Communication Experiences of Neurological Voice Disorder Patients With Automatic Voice Assistants and Human Listeners

Automated voice assistants (AVAs) are increasingly important to modern communication. Neurological voice disorders (NVDs) impair voice quality and speech intelligibility, leading to communication challenges. Although dysphonia disrupts communication with human listeners, the communication experience with AVA is unknown for individuals with NVDs. This study aimed to investigate self-reported communication experiences across AVA and human interactions for individuals with NVDs.

Cross-sectional METHODS: The patient group comprised individuals with NVDs who were planning to receive botulinum toxin for their voice. The control group consisted of vocally typical adults. All participants provided HIPAA (Health Insurance Portability and Accountability Act) release and completed a novel five-item speech communication experience survey (SCES) and the speech handicap index (SHI). Fisher's exact test and two-sided t tests were used to compare results between groups.

Across SCES items, the NVD group (n = 46) reported greater self-perceived communication challenges compared with the control group (n = 90) with familiar listeners (false discovery rate [FDR] = 0.0008), unfamiliar listeners (FDR = 0.0008), and AVAs (FDR = 0.0008). The NVD group interacted more with AVA (0.04) and liked AVA less (0.0037). Additionally, the NVD group reported significantly higher SHI total scores than the control group (P < 0.0001).

Individuals with NVDs, undergoing botulinum toxin treatment, experience substantial speech-related communication barriers with humans and AVAs. Study findings expand knowledge of NVD communication experience and highlight the need for inclusive speech technology.