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00:00:00
uh people who are speaking uh differently have that speech
00:00:06
and i'm always surprised how i'm i'm fascinated how
00:00:12
speech is organised and as you can see in the analysis that drop
00:00:16
present that it's complicated but when we do it is going automatically
00:00:21
fluently we can switch from one song to another we can switch one language to another
00:00:29
and it's always amazing for me still amazing after all that years
00:00:34
but unfortunately at its sensitive to damage
00:00:39
and that much is uh looking all the time around that can happen to everyone
00:00:44
and i'm happy with that this project uh because it will
00:00:49
pay a lot of attention to to this problem and help to solve a little
00:00:53
bit of this prop so but speak with you about this ah korea
00:00:59
and i hope it will be clear what is our idea is what
00:01:03
are the key features but do we have to pay attention to
00:01:07
how we can recognise it whether the descriptors it's not that we need to do it good to have a
00:01:14
very uh precise uh a diagnostic feeling but to understand
00:01:18
that the feel this is these are clear
00:01:21
that what is going about that way we can improve at that
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the speech of the patients and the intelligibility so i do introduce
00:01:32
myself i'm coming from and where it's the closest place
00:01:36
we're all the research issue came this morning i guess that they it's less than one hundred
00:01:40
kilometre from here maybe sixty kilometre and we uh are happy to participate in this project
00:01:48
i often use this ad image of and purpose in in in my introductions because it presents
00:01:55
the cathedral of antwerp like it is now in the right side with
00:01:58
a a very big tower it's famous for the skyline of antwerp
00:02:03
and then a small paul it's almost like one third of their uh left one
00:02:09
and everyone is wondering why is that why did it happen to different hours for a capital
00:02:15
and in the left side you see the image that the architects meeting the part in the past
00:02:21
that was the idea about the cat to do that was a a
00:02:25
and an immense monument than over estimation of what was possible because
00:02:29
finally there was not the money not that time they were commit hundreds of years and
00:02:35
the cathedral is what it is no in perfect that very beautiful and it happens
00:02:41
uh with people too and if you have a visit or hospital i hope not like a
00:02:46
patient but like to visit it you will see that stat you in the entrance
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and the name of the start you is how morph a morph means
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uh with the lack of a definite form or clear shape
00:03:01
it's in a place that you're in the beginning of on the the ugly
00:03:04
i thought can they find nothing better for the entrance but it's
00:03:09
what can happen to human beings to be imperfect to be without the
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formats we hope we always hope that is pressed and it's uh
00:03:20
it's an uh a practical aspect for speech too often it is not perfect
00:03:27
but that's why we are here so i will i speak about this
00:03:31
artery yeah and this up here is in the speech does order
00:03:35
like there are many people not address all of them maybe it is some of the speakers will do
00:03:41
but these are korea is is a very fascinating group for me because it's a big group
00:03:47
and it is for the first time described by um
00:03:53
da early aaronson a brown in nineteen uh seventy
00:03:56
five in this uh green book and still
00:04:00
the terminology good definitions are uh relying on that uh bach
00:04:08
and it's a little bit it was a solution to describe a difficult problem but
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it has a problem too because there are too many uh descriptors that or not
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well defined and we need a better a way to address this out here
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so these obvious a speech disorder resulting from weakness but others this or in
00:04:30
coordination of the musculature the speaks speech musculature that this neurological of origin
00:04:37
the trilogy is central it's more a high in the brain but
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if eric it's more like the level of the lips
00:04:47
you can be born with its congenital or acquired by can have a
00:04:52
stroke or a problem our next event with his obvious a consequence
00:04:57
the problem can be static i think about multiple
00:05:01
sclerosis patients that have a problem almost
00:05:05
all their life as long as they have the disease it can be progress it
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like in a lot of part in some patients or regress if
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it can improve if i have that much to open my
00:05:19
uh believing is absorbing in the brain then i will improve after a
00:05:23
number of weeks maybe a number of months but it's a different
00:05:28
evolution is possible and its associated with a big variety of neural janet diseases
00:05:34
and the most uh it's the most frequent speech disorder you can see in
00:05:42
hospitals and in healthcare settings of when we think it is uh
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a phase e. r. or something else but it is designed to just to have an auditory impression i have
00:05:53
the uh small movie of this patient that you get familiar with the sound
00:05:57
and you will hear i put it in the maximum of log was but i hope the
00:06:02
technical operate can put a little bit louder the speech of bizarre to patients is difficult
00:06:09
it's an acoustic nightmare for a lot of engineers that i was working with because
00:06:14
they have not enough intensity there have not clear borders of the sounds
00:06:18
it's it's it's horrible but that is also for the yeah
00:06:22
so just to give you an impression i get a i looked you he does patients a couple of you want to see
00:06:34
you hear you
00:06:38
oh no no i it
00:06:42
oh when i'm just
00:06:45
mm who the them
00:06:51
who the owners who do a loss of a womb
00:07:01
but the uh
00:07:05
just to have an impression so when i would ask it twos ride on the most reborn remarkable
00:07:12
as soon turns everyone will write something different because
00:07:16
you're you're is captured by the specific sound
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it's not important you you don't understand the language because you have
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to pay attention to the way he speaks it's p. h.
