JSLHR
Article
An Acoustic Study of the Relationships Among
Neurologic Disease, Dysarthria Type,
and Severity of Dysarthria
Yunjung Kim,a Raymond D. Kent,b and Gary Weismer b
Purpose: This study examined acoustic predictors of speech
intelligibility in speakers with several types of dysarthria
secondary to different diseases and conducted classification
analysis solely by acoustic measures according to 3 variables
(disease, speech severity, and dysarthria type).
Method: Speech recordings from 107 speakers with dysarthria
due to Parkinson’s disease, stroke, traumatic brain injury, and
multiple system atrophy were used for acoustic analysis and for
perceptual judgment of speech intelligibility. Acoustic analysis
included 8 segmental/suprasegmental features: 2nd formant
frequency slope, articulation rate, voiceless interval duration,
O
ne of the most important developments in the
understanding of dysarthria was the introduc-
tion of a classification system by Darley, Aronson,
and Brown (1969a, 1969b). This system (hereafter, the
Mayo System) is widely used for research and clinical
purposes, but questions persist concerning its reliability
and validity for different groups of raters. Zyski and
Weisiger (1987), who reported on ratings by graduate stu-
dents and experienced clinicians, expressed doubts about
the suitability of the system for clinical purposes, noting
low reliability and low rates of accurate classification.
More recently, Fonville et al. (2008) reported on classifi-
cation accuracy for neurologists and neurology trainees,
and Van der Graaf et al. (2009) reported on classification
accuracy for neurologists, residents in neurology, and
speech therapists. In these studies, the rate of correct
a Severity of Dysarthria
Louisiana State University, Baton Rouge
b
University of Wisconsin—Madison
Correspondence to Yunjung Kim: ykim6@lsu.edu
Editor: Anne Smith
Associate Editor: Wolfram Ziegler
Received January 26, 2010
Accepted August 30, 2010
DOI: 10.1044/1092-4388(2010/10-0020)
Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011 • D American Speech-Language-Hearing Association
1st moment analysis for fricatives, vowel space, F0, intensity
range, and Pairwise Variability Index.
Results: The results showed that (a) acoustic predictors of speech
intelligibility differed slightly across diseases and (b) classification
accuracy by dysarthria type was typically worse than by
disease type or severity.
Conclusions: These findings were discussed with respect to
(a) the relationship between acoustic characteristics and speech
intelligibility and (b) dysarthria classification.
Key Words: acoustic measures, dysarthria, classification
classification ranged from about 35% to 40%. Both Fonville
et al. and Van der Graaf et al. concluded that classification
by perceptual judgment alone is not adequate and that
professionals should rely on other sources of information.
On the other hand, Guerra and Lovely (2003) reported
promising results for classification of dysarthria type us-
ing nonlinear self-organizing maps operating on a com-
bination of acoustic and perceptual data. A recent study
by Liss et al. (2009) reported that rhythm metrics are
able to distinguish dysarthric speech from controls and
even between dysarthria subtypes, when the subtypes
are chosen to be highly representative of their classical
description. Forty years after publication of the Mayo
System, it seems fair to say that its classification accu-
racy, either by perceptual or instrumental measures, has
not been adequately established in the research literature.
A potentially complicating factor in the classification
of dysarthria type is speech severity. The Mayo Clinic
studies that provided the empirical basis for classifica-
tion of dysarthria did not control for severity. Rather,
severity was allowed to vary within each of the disease
groups studied (Darley, Aronson, & Brown, 1975). There
is no standard measure of speech severity in dysarthria,
417
but estimates of speech intelligibility are often used to
index the extent to which neurological disease affects the
speech mechanism (R. D. Kent et al., 1989). The main
barrier to separating effects of severity from types of dys-
arthria, or other potential classification variables (see
the Discussion section), has been the lack of relevant ana-
lyses from a sufficiently large number of speakers with dif-
ferent dysarthria types and various levels of severity. The
present study draws from a relatively large dysarthria
database generated by collaboration between the Mayo
Clinic and the University of Wisconsin—Madison to
investigate the distribution of selected speech acoustic
characteristics within and across dysarthria types and
levels of severity, the latter based on estimates of speech
intelligibility.
