Comprehension of synthetic speech and digitized natural speech by adults with aphasia

Using text-to-speech technology to provide simultaneous written and auditory content presentation may help compensate for chronic reading challenges if people with aphasia can understand synthetic speech output; however, inherent auditory comprehension challenges experienced by people with aphasia may make understanding synthetic speech difficult. This study's purpose was to compare the preferences and auditory comprehension accuracy of people with aphasia when listening to sentences generated with digitized natural speech, Alex synthetic speech (i.e., Macintosh platform), or David synthetic speech (i.e., Windows platform). The methodology required each of 20 participants with aphasia to select one of four images corresponding in meaning to each of 60 sentences comprising three stimulus sets. Results revealed significantly better accuracy given digitized natural speech than either synthetic speech option; however, individual participant performance analyses revealed three patterns: (a) comparable accuracy regardless of speech condition for 30% of participants, (b) comparable accuracy between digitized natural speech and one, but not both, synthetic speech option for 45% of participants, and (c) greater accuracy with digitized natural speech than with either synthetic speech option for remaining participants. Ranking and Likert-scale rating data revealed a preference for digitized natural speech and David synthetic speech over Alex synthetic speech. Results suggest many individuals with aphasia can comprehend synthetic speech options available on popular operating systems. Further examination of synthetic speech use to support reading comprehension through text-to-speech technology is thus warranted.