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and someone some people will say that this person is speaking very slow
00:07:33
the others will say the voice is soft and difficulty others say that because elation
00:07:37
is is not well differentiated then all all of them are right because
00:07:43
this page has problems in almost all the dimensions of speech we can further in
00:07:49
the in the question of classification to address that issue so about prevalence
00:07:57
you see here there's are a grass from the fee it's it's a
00:08:01
real preference for these are korean motor speech and he um
00:08:06
i calculated the number of patients uh it is a problem for the big group
00:08:12
and it's based on almost five hundred to evaluations you see the biggest group
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of acquired a communication disorders from the mayo clinic
00:08:22
is the group of this artery at a lot of people don't realise that
00:08:26
so a lot more than a phase yeah or eugenics
00:08:30
voices orders orb cycle agenda or other diseases
00:08:35
within that group of euro jen make this is on the did
00:08:39
new regenerate this is the i quiet speakers of that
00:08:43
but with the the group of your agenda this or this date is almost
00:08:47
fifty percent of the patients if you go to a department of urology
00:08:52
you go to ten rooms you will have more or less five frames with patients with these are clear to some degree
00:09:02
copy it's not it's different i will not address it to
00:09:06
i'm in detail but does actually it is not the same as a proxy of
00:09:10
speech because that is is teach these out it's mainly articulation that is affected
00:09:16
based on the cortical lesion and it is mainly a problem programming
00:09:23
the articulation and to organise to sequences of the sounds
00:09:27
uh that so it's not the yeah is not about that is obvious weakness
00:09:32
in coding nation uh and loss of control of the movements and of speech
00:09:40
and it's not a a phase yet because of phase yet is the language disorder
00:09:45
and i'm maybe someone else will address it and that is um affecting
00:09:50
the language people with a face it can articulate quite good
00:09:55
maybe they select the wrong sound but they have a language disorder and not the speech to sock
00:10:03
okay rope already shot the graph of the vocal tract and the vocal tract is uh
00:10:09
the way we produce sounds coming from from the likeness to
00:10:13
the to the mouth and to produce intelligible speech
00:10:19
i can not to make any sound when i have not a air to produce so it's a bottom up model
00:10:26
i cannot have a i can only have voice with wispy
00:10:29
relation i can only have risen of those qualities
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when i have voice so i need to to former process is i can only
00:10:39
articulate when i have uh some sound i can articulate without without voice
00:10:45
but you will not hear it the voices the carrier of the message and at the end you have prosody value can
00:10:53
have make your um speech more life with texans with intonation bit speech rate
00:11:00
so this important to understand that you cannot read use a speech is out
00:11:06
like this are clear to articulation what is happening in the market
00:11:12
you have to see speech as a complete uh
00:11:17
as in a complex of processes that are described here and that
00:11:22
will be affected in this doctor yeah more or less
00:11:28
one or more of these processes will be effect
00:11:33
what is that
00:11:36
the authors i mentioned barley aaronson a brown made a classification of
00:11:43
this act yeah people will work with it we'll see
00:11:46
it comes back all the time that types of this act yeah they they did
00:11:52
to organise their ideas about these are clear and
00:11:56
it was based on perceptual uh descriptors
00:12:02
it was a very huge work based on a lot of patience and they look for the uh type of this
00:12:09
artery yeah but you see here in the low courage but
00:12:14
the problem uh comes from and the primary deficits
00:12:20
they distinguish a two four six seven types some
00:12:26
discuss about this one bit in brackets but
00:12:29
i included because recent publications do with l. so and one is called the flats it
00:12:37
and it is mainly weakness of speech you can remember it like that
00:12:42
but it's not that important if you forget this plastic is specificity su not with this
00:12:48
i'm bridget out with the cramp attack sick is a problem of coordination
00:12:55
and it's mainly a due to settle control uh problems settler control problems
00:13:02
the hyper kinetic type is what you recognise him parkinson patients get rigidity
00:13:09