Reviews of dysarthria symptoms at both the articu-
latory and acoustic levels of analysis (Weismer, 1997;
Weismer & Kim, 2010) identify much that is common to
speakers with dysarthria, regardless of type. Moreover,
the typically large interspeaker variability observed in
almost any study of a particular dysarthria type is likely
due, in part, to variations in severity of speech involve-
ment. Even in the original Mayo Clinic studies (Darley
et al., 1969a, 1969b), there was substantial overlap across
dysarthria types in perceptual characteristics (see dis-
cussion in Weismer, 1997). Possibly, variation in speech
severity within a dysarthria type explains as much vari-
ance in physiological, acoustic, and/or perceptual data
as variation across dysarthria type. If this is the case,
classification of speakers according to speech severity
level might be expected to be roughly as accurate as classi-
fication by dysarthria type, when properly selected acous-
tic measures are used as input variables.
The issue of classification accuracy can be expanded
to include other potential classification variables. One
such variable is disease type. In the original Mayo Clinic
studies, the groups were formed based on disease or groups
of related diseases such as Parkinson’s disease, cerebellar
disease, and so forth (Darley, Aronson, & Brown, 1975).
In many cases, there is good correspondence between dis-
ease type and dysarthria type, but in other cases, the cor-
respondence is weaker, with multiple dysarthria types
being possible for a single disease type because some dis-
eases can affect more than one component of the motor
system (Duffy, 2006, pp. 31–33, Table 2-3 and associated
text). In the current study, classification according to
disease type was also investigated. A reasonable initial
hypothesis derived from the Mayo System and its pre-
sumed neuropathological basis is that classification ac-
cording to dysarthria type will be better (i.e., more accurate)
than classification based on disease type or severity of
speech involvement. This prediction is reasonable because
a single disease may be associated with more than one
dysarthria type, as noted previously, and severity plays
no classification role in the Mayo System.
418 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
The classification issue in dysarthria is important
for several reasons. First, a complete understanding of
any disorder and the development of a scientific program
to investigate its characteristics depend on a sound theo-
retical basis. The theoretical basis of the distinctions
between dysarthria types is an assumed feature of the
Mayo System but has rarely been investigated when other
classification options (such as severity or disease type)
are considered. In other words, there is little empirical
basis for the classification scheme specified by Darley
et al. (1969a, 1969b), as compared with other potential
classification approaches. Challenges to the Mayo System
based on perceptual judgments have been described pre-
viously in this article. Second, investigations in dysarthria
often involve groups of participants classified as having a
common dysarthria and who are compared with a control
group. Much more rarely, multiple groups of participants
with perceptually judged, varying dysarthria types may
be compared with each other (and with a control group)
for distinguishing characteristics (e.g., Liss et al., 2009).
Investigation of alternate classification schemes may
inform scientists concerning the relative homogeneity
of participant groups defined in different ways.
Acoustic Methods
The current classification analyses were based on
acoustic measures thought to reflect salient aspects of
speech production in persons with motor speech disor-
ders (Kent & Kim, 2008). The advantage of an acoustic
approach to understanding motor speech disorders has
been noted (Ansel & Kent, 1992; Weismer, 1984). Pre-
vious efforts have pursued two main goals: (a) identifi-
cation of the signal properties underlying intelligibility
deficits in dysarthria and (b) identification of acoustic
characteristics of specific dysarthria types. Studies have
been conducted to (a) identify acoustic measures that pre-
dict speech intelligibility scores and (b) investigate the
physical correlates of perceptual features in selected types
of dysarthria. Examples of acoustic parameters that pre-
dict speech intelligibility in speakers with dysarthria
include acoustic vowel space (Liu, Tseng, & Tsao, 2000;
McRae, Tjaden, & Schoonings, 2002; Tjaden & Wilding,
2004; Weismer, Jeng, Laures, Kent, & Kent, 2001); sec-
ond formant frequency (F2) slope (J. F. Kent et al., 1992;
R. D. Kent et al., 1989; Kim, Weismer, Kent, & Duffy,
2009; Mulligan et al., 1994; Weismer, Martin, Kent, &
Kent, 1992); and voice onset time (VOT; Liu et al., 2000).
