Hyperkinetic Dysarthria’s Effect On Articulation 1

Running Head: HYPERKINETIC DYSARHTRIA’S EFFECT ON

ARTICULATION

The Effects of Hyperkinetic Dysarthria – Organic Voice Tremors on the Speed of

Articulation

Chelsey Tuttle

The Pennsylvania State University

 Hyperkinetic Dysarthria’s Effect On Articulation 2

The Effects of Hyperkinetic Dysarthria – Organic Voice Tremors on the Speed of

Articulation

This paper is going to discuss the speech intelligibility of an individual who has a

Hyperkinetic Dysarthria Organic Vocal Tremor in comparison to those who have

Amyotrophic Lateral Sclerosis. Both of these types of disorders are ones that can inhibit

the production of syllables. Without the correct production and smoothness of transitions

between each syllable it can sometimes cause frustration to an individual as well as

difficulty for someone to understand them. This paper is going to justify whether or not

Hyperkinetic Dysarthria Organic Vocal Tremor indeed has an effect on articulation or

not. By doing so, we will also be able to clarify if the second-formant transition rate,

which states whether the patient expresses speech intelligibility or not.

Speech intelligibility is important to this particular study and is defined as, the

accuracy with which a normal listener can convey a spoken word or phrase, according to

Yorkston and Beukelman (1980) (Kent & Weismer, 1989). The speech intelligibility of

patients with ALS and the slope of the transition of the second formant (F2) frequency

are what are measured in order to determine if the patients are considered intelligible or

not (Kent & Kent, 1989).

Dysarthria is a speech disorder that results from damage to the nerves and/or

muscles. This can cause there to be weakness or incoordination in the respiratory,

phonatory, and articulatory systems. Dysarthria is referred to as a partial disturbance in

motor speech. Dysarthria is also known to occur at the later stages of motor

programming, during the level of speech processing (Ferrand, 1997).

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Hyperkinetic Dysarthria patients have had some sort of a lesion to their basal

nuclei; therefore it is categorized as an Extrapyramidal disease. It is an extrapyramidal

disease, because it pertains to the corticobulbar tract and the indirect motor tract, the

basal ganglia. This is where some sort of damage is done, causing there to be problems.

There are excessive movements in hyperkinesias that include different types of tics and

tremors, dystonia and chorea. A tremor is known as rhythmic changes in frequency

and/or amplitude of vocal fold vibration, which is perceived as a tremble quality in the

voice. The pitch may be too low, too high, lack variety, or could even sound like two

pitches are occurring at the same time. The loudness level could occur in jerky bursts,

may be too great, or may not be great enough. The resonance disorders could cause

hyponasality, as well as hypernasality, or even stridor may be heard if the airway is

compressed. There are several types of tremors, however the one that pertains to an

Organic Voice Tremor is what is known as the Essential tremor. This tremor is a tremor

that usually occurs in middle age. It consists of involuntary rhythmic movements of the

head, face, tongue, jaw, laryngeal muscles, arms, and hands. It can be treated with

certain medications (Ferrand, 1997).

In order to bridge the gap between a patient with Hyperkinetic Dysarthria with an

Organic Voice Tremor and those with ALS to be explained is going to take place

throughout the duration of this study by explaining whether or not the information of a

Hyperkinetic Dysarthria patient generalizes to a patient with ALS.

METHOD
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In this particular study the patient was previously diagnosed with Hyperkinetic

dysarthria with an Organic Voice Tremor. The 72-year-old male read the passage

entitled, My Grandfather Passage (Aronson & Brown, 1969). For this particular study

the patient just read the first half of the passage. The words of importance for this

particular study included only those that contain a stop consonant with a vowel that

followed. As the patient read this particular part of the passage, the words that fit into the

previous category was as followed: to, coat, buttons, beard, and giving. This information

was entered into a program called, PRAAT. PRAAT is a computer-based software that

was designed to analyze speech in phonetics. PRAAT is used to allow students and

teachers to analyze particular aspects of speech, including: spectral analysis, intensity

and frequency analysis (Boersma & Weenink, 2009).

PRAAT is used specifically in this study to measure the slopes of the second

formant transitions of those stop consonant-vowel syllables: to, coat, buttons, beard, and

giving, in the passage that are in word-initial position and receive either primary or

secondary stress. In order to be able to find those slopes it is necessary to isolate the

stop-vowel syllable by finding the transition from the end of the consonant to the end of

the vowel. This is the portion of the stop-vowel consonant syllable that is measured.

This particular portion of the passage was put into a spectrogram to be able to

listen and see the data properly. It is necessary to have the entire passage in the

spectrogram, causing the seconds to be changed to 330 seconds in the analysis portion of

PRAAT. The dynamic range could also be changed to 45 dB in order to make the

spectrogram clearer. To determine the second formant frequency transition slope it is

 Hyperkinetic Dysarthria’s Effect On Articulation 5

necessary that the syllables are isolated, so only the initial onsets of the vowels, which is

indicated on the spectrogram as a white vertical line on the spectrogram, until the offset,

or steady state of where the vowel ended are seen.