it's a a lack of movements and you see it in the face you see it in the movements of the handset the lex
00:13:16
if you see uh parkinson patient walking are moving you will see
00:13:20
you make small steps small articulation movements so it's a lack
00:13:24
of a movement ten digits the hyper kinetic is involuntary movements
00:13:32
uh yeah the uni lateral uh and uh uh promote on your own uh
00:13:36
these are clear which i will not address and the mixed form
00:13:40
that is very important because a majority of patients have more
00:13:45
than one problem so to understand the idea about that
00:13:51
classification it's important to note that control of the speech
00:13:57
is coming from uh the motor cortex that has
00:14:02
uh an important role in the planning and the initiating the speech
00:14:07
but the execution is in the very for it if it parts
00:14:12
so it you have an upper more talking you wrong
00:14:15
and allow remote when you're wrong and that is uh from all the level of
00:14:20
the uh brings them the speaker one no remote and your own disease
00:14:25
it just says something about the level of pathology that provokes the uh the soccer
00:14:34
okay what are bad descriptors that donnelly and products
00:14:38
made in nine the seventy five they
00:14:42
distinguish thirty eight descriptors so you feel already this
00:14:48
is a difficult model even for trained clinicians
00:14:53
i have more than thirty five eight years of experience it's it's very hard to do
00:14:58
that in the in the good way and you see a lot of this
00:15:04
descriptors are related with voice you hear voice today modified loudness the key a
00:15:11
harsh voice bread the voice that or all related with vocal symptoms
00:15:19
you have a number of descriptors related with
00:15:24
a resonance hyper nasality is thinking mine on on
00:15:29
on the time just type of nasality
00:15:32
hypo necessity is the lack of nasal resonance
00:15:36
uh sometimes you have nasal admission is patience to make it sounds coming by the nose
00:15:44
a number of descriptors are related with a spirit
00:15:47
with the respiration forced in an expedition
00:15:51
and all the others have correlated with prosody speech
00:15:55
rate too fast too slow increase of rate
00:15:58
short pressures of a row speech rate variable rate
00:16:03
and the last correlated with that relation
00:16:07
which is very important and probably the most important in our
00:16:13
understanding of fathers and is the precise nest of the sound
00:16:18
and the capacity of the patient to produce distinctive features
00:16:24
like rob described then if you lose that distinctive characteristic
00:16:28
you lose the intelligibility so that is important patients can do that can
00:16:33
i have that capacity because that will make you to understand that
00:16:38
okay so i will go with you to a number of this types
00:16:43
just to have an i. t. so the first died that day
00:16:47
uh that described was the flask this out yeah that is a
00:16:52
a problem of the lower motor new wrong main it's often
00:16:56
brain stump ontology and it just see a lot
00:17:00
of these patients have um a traumatic origin
00:17:04
like a surgical from unfortunately when your operated from but you more always that much
00:17:10
can be there after the surgery and you can he read here the characteristics
00:17:18
while i played to the sample the samples or from the uh that
00:17:23
happens on tapes that are famous tapes with his optics samples
00:17:27
and they always use an um standard passage it's something we always like to use than the
00:17:33
passage because you know what you have to hear from so this is the grandfather passage
00:17:39
um it's a famous passage with that is phonetically balanced and used often for speech recordings
00:17:45
um and you will hear because the system is has a lack of um muscle power
00:17:52
you hear hyper nasality speaking by the nose a breathy voice noisily mission
00:17:58
in precise consonants sometimes to be that you also hear it is monotonous
00:18:04
short sentences and if you look to the patient this is on the you know the sample but with the absolute
00:18:11
you see also lack of expression a lack of movements
00:18:16
of the lips so the hype attorney is
00:18:18
something you can see what hockey and that you're here to get familiar with the sound
00:18:25
ooh oh
00:18:30
while ooh well oh
00:18:36
ooh oh well
00:18:43
ooh oh
00:18:50
oh ooh oh uh_huh
00:18:55
oh ooh
00:18:59
okay does the it starts like you wish to now all about my grandfather if you don't
00:19:05
know that sentences you can not guess what the patient to see so it's very
00:19:11
uh and caressing for patients but also for family clinicians
00:19:15
when you're confronted with someone and you don't
