Patterns of Misidentified Vowels in Individuals With Dysarthria Secondary to Amyotrophic Lateral Sclerosis

Purpose: The current study examines the pattern of misidentified vowels produced by individuals with dysarthria secondary to amyotrophic lateral sclerosis (ALS). Method: Twenty-three individuals with ALS and 22 typical individuals produced 10 monophthongs in an /h/-vowel-/d/context. One hundred thirty-five listeners completed a forced-choice vowel identification test. Misidentified vowels were examined in terms of the target vowel categories (front-back; low-mid-high) and the direction of misidentification (the directional pattern when the target vowel was misidentified, e.g., misidentification "to a lower vowel"). In addition, acoustic predictors of vowel misidentifications were tested based on log first formant (F1), log second formant, log F1 vowel inherent spectral change, log second formant vowel inherent spectral change, and vowel duration. Results: First, high and mid vowels were more frequently misidentified than low vowels for all speaker groups. Second, front and back vowels were misidentified at a similar rate for both the Mild and Severe groups, whereas back vowels were more frequently misidentified than front vowels in typical individuals. Regarding the direction of vowel misidentification, vowel errors were mostly made within the same backness (front-back) category for all groups. In addition, more errors were found toward a lower vowel category than toward a higher vowel category in the Severe group, but not in the Mild group. Overall, log Fl difference was identified as a consistent acoustic predictor of the main vowel misidentification pattern. Conclusion: Frequent misidentifications in the vowel height dimension and the acoustic predictor, F1, suggest that limited tongue height control is the major articulatory dysfunction in individuals with ALS. Clinical implications regarding this finding are discussed.