This information was then taken and compared to that from the Kent & Kent

(1989) study. Finding the interquartile range, as well as the median, from the normative

data, the ALS data, and the Hyperkinetic Dysarthria data did this. Once the median of

each data was found, the lower half is considered the lower quartile and the higher half is

considered to be the upper quartile. Once these were found, the median of those also

needs to be found and that is known as the 25th percentile and the 75th percentile,

respectively. Next, it was time to find the interquartile range of all of this data by

subtracting the 25th percentile from the 75th percentile.

RESULTS

Now that the Hyperkinetic Dysarthria with an Organic Voice Tremor patients data

has been compared to that of the ALS patient and normative data in the Kent & Kent

(1989) study it is easy to look at the tables to compile the data. In Table 1 it shows the

stop-consonant vowel syllables as well as the entire word. It also indicates what the

second-formant frequency transition rate was for the Hyperkinetic Dysarthria patient.

This table also shows the median and the interquartile range for this particular disorder as

well. Table 2 is showing the data that was collected in the Kent & Kent (1989) study,
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which is the median and interquartile range values for all three categories: normative

data, ALS data, and the Hyperkinetic Dysarthria data. After looking at the data, the final

result concludes that the transition rate of the second formant frequency for those ALS

patients was intelligible when compared to the normative data. The Kent & Kent (1989)

study shows that the normative data has an interquartile range of .61 and a median of 3.2.

Thus, stating that the normative male that was studied does have intelligible speech

according to Kent & Kent (1989). The data that stated they were 90% above, meaning

above the 2.5 marker for the formant frequency, are considered intelligible, where those

that fell below 2.5 were considered to be unintelligible (Kent & Kent, 1989). Table 2

shows that the ALS data is as following, .89 for the interquartile range and 2.6 for the

median, meaning that the ALS patient is also considered to have intelligible speech. The

results of they Hyperkinetic Dysarthria patient are also listed here, showing that they two

are considered to be intelligible.

DISCUSSION

This particular patient with a Hyperkinetic Dysarthria with an Organic Voice

Tremor disorder can be generalized to the patient with ALS in the Kent & Kent (1989)

study. The reason this statement is made is because both of the data for the two disorders

considers them to have speech intelligibility. The second formant frequencies that were

collected from each of the patients indicate that they can indeed be generalized with one

another. A Hyperkinetic Dysarthria with an Organic Voice Tremor patient clearly has

different symptoms and other neurological defects compared to that of an ALS patient,
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however they are both able to be considered intelligible speakers, pertaining to this

specific situation and data.

Although this is generalized specifically to the ALS patient, it is difficult to state

whether or not it is generalized to all types of the various kinds of Dysarthria. It is not

assumed that any particular test for intelligibility is something that is going to be able to

satisfy every specific purpose in the actual assessment for intelligibility (Kent &

Weismer, 1989). Therefore, intelligibility is something that is sometimes quite vague and

difficult to determine whether or not someone is indeed intelligible.

There are many dysarthria disorders that people struggle with on a daily basis and

as a Speech Language Pathologist it is deemed necessary to be able to gain as much

speech intelligibility as possible out of them. However, as previously stated, every

disorder varies and these two disorders in particular, ALS and Hyperkinetic Dysarthria

with an Organic Voice Tremor, just so happen to fall under the same category when

comparing the second formant frequency transition rates.

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REFERENCES

Aronson, A., and Brown, J. (1969) Study of motor speech disorders. Journal of Speech

and Hearing Research.

Aronson, A., and Brown, J. (1975). Motor Speech Disorders

Boersma, P. & Weenink, D. (2009):Praat: Doing phonetics by computer (Version 5.1.15)

[Computer program].Retrieved September 9, 2009, from http://www.praat.org/

Ferrand, C. T. & Bloom, R. L. (1997). Introduction to organic and neurogenic disorders

of communication. Boston: Allyn and Bacon

Kent, R.D., Kent, J.F., Weismer, G., Sufit, R.L., Brooks, B.R., & Rosenbek, J.C. (1989).

Relationships between speech intelligibility and the slope second-formant

transitions in dysarthric subjects. Clinical Linguistics & Phonetics, 3, 347-358.

Kent, R.D., Wesimer, G., Kent, J.F., & Rosenbek, J.C. (1989). Toward phonetic

intelligibility testing in dysarthria. Journal of Speech and Hearing Research, 54,

482-499.
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Table 1
Transition Rates in Hz/ms for Stop Consonants and Vowel Syllables in a Hyperkinetic
Dysarthria Organic Voice Tremor Patient

Phonetic Syllables Words Second Formant Frequency (Hz/ms)

/tu/ to 4.1
/k / coat 2.8
/b / buttons 4.4
/bi/ beard 1.9
/g / giving 1.6

Median: 2.8
Interquartile Range: 1.7

This data above is from a study on a Hyperkinetic Dysarthria – Organic Voice Tremor
Patient.

Table 2
Transition Rates in Hz/ms for Stop Consonants and Vowels Syllables in the Current
Study for Kent et al 1998

Normative Data ALS Patient Hyperkinetic Dysarthria Patient

Median 3.2 2.6 2.8

Interquaritle Range .61 .89 .17

This data above is obtained from the Kent & Kent (1989) study on ALS patients as well

as a normal patient.