Item Details

Reduced breath support in a speaker with dysarthria secondary to multiple sclerosis: Its impact on conversational speech

Issue: Vol 4 No. 1 (2013) Conversation Analytic Investigations of Dysarthria and Hearing Impairment

Journal: Journal of Interactional Research in Communication Disorders

Subject Areas: Linguistics

DOI: 10.1558/jircd.v4i1.27


This case study describes a patient with reduced breath support due to multiple sclerosis. Although deficits to the supralaryngeal structures are more commonly associated with a reduction in intelligibility, atypical breathing patterns can severely impact the perceptual coherence of dysarthric speech. This is most likely to manifest in conversational speech as the demands of correctly signalling syntactic, pragmatic and interactional information all rely on control of the breath support system. The study uses the method of interactional phonetics to consider in combination the role of phonetic, linguistic and interactional design in the speaker’s natural conversation. The analysis was carried out by taking into account the sequential order of turns and representative extracts are presented. The patient’s dysarthria has previously been identified as mild but the findings indicate that issues surrounding breath group length, speech rate and phonatory instability all surface in conversational speech. Of particular interest are the introduction of new person referents and their potential to trigger repair sequences. The findings indicate that a mild dysarthria with reduced breath support as a primary symptom can cause considerable problems of understandability in conversational speech. However, attention to the way in which potentially problematic interactional tasks are carried out and the successful use of repair strategies can minimise these issues.

Author: Ben Rutter

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References :

