evaluations. A set of ten word lists is drawn out to test a general Malay-speaking population. A normal discrimination curve is obtained using these materials and some examples of clinical applications are illustrated.

Matched MeSH terms: Audiometry, Speech*; Speech Discrimination Tests
Hypernasality in singing among children with cleft palate: a preliminary study

Peter S, Abdul Rahman ZA, Pillai S

Int J Oral Maxillofac Surg, 2019 Oct;48(10):1317-1322.
PMID: 31014926 DOI: 10.1016/j.ijom.2019.03.896

The aim of this study was to document differences in hypernasality during speaking and singing among children with cleft palate and to compare nasality score ratings of trained and untrained listeners. Twenty subjects with cleft palate aged between 7 and 12 years participated in this study. Audio recordings were made of the children reading a passage and singing a common local song, both in the Malay language. The degree of hypernasality was judged through perceptual assessment. Three trained listeners (a speech therapist, a classical singer, and a linguistic expert - all academicians) and two untrained listeners (a cleft volunteer worker and a national high school teacher) assessed the recordings using a visual analogue scale (VAS). Inter-rater and intra-rater reliability for hypernasality in both speaking and singing were verified using the intra-class correlation coefficient (ICC). A significant reduction in hypernasality was observed during singing as compared to speaking, indicating that hypernasality reduces when a child with cleft palate sings. The act of singing significantly reduces hypernasality. The outcome of this study suggests that children with cleft palate would benefit from singing exercises to ultimately reduce hypernasality. However, future research is needed to objectively measure nasality in singing compared to speaking.

Matched MeSH terms: Speech Perception*; Speech Production Measurement
Fulltext The role of f0 shape and phrasal position in Papuan Malay and American English word identification

Kaland C, Gordon MK

Phonetica, 2022 Jun 27;79(3):219-245.
PMID: 35981718 DOI: 10.1515/phon-2022-2022

The prosodic structure of under-researched languages in the Trade Malay language family is poorly understood. Although boundary marking has been uncontroversially shown as the major prosodic function in these languages, studies on the use of pitch accents to highlight important words in a phrase remain inconclusive. In addition, most knowledge of pitch accents is based on well-researched languages such as the ones from the Western-Germanic language family. This paper reports two word identification experiments comparing Papuan Malay with the pitch accent language American English, in order to investigate the extent to which the demarcating and highlighting function of prosody can be disentangled. To this end, target words were presented to native listeners of both languages and differed with respect to their position in the phrase (medial or final) and the shape of their f0 movement (original or manipulated). Reaction times for the target word identifications revealed overall faster responses for original and final words compared to manipulated and medial ones. The results add to previous findings on the facilitating effect of pitch accents and further improve our prosodic knowledge of underresearched languages.

Matched MeSH terms: Speech Acoustics; Speech Perception*
The Malay hearing in noise test

Quar TK, Mukari SZ, Abdul Wahab NA, Abdul Razak R, Omar M, Maamor N

Int J Audiol, 2008 Jun;47(6):379-80.
PMID: 18569117 DOI: 10.1080/14992020801886796
Matched MeSH terms: Audiometry, Speech/standards*; Speech Perception*
Fulltext Management of dysphagia by speech-language pathologists in Malaysia]. Pengendalian disfagia oleh patologis pertuturan-bahasa di Malaysia

Sharma, Shobha, Haryani Harun, Rahayu Mustaffa Kamal, Srinovianti Noerdin

Jurnal Sains Kesihatan Malaysia, 2006;4(2):39-51.
MyJurnal

This study in the management of dysphagia or swallowing disorders involved 72 contactable Speech-Language Pathologists (SLP) in Malaysia. A survey was undertaken to identify the patterns of dysphagia management by SLPs in Malaysia by identifying the percentage of SLPs in Malaysia who have managed swallowing disorders, the approximate number of patients, assessment and therapy techniques used, other professional involvement and the factors that influenced the confidence levels of the SLPs in managing swallowing disorders. Fifty percent (50%) of the forty four SLPs (61.6%) who responded to the survey had previously managed swallowing disorders. It was estimated that 5% (430 of 8268) of patients referred to the SLPs in Malaysia presented with dysphagia and were subsequently managed for their swallowing problems. The oromotor examination was carried out most frequently (100%) for evaluation of dysphagia while the compensatory technique proved to be the most frequently used management technique (77.3%). Most referrals to the SLPs were received from the neurosurgeon (59.1%); the otorhinolaryngologist was most referred to by the SLPs (50%). By using the Chi-squared analysis, it was found that clinical training in dysphagia at the undergraduate or post-graduate levels influenced the confidence levels of the SLPs in managing dysphagia cases (χ2 = 10.063 with p value = 0.007).