00:19:17
understand anything so if you don't know the context that you lose all the all the information
00:19:24
and you hear all the the descriptors are they are but when
00:19:29
you hear didn't next samples you would say okay this is
00:19:33
quite similar quite soon they look all it's all that speech
00:19:37
and they're all have a similar characteristics that is uh
00:19:41
okay let me show you uh let you hear something about specific these are clear
00:19:48
that is often a out the consequence of a degenerative disease
00:19:55
so that patients are yan mainly progress if and coke
00:20:00
also here you have the in precise consonants
00:20:03
but the voice is not that to be the voices more rough and strained
00:20:08
uh but the speech rate is slow too so the you can see these patients have sorry
00:20:15
have spots to city you can often see it in the face are in there
00:20:20
uh next or in the arms they have often have um in
00:20:24
the plead yep it's about alice's of of of the body
00:20:28
a a hyper reflects yeah it's a reacting very primitive on on statement so i
00:20:37
mm play the sample line way well oh we don't know all well mine
00:20:44
when ah well new yale oh ooh
00:20:50
oh yeah sure we yeah one
00:20:53
the religion no ooh well well well new
00:21:00
oh well we're doing really chain new one o. name
00:21:08
ooh okay you know maybe you understood better you wish
00:21:12
to know all about my grandfather his almost ninety
00:21:15
four years old so if you know there's so you can follow and you hit devices is a
00:21:21
i'm ralph but you can understand it better the articulation is a little bit more precise
00:21:27
but it's still that speech but you when you try to understand that you don't know the context
00:21:34
so this is a this was this plastic now we go to the at tech sick at texas this artist
00:21:41
or a related with the set up the other system
00:21:46
and the said about the system uh is here
00:21:50
and this and functioning like a coordinator for the speech and if you have a
00:21:56
a problem in the setup ellen it's difficult to walk to keep your buttons
00:22:02
and to speak with the with the ride a prose of
00:22:05
the you will hear that it's specifically um it has
00:22:10
it's strange accent so often these patients put accents where you
00:22:14
don't expect them because they have no control on
00:22:18
uh on the speech you can compare with with someone who have who has alcohol abuse
00:22:25
yeah for a suitable or a symptoms to when you hit
00:22:28
that they make sometimes a a strange um accent
00:22:33
but you don't expect it of course the articulation is that too and they have variable speech rate
00:22:41
listen to them
00:22:43
lunch change oh well well well thank you will see a yep style
00:22:52
well thank you also for each trash oh well oh well i well you change chaplains
00:23:01
now they are language change change while still
00:23:06
sell right now well i average
00:23:12
okay
00:23:14
that for attacks sick hyper kinetic uh type
00:23:19
is due to an extra vitamins out a problem uh the
00:23:24
most um the best known as the parkinson disease
00:23:28
and typical for the parkinson disease if you remember a famous faces and here you have a
00:23:35
uh did expo up you have a mormon tallied a number of others you see deface
00:23:42
is a rigid so you see no uh no me make
00:23:46
the eyesore are not moving well they have a
00:23:50
a rigid face they call it a mosque the parking some mass
00:23:54
they look like and uh with fit with few expression
00:23:59
and it's one no and that is the same for the speech you you hit few expression
00:24:04
uh monotony now accent no distinctiveness between consonants
00:24:10
and short clashes of speech is sometimes a speedup for a number
00:24:14
of syllables and then they go slowly getting it's very unpredictable
00:24:20
and the um uh the so that they are in
00:24:24
general slow and another typical aspect for this type
00:24:27
is that it can happen that the three more um is present unlikely to sometimes for the hands
00:24:34
uh it is uh the keys for the speech and you can something to eat on the on the walls
00:24:40
uh sometimes you hear repetitive sounds to uh like in
00:24:44
stuttering you sometimes confuse that it may be stuttering
00:24:50
okay
00:24:52
whoa whoa whoa whoa whoa whoa whoa
00:24:59
whoa whoa whoa whoa whoa
00:25:04
whoa whoa whoa whoa whoa whoa whoa whoa whoa what okay
00:25:12
but everyone knows uh parkinson patient that's very well
00:25:16
oh i will will recognise it it is
00:25:21
a a problem and it's progressive
00:25:24
and the therapy is asking special or a special approach
00:25:29
that uh uh be been addressed later on
00:25:32
okay that hyper kinetic bizarre korea is uh uh like to recognise
