Reliability and validity of speech & pause measures during passage reading in ALS

Area of Science:

• Neurology
• Speech-Language Pathology

Background:

• Speech measures are increasingly utilized for monitoring bulbar disease progression in amyotrophic lateral sclerosis (ALS).
• Objective assessment of speech and pause timing is crucial for understanding disease trajectory.

Purpose of the Study:

• To establish the psychometric properties, including reliability, validity, sensitivity, and specificity, of speech and pause timing measures.
• To evaluate the utility of these measures in detecting early-stage bulbar ALS.

Main Methods:

• Analysis of a large dataset of passage recordings from individuals with ALS (N=775) and neurotypical controls (N=323).
• Utilized a semi-automatic method, Speech and Pause Analysis (SPA), for detailed acoustic analysis.
• Assessed reliability through repeated recordings in control participants and validity through group comparisons and correlations with clinical measures.

Main Results:

• Speech and pause measures demonstrated acceptable reliability and strong construct validity.
• Significant differences were found between ALS patients and controls, correlating with clinical severity.
• Speaking rate, pause events, and mean pause duration effectively identified presymptomatic bulbar ALS with high discrimination (AUC 0.81).

Conclusions:

• Speech and pause timing analysis is a valuable tool for detecting early and progressive changes in bulbar ALS.
• The established psychometric properties support its clinical application in ALS management.
• This method offers a sensitive approach to monitoring disease progression.