Matched MeSH terms: Speech-Language Pathology
Fulltext Ambient noise reduction using improved least mean square adaptive filtering

Noor, A.O.A., Samad, S.A., Hussain, A.

ASM Science Journal, 2010;4(2):133-141.
MyJurnal

In this paper, an improved method of reducing ambient noise in speech signals is introduced. The proposed noise canceller was developed using a computationally efficient (DFT) filter bank to decompose input signals into sub-bands. The filter bank was based on a prototype filter optimized for minimum output distortion. A variable step-size version of the (LMS) filter was used to reduce the noise in individual branches. The subband noise canceller was aimed to overcome problems associated with the use of the conventional least mean square (LMS) adaptive algorithm in noise cancellation setups. Mean square error convergence was used as a measure of performance under white and ambient interferences. Compared to conventional as well as recently developed techniques, fast initial convergence and better noise cancellation performances were obtained under actual speech and ambient noise.

Matched MeSH terms: Speech
Fulltext Improved architecture of speaker recognition based on wavelet transform and Mel Frequency Cepstral Coefficient (MFCC)

Nor Ashikin Rahman, Noor Azilah Muda, Norashikin Ahmad

Pertanika Journal of Science & Technology, 2017;25(106):1-10.
MyJurnal

Combining Mel Frequency Cepstral Coefficient with wavelet transform for feature extraction is not new. This paper proposes a new architecture to help in increasing the accuracy of speaker recognition compared with conventional architecture. In conventional speaker model, the voice will undergo noise elimination first before feature extraction. The proposed architecture however, will extract the features and eliminate noise simultaneously. The MFCC is used to extract the voice features while wavelet de-noising technique is used to eliminate the noise contained in the speech signals. Thus, the new architecture achieves two outcomes in one single process: ex-tracting voice feature and elimination of noise.

Matched MeSH terms: Speech
Speech by Dato' Paduka Dr Ruby binti Abdul Majeed, President of the Academy of Family Physicians of Malaysia on the occasion of the Convocation and Launching of the joint training programme between UPM and the Academy of Family Physicians of Malaysia

Abdul Majeed R

Family Physician, 2001;11(3):v-vi.

Matched MeSH terms: Speech
Fulltext Speech token detection and discrimination in individual infants using functional near-infrared spectroscopy

Mao D, Wunderlich J, Savkovic B, Jeffreys E, Nicholls N, Lee OW, et al.

Sci Rep, 2021 12 14;11(1):24006.
PMID: 34907273 DOI: 10.1038/s41598-021-03595-z

Speech detection and discrimination ability are important measures of hearing ability that may inform crucial audiological intervention decisions for individuals with a hearing impairment. However, behavioral assessment of speech discrimination can be difficult and inaccurate in infants, prompting the need for an objective measure of speech detection and discrimination ability. In this study, the authors used functional near-infrared spectroscopy (fNIRS) as the objective measure. Twenty-three infants, 2 to 10 months of age participated, all of whom had passed newborn hearing screening or diagnostic audiology testing. They were presented with speech tokens at a comfortable listening level in a natural sleep state using a habituation/dishabituation paradigm. The authors hypothesized that fNIRS responses to speech token detection as well as speech token contrast discrimination could be measured in individual infants. The authors found significant fNIRS responses to speech detection in 87% of tested infants (false positive rate 0%), as well as to speech discrimination in 35% of tested infants (false positive rate 9%). The results show initial promise for the use of fNIRS as an objective clinical tool for measuring infant speech detection and discrimination ability; the authors highlight the further optimizations of test procedures and analysis techniques that would be required to improve accuracy and reliability to levels needed for clinical decision-making.