00:25:39
in the korea disease it is i mean the correct rise
00:25:43
by this still new at this tune yeah is that lack of control on the most also the most of the slide
00:25:50
heck in a cramp all the time or makes unexpected movements
00:25:55
and a lot of times the region is not known
00:25:59
and they distinguish two types it's not that important to know with it
00:26:03
just uh the image that you have to take with you but
00:26:09
i give us a sample of um this don't yeah uh one
00:26:14
of the quick type in one of the slow tied um
00:26:18
it is more theoretical different but okay try to focus on
00:26:22
the sound and to get whoa whoa whoa whoa whoa
00:26:31
whoa whoa whoa whoa whoa
00:26:36
whoa whoa whoa whoa whoa whoa whoa whoa whoa yeah oh
00:26:42
okay wait it stick this is a yeah ah ah
00:26:54
it was working but want to know what the sound so i hope it
00:26:58
yeah ah roller hockey buzz shame on ah
00:27:04
um didn't change your johnston probably uh_huh
00:27:08
yeah a big yeah ah yeah o. d. yeah there's another one
00:27:17
ah
00:27:19
yeah really just a minute little fish withdrawn from twenty one to to see it
00:27:27
re
00:27:32
yeah uh_huh uh_huh
00:27:37
ah huh oh no well it big joe
00:27:44
p. h. p. h. no well i should know better but ah you see
00:27:54
d. o. k. o. k. o. big how will be
00:28:00
huge the h. c. f. p. h. okay if you don't know that
00:28:06
patient the first time i heard it i thought it was
00:28:09
a a patient with the is vigil speech
00:28:14
like a lead injected me because it seems like he's injecting yeah it is it is it just don't yeah
00:28:20
and uh and his reading that touch standard passage pop and lose
00:28:26
some other source on the bottom of the today this that isn't capital so i don't think but i'd as you
00:28:32
almost no one can understand anywhere and that this is
00:28:36
typically for distorting yeah it's very difficult to control
00:28:40
uh the patience to this with difficult is that try to control the is the this don't yeah with
00:28:46
a bow talks that improved to uh for a while but it's a different and it's a very
00:28:53
yet in russian problem okay and upper motor new in just
00:28:58
to finish is it's a lighter form um it's
00:29:03
a unilateral dimension the promoted in your own unilateral means you have always
00:29:07
a better chance for composition we have we are lucky to have
00:29:11
two parts in the brain and sometimes uh the other one is assisting a little bit
00:29:17
almost always vascular and it gives more light problems
00:29:26
oh
00:29:29
oh
00:29:32
oh i thought
00:29:41
so you're here it is um i understand the boat you can follow it but it's not the
00:29:48
speech we expect from an adult lady with a good indication so it will always give uh
00:29:55
a difficult feeling it for these people even when you speak like this it is a difficult
00:30:01
to make a good context to do a solicitation to do that kind of things
00:30:06
and finally the mixed is our korea that is the majority
00:30:09
of the uh this obvious you have here and um
00:30:14
and p. l. s. patients that are made perfect lateral sclerosis maybe you know with
00:30:19
it's a very severe progress if a disease that uh often
00:30:26
oh whoa oh oh
00:30:30
oh oh oh oh oh oh we'll
00:30:36
oh oh oh oh we'll hockey i move on because
00:30:43
probably difficult to understand and they look all
00:30:48
that this thing but that is the point of my story so what is that
00:30:54
this type this classification was a a nice in
00:31:00
the time to understand better this sentence
00:31:03
and you're not just in that time relied on the speech in terms to
00:31:09
gets something about the origin in the brain
00:31:13
meanwhile arm your imaging is very precise
00:31:17
not when you're not just didn't rely on it so they look to
00:31:20
the images and they can find me back to die noses
00:31:25
on images than on sounds all whatever sometimes we see
00:31:29
patients coming for the first time in my department
00:31:33
say okay my speech changed and they have a little bit of hyper necessity
00:31:38
to have a little bit change of a a a speech rate
00:31:43
and we are always suspected because one of the first signs
00:31:47
of uh didn't is degenerative diseases is speech changes
00:31:52
and sometimes you send them to your o. g. m. they seem to have
00:31:55
clear images and three or five months later it seems they have
00:32:00
uh i did that disease uh anyway so it is often a predicted that this something coming
00:32:07
and that cannot to always be a confirmed by
00:32:11
the first investigations unfortunately so this classification
00:32:17
is universal is used in all the centres this standard
00:32:22
but it's uh that is good but the bad thing is