Auer, P. and Rönfeldt, B. (2004). Prolixity as adaptation: Prosody and turn-taking in German conversation with a fluent aphasic. In E. Couper-Kuhlen and C. E. Ford (eds) Sound Patterns in Interaction, 171–200. Amsterdam: John Benjamins.
Bellaire, K., Yorkston, K. M. and Beukelman, D. R. (1986). Modification of breath patterning to increase naturalness of a mildly dysarthric speaker. Journal of Communication Disorders, 19 (4): 271–280.
Bloch, S. and Wilkinson, R. (2009). Acquired dysarthria in conversation: identifying sources of understandability problems. International Journal of Language and Communication Disorders 44 (5): 769–783.
Boersma, P. and Weenink, D (2012). Praat: doing phonetics by computer [Computer program]. Version 5.3.18, retrieved 15 June 2012 from
Bradlow, A. R., Kraus, N. and Hayes, E. (2003). Speaking clearly for children with learning disabilities: Sentence perception in noise. Journal of Speech, Language, and Hearing Research 46 (1): 80–97.
Comrie, P., Mackenzie, C. and McCall, J. (2001). The influence of acquired dysarthria on conversational turn taking. Clinical Linguistics and Phonetics 15 (5): 383–398.
Curl, T. (2004). ‘Repetition’ repairs: The relationship of phonetic structure and sequence organization. In E. Couper-Kuhlen and C. E. Ford (eds) Sound Patterns in Interaction, 273–298. Amsterdam: John Benjamins.
Duffy, J. R. (2005). Motor Speech Disorders: Substrates, Differential Diagnosis and Management (2nd edn). St Louis, MO: Elsevier Mosby.
Feijo, A. V., Parente, M. A., Behlau, M., Haussen, S., De Veccino, M. C. and Faria Martignago, B. C. (2004). Acoustic analysis of voice in multiple sclerosis patients. Journal of Voice 18 (3): 341–347.
Ferguson, S. H. and Kewley-Port, D. (2007). Talker differences in clear and conversational speech: Acoustic characteristics of vowels. Journal of Speech, Language, and Hearing Research 50: 1241–1255.
Fox, C., Morrison, C., Ramig, L. and Sapir, S. (2002). Current perspectives on the Lee Silverman Voice Treatment (LSVT). American Journal of Speech-Language Pathology 11: 111–123.
Goberman, A. M. and Elmer, L. W. (2005). Acoustic analysis of clear versus conversational speech in individuals with Parkinson disease. Journal of Communication Disorders 38 (3): 215–230.
Halliday, M. A. K. and Hasan, R. (1976). Cohesion in English. London: Longman.
Hartelius, L., Buder, E. H. and Strand, E. A. (1997). Long-term phonatory instability in individuals with multiple sclerosis. Journal of Speech, Language, and Hearing Research 40: 1056–1072.
Heselwood, B. (2007). Breathing-impaired speech after brain haemorrhage: A case study. Clinical Linguistics and Phonetics 21 (8): 577–604.
Hoit, J. D., Solonon, N. P. and Hixon, T. J. (1993). Effect of lung volume on voice onset time (VOT). Journal of Speech and Hearing Research 36: 516–520.
Huggins, A. W. F. (1978). Speech timing and intelligibility. In J. Requin (ed.) Attention and Performance, VII. Hillside, N.J.: Lawrence Erlbaum.
Hustad, K. C. and Weismer, G. (2007). A continuum of interventions for individuals with dysarthria: Compensatory and rehabilitative treatment approaches. In G. Weismer (ed.), Motor Speech Disorders: Essays for Ray Kent, 261–303. San Diego, CA: Plural Publishing.
Jasperson, R. (2002). Some linguistic aspects of closure cut-off. In C. E. Ford, B. A. Fox and S. A. Thompson (eds) The Language of Turn and Sequence, 257–286. Oxford: Oxford University Press.
Lansford, K. L., Liss, J. M., Caviness, J. N. and Utianski, R. L. (2011). A cognitive perceptual approach to conceptualizing speech intelligibility deficits and remediation practice in hypokinetic dysarthria. Parkinson’s Disease 2011.
Liss, J. (2007). The role of speech perception in motor speech disorders. In G. Weismer (ed.), Motor Speech Disorders: Essays for Ray Kent, 187–219. San Diego, CA: Plural Publishing.
Local, J. (2004). Getting back to prior talk: and-uh(m) as a back-connecting device. In E. Couper-Kuhlen and C. E. Ford (eds), Sound Patterns in Interaction: Cross-linguistic Studies of Phonetics and Prosody for Conversation, 377–400. Amsterdam and Philadelphia, PA: John Benjamins.
Ogden, R. (2001). Turn transition, creak and glottal stop in Finnish talk-in-interaction. Journal of the International Phonetics Association 31 (1): 139–152.
Rutter, B. (2009). Repair sequences in dysarthric conversational speech: A study in interactional phonetics. Clinical Linguistics and Phonetics 23 (12): 887–900.
Sacks, H. and Schegloff, E. A. (1979). Two preferences in the organization of reference to persons and their interaction. In G. Psathas (ed.) Everyday Language: Studies in Ethnomethodology, 15–21. New York: Irvington Publishers.
Sacks, H., Schegloff, E. A. and Jefferson, G. (1978). A simplest systematic for the study of turn-taking in conversation. Language 50 (4): 696–735.
Schegloff, E. A. (2007). Sequence Organization in Interaction: A Primer in Conversation Analysis. Cambridge: Cambridge University Press.
Schegloff, E. A., Jefferson. G. and Sacks, H. (1977). The preference for self-correction in the organisation of repair in conversation. Language 53 (2): 361–382.
Schegloff, E.A. and Sacks, H. (1973). Opening up closings. Semiotica 8 (4): 289–327.
Sidnell, J. (2010). Conversation Analysis: An Introduction. Chichester: WileyBlackwell.
Smiljanic, R. and Bradlow, A. R. (2005). Production and perception of clear speech in Croatian and English. Journal of the Acoustical Society of America 118 (3): 1677–1688.
Smith, S. W., Noda, H. P., Andrews, S and Jucker, A. H. (2005). Setting the stage: How speakers prepare listeners for the introduction of referents in dialogues and monologues. Journal of Pragmatics, 37 (11): 1865–1895.
Tarplee, C. and Barrow, E. (1999). Delayed echoing as an interactional resource: A case study of a three year old child on the autistic spectrum. Clinical Linguistics and Phonetics, 13(6), 449-482.
Theodoras, D. G., Murdoch, B. E. and Ward, E. C. (2000). Perceptual features of dysarthria in multiple sclerosis. In B. Murdoch and D. Theodoros (eds), Speech and Language Disorders in Multiple Sclerosis, 30–46. London: Whurr.
Tjaden, K. and Watling, E. (2003). Characteristics of diadochokinesis in multiple sclerosis and Parkinson disease. Folia Phoniatrica Logopaedica, 55 (5): 241–259.
Utianski, R. L., Lansford, K., Liss, J. M., Azuma, T. (2011). The effects of topic knowledge on intelligibility and lexical segmentation in hypokinetic and ataxic dysarthria. Journal of Medical Speech Language Pathology 19 (4): 25–36.
Walker, G. (2007). On the design and use of pivots in everyday conversation. Journal of Pragmatics 39 (12): 2217–2243.
Wells, B. and Local, J. (2009). Prosody as an interactional resource: A clinical linguistic perspective. International Journal of Speech-Language Pathology. 11 (4): 321–325.
Yorkston, K. M. (1999). Management of Motor Speech Disorders in Children and Adults. Austin, TX: Pro-Ed.
Yorkson, K. M., Beukelman, D. R. and Bell, K. R. (1988). Clinical Management of Dysarthric Speakers. Boston, MA: Little, Brown and Company.