Matched MeSH terms: Speech/physiology*; Speech Perception/physiology*
Fulltext Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness')

Katiri R, Hall DA, Killan CF, Smith S, Prayuenyong P, Kitterick PT

Trials, 2021 Mar 20;22(1):220.
PMID: 33743802 DOI: 10.1186/s13063-021-05160-5

BACKGROUND: This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials.
METHODS: Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis.
RESULTS: Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains.
CONCLUSIONS: This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains.
TRIAL REGISTRATION: The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.

Matched MeSH terms: Speech Perception*
The development of tone discrimination in infancy: Evidence from a cross-linguistic, multi-lab report

Kalashnikova M, Singh L, Tsui A, Altuntas E, Burnham D, Cannistraci R, et al.

Dev Sci, 2024 May;27(3):e13459.
PMID: 37987377 DOI: 10.1111/desc.13459

We report the findings of a multi-language and multi-lab investigation of young infants' ability to discriminate lexical tones as a function of their native language, age and language experience, as well as of tone properties. Given the high prevalence of lexical tones across human languages, understanding lexical tone acquisition is fundamental for comprehensive theories of language learning. While there are some similarities between the developmental course of lexical tone perception and that of vowels and consonants, findings for lexical tones tend to vary greatly across different laboratories. To reconcile these differences and to assess the developmental trajectory of native and non-native perception of tone contrasts, this study employed a single experimental paradigm with the same two pairs of Cantonese tone contrasts (perceptually similar vs. distinct) across 13 laboratories in Asia-Pacific, Europe and North-America testing 5-, 10- and 17-month-old monolingual (tone, pitch-accent, non-tone) and bilingual (tone/non-tone, non-tone/non-tone) infants. Across the age range and language backgrounds, infants who were not exposed to Cantonese showed robust discrimination of the two non-native lexical tone contrasts. Contrary to this overall finding, the statistical model assessing native discrimination by Cantonese-learning infants failed to yield significant effects. These findings indicate that lexical tone sensitivity is maintained from 5 to 17 months in infants acquiring tone and non-tone languages, challenging the generalisability of the existing theoretical accounts of perceptual narrowing in the first months of life. RESEARCH HIGHLIGHTS: This is a multi-language and multi-lab investigation of young infants' ability to discriminate lexical tones. This study included data from 13 laboratories testing 5-, 10-, and 17-month-old monolingual (tone, pitch-accent, non-tone) and bilingual (tone/non-tone, non-tone/non-tone) infants. Overall, infants discriminated a perceptually similar and a distinct non-native tone contrast, although there was no evidence of a native tone-language advantage in discrimination. These results demonstrate maintenance of tone discrimination throughout development.

Matched MeSH terms: Speech Perception*
A speech pronunciation practice system for speech-impaired children: A study to measure its success

Salim SS, Mustafa MB, Asemi A, Ahmad A, Mohamed N, Ghazali KB

Res Dev Disabil, 2016 Sep;56:41-59.
PMID: 27262125 DOI: 10.1016/j.ridd.2016.05.013

BACKGROUND: The speech pronunciation practice (SPP) system enables children with speech impairments to practise and improve their speech pronunciation. However, little is known about the surrogate measures of the SPP system.
AIMS: This research aims to measure the success and effectiveness of the SPP system using three surrogate measures: usage (frequency of use), performance (recognition accuracy) and satisfaction (children's subjective reactions), and how these measures are aligned with the success of the SPP system, as well as to each other.
METHODS AND PROCEDURES: We have measured the absolute change in the word error rate (WER) between the pre- and post-training, using the ANOVA test. Correlation co-efficiency (CC) analysis was conducted to test the relation between the surrogate measures, while a Structural Equation Model (SEM) was used to investigate the causal relations between the measures.
OUTCOMES AND RESULTS: The CC test results indicate a positive correlation between the surrogate measures. The SEM supports all the proposed gtheses. The ANOVA results indicate that SPP is effective in reducing the WER of impaired speech.
CONCLUSIONS AND IMPLICATIONS: The SPP system is an effective assistive tool, especially for high levels of severity. We found that performance is a mediator of the relation between "usage" and "satisfaction".

Matched MeSH terms: Speech Disorders/rehabilitation*; Speech Intelligibility; Speech Therapy/methods*

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