00:32:26
the classification is always problematic insisted is about reliability
00:32:32
only five studies on setting can say it is an acceptable
00:32:35
reliability let the but if we are if it's good
00:32:39
uh we have a training then the majority in this room should make
00:32:42
this same classification and that is not the the case in it
00:32:47
the one of the most recent the investigations was here from the netherlands where they at
00:32:54
checked euro just and three anything neurology all they could classify correctly
00:33:01
they cases that were presented and only a thirty five to forty percent of the cases are
00:33:09
classified in a corporate so it means that even for specialist it is a
00:33:14
challenge i and a problem too if you don't do it correctly so
00:33:21
um what is my advice always to to my students
00:33:26
that it is better to make an accurate description
00:33:30
then to make a wrong classification if you had the right
00:33:34
if you can put your finger on the right problem
00:33:38
if you can make a good inventory of the problems you can think about improving
00:33:43
and about solutions that is what we need to do to do now
00:33:48
what is the most the problem with the biggest impact on intelligibility
00:33:53
and how can be managed to improve intelligibility in the speech
00:34:00
so better good description but we need the good descriptors
00:34:07
and uh i will not go far in the assessment that the descriptors we use perceptually
00:34:14
or good but always perception is the human ear
00:34:20
and i learned in my long period that your own
00:34:24
here is a liar you hear what you want
00:34:28
to hear what you like to hear what you hope to hear it's like a doctor always
00:34:34
or then to see the problems that he thinks that are present it's
00:34:39
yeah except beneath their bias and we have it all i confess i have
00:34:45
it all at least and then when i had a lot of not
00:34:49
so we need better descriptors and i'm a big believer
00:34:52
that acoustics an acoustic measurements and acoustic approach
00:34:57
is helpful to understand better to control better that examine it and bias
00:35:04
so uh there is no standard to assess um this out yeah
00:35:09
a two more there's assertion about speech assistant so i will not go for but
00:35:15
we rely always on this model of the of
00:35:19
world health association to describe the body functions
00:35:24
uh the activities because i can have a severe problem but i can have
00:35:28
still good activities and participation this five piece of my
00:35:34
the problem i problem with depend on more than mind this is a long
00:35:39
okay i don't not going to the projects cut that
00:35:42
we know but a good protocol for motor speech
00:35:49
we'll look to nonspeech activities you look to the mall to the lips how they can
00:35:53
move out the muscles or how they can behave so that this nonspeech it's
00:35:59
even when a patient doesn't speak you can read a lot
00:36:05
the second is that you we do the perceptual characteristics
00:36:09
we don't escape we have to to register done
00:36:13
the target is to have a good measure for intelligibility because
00:36:17
intelligibility is the key to our communication uh_huh even
00:36:21
when i'm speaking to slow and you can understand me all one hundred percent there is no problem
00:36:27
i'm slow but there's no problem divine speaking to forced to be be a problem so
00:36:33
small details or an important as long as you can understand your part in communication
00:36:41
number four or objective measurements that have to be go to and
00:36:47
recognisable bike technicians because often uh engineers and physicists look
00:36:52
for measures and use a a different language
00:36:57
a a different approach and we're thinking more in a in patients b. c. the look and
00:37:03
feel of the patient and lessen the sound but we have to learn from each other
00:37:08
and then a big believer debt these descriptors out at least
00:37:12
helped me a lot in the past to um
00:37:17
just if i had to put my own perception into the right perspective
00:37:22
and the last uh is to have a a good solid assessments with the quality of life measurements i'm sorry
00:37:30
are very important to now what is the impact of this problem on a patient slide
00:37:36
that are very very important issues i will um finish here but if someone
00:37:42
has a question her remark i would be happy to reply it
00:37:48
hi
00:37:58
okay up his yeah
00:38:30
okay i understand what you say and i i've been i say that here
00:38:35
is a is a liar that is due to a certain degree because
00:38:41
of course we have a standard and princes i did myself
00:38:45
a lot of research for voice quality and perceptual scales
00:38:51
