Free classification of dysarthric speech

Often termed the "gold standard" in the differential diagnosis of dysarthria, the etiology-based Mayo Clinic classification approach has been used nearly exclusively by clinicians since the early 1970s. However, the current descriptive method results in a distinct overlap of perceptual features across various etiologies, thus limiting the clinical utility of such a system for differential diagnosis. Acoustic analysis may provide a more objective measure for improvement in overall reliability (Guerra & Lovely, 2003) of classification. The following paper investigates the potential use of a taxonomical approach to dysarthria. The purpose of this study was to identify a set of acoustic correlates of perceptual dimensions used to group similarly sounding speakers with dysarthria, irrespective of disease etiology. The present study utilized a free classification auditory perceptual task in order to identify a set of salient speech characteristics displayed by speakers with varying dysarthria types and perceived by listeners, which was then analyzed using multidimensional scaling (MDS), correlation analysis, and cluster analysis. In addition, discriminant function analysis (DFA) was conducted to establish the feasibility of using the dimensions underlying perceptual similarity in dysarthria to classify speakers into both listener-derived clusters and etiology-based categories. The following hypothesis was identified: Because of the presumed predictive link between the acoustic correlates and listener-derived clusters, the DFA classification results should resemble the perceptual clusters more closely than the etiology-based (Mayo System) classifications. Results of the present investigation's MDS revealed three dimensions, which were significantly correlated with 1) metrics capturing rate and rhythm, 2) intelligibility, and 3) all of the long-term average spectrum metrics in the 8000 Hz band, which has been linked to degree of phonemic distinctiveness (Utianski et al., February 2012). A qualitative examination of listener notes supported the MDS and correlation results, with listeners overwhelmingly making reference to speaking rate/rhythm, intelligibility, and articulatory precision while participating in the free classification task. Additionally, acoustic correlates revealed by the MDS and subjected to DFA indeed predicted listener group classification. These results beget acoustic measurement as representative of listener perception, and represent the first phase in supporting the use of a perceptually relevant taxonomy of dysarthria.