and the standard for saying that voices normal orbit forces bat
00:38:56
is the human ear because say okay this voice
00:38:59
sounds good so you don't need this group is and if you use it this is not good
00:39:05
you don't need to be intelligent not to be trained because you have an internal standard about a good voice
00:39:12
it's like you have a good idea about size if you admit to person like this this is this is
00:39:16
too small even if i don't know the exact measure of persons it that's a place or society
00:39:23
so we have an internal standard but it's it's uh you have to know the
00:39:27
mechanisms if you see a lot of that patients what i do every day
00:39:33
you get familiar with it you start accepting it so but i don't see a lot of comics
00:39:39
who work more in in in the high mind make in radio a presence in there
00:39:44
listen to me but this is but i see is good we understand the man and
00:39:48
so we have a different opinion about good and bad it's within the spectrum everywhere
00:39:54
so we know that when we can avoid it with judging
00:39:59
with panels and with the groups office experts and
00:40:02
that's the way we do it because you cannot rely on one judge this at least what that and
00:40:08
because you you change your opinion while you're doing that give a professor is doing
00:40:13
coral examinations with you and you can just after a very clever one
00:40:19
you have the risk to to do have a lower judgement and then
00:40:23
you come after in a a stupid one so it will
00:40:26
the ranking of the what you hear is presented the familiarity
00:40:31
it's so critical we have to be aware of that and of course the
00:40:37
it's through the perception is that they're the gold standard for
00:40:42
saying it's normal good that more or less but we have to uh
00:40:50
to uh combine it that's the way we try to do it through
00:40:53
voice to we try to do always objective measurements and to see
00:40:58
do we find confirmation for what we hear or do we don't we find that any confirmation then we
00:41:04
have to question or cells and it's good to build models that based or based on perception but
00:41:11
um yeah it's always the question how good was
00:41:16
that perceptual classification yeah i it's a it's a
00:41:20
strange um phenomenon ah and i work more
00:41:26
than twenty years with the on perception and i'm always amazed with the with the
00:41:31
judgements sessions and so we you have to organise vertigo but of course it's the baby have to do with
00:41:37
and but i'm sure your perception is improving when you're
00:41:41
supported with good the measures i'm sure about that
00:41:46
okay please
00:41:59
i
00:42:02
that is of course
00:42:11
oh
00:42:24
ah but if you use all that aspects of the evaluation protocol of
00:42:30
the assessment protocol we have a good overview you don't miss
00:42:33
you're not it's it's objective and subjective it's uh with assessment of that
00:42:39
investigator with the judgement of the patients show you combine different sources of information so you
00:42:45
will have a well balanced approach it's weird that this i'm not no problem either
00:42:54
uh
00:42:56
oh
00:43:06
because he gets familiar with his disease or he accepts it but it's something you have to know how
00:43:11
it happens that that people feel a lot better but the opposite happens to that clinicians during the
00:43:18
patients is is it that you're a lot better we understand you better but he's still unhappy
00:43:23
and a lot of patients still always look to the worst thing it's like a
00:43:28
uh we look always to the worst part of of of the body or or your
00:43:33
so it is but it's like that you have to know but then it's if a patient has not the real uh
00:43:39
that feeling with his speaking control you have to wonder if
00:43:44
you have to organise a program or not though

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Conference Program

Introduction to Phonetics and Speech
Rob van Son, Amsterdam
Sept. 24, 2018 · 9:02 a.m.
297 views
Dysarthria
Marc de Bodt, Antwerp
Sept. 24, 2018 · 9:45 a.m.
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Children’s speech: development, pathologies and processing
Alberto Abad, Lisbon
Sept. 24, 2018 · 2 p.m.
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Speech after Treatment for Head and Neck Cancers
Michiel van den Brekel, Amsterdam
Sept. 24, 2018 · 2:45 p.m.
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Speech therapy
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eTherapy
Elmar Nöth, Erlangen-Nürnberg
Sept. 25, 2018 · 11:45 a.m.
128 views
Assessment in speech disorders
Virginie Woisard, Toulouse
Sept. 25, 2018 · 2:45 p.m.
138 views

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