In addition, acoustic measurements have been used
to investigate characteristics of specific types of dysar-
thria. For example, ataxic dysarthria has been character-
ized by slow speaking rate, relatively great variability in
VOT, a tendency toward equalized vowel/syllable dura-
tions within utterances, and an unusually large fundamen-
tal frequency (F0) range across utterances (Ackermann
& Hertrich, 1997; Chiu, Chen, & Tseng, 1996; R. D. Kent
et al., 2000; Stuntebeck, 2002). Salient acoustic features of
hypokinetic dysarthria, as another example, have included
either normal or faster-than-normal speaking rates, rela-
tively high mean F0, decreased F2 extents and slopes, and
decreased F0 variability (Canter, 1963; Forrest, Weismer,
& Turner, 1989; Goberman, Coelho, & Robb, 2005; Solomon
& Hixon, 1993; Weismer, 1984, 1991). Other studies have
investigated selected acoustic characteristics in spastic
(Ozawa, Shiromoto, Ishizaki, & Watamori, 2001; Ozsancak,
Auzou, Jan, & Hannequin, 2001; Ziegler & von Cramon,
1986), hyperkinetic (Ackermann, Hertrich, & Hehr, 1995;
Hertrich & Ackermann, 1994; Ludlow, Connor, & Bassich,
1987), and flaccid (Morris, 1989) dysarthria, as well as in
mixed dysarthrias (Liss et al., 2009; Wang, Kent, Duffy,
& Thomas, 2005).
Interestingly, although the Mayo System is widely
accepted in clinical practice and for the definition of pre-
sumably homogeneous participant groups in research
studies (see Duffy, 2005), very few studies other than
Liss et al. (2009) have examined the possibility of clas-
sification of dysarthria on the basis of acoustic attributes.
The unique clusters of perceptual characteristics thought
to be the core of the Mayo System (Darley et al., 1975)
prompt the hypothesis that properly selected and com-
bined acoustic measures can discriminate among dys-
arthria types with a reasonable degree of accuracy. As
described previously, the same hypothesis of classification
from acoustic variables can be entertained for the clas-
sification variables of severity and neurological disease
type (and, possibly, other variables not discussed here).
Apart from Liss et al. (2009), there is no study of
classification of dysarthria, in which a single protocol
has been used with a relatively large number of speakers
having different dysarthria types, varying severities of
speech involvement, and different underlying diseases.
In general, studies in which instrumental measures of
any type have been used to differentiate the dysarthrias
are relatively rare and, when available, are usually based
on a single measure (or derivatives of that measure). For
example, Nishio and Niimi (2001) measured speaking
rate and measures associated with it (articulation rate,
pause time) in seven different dysarthria types; these
measures were not particularly effective in distinguish-
ing among the different dysarthrias. Similarly, Morris
(1989) showed long-lag VOTs to be shorter than normal
in talkers with five different types of dysarthria. For-
mant frequency measures, formant transition rates, and
even lip/jaw motions have all been shown to be similar
across different types of dysarthria (see Ackermann &
Hertrich, 1997; see also reviews in Weismer, 1997; Weismer
& Kim, 2010). It is unknown, however, whether combina-
tions of measures reflecting different aspects of articu-
latory behavior (or the speech acoustic signal) would
distinguish among different dysarthria types.
To begin the process of exploring the classification of
dysarthria based on multiple acoustic measures, the fol-
lowing questions were asked. First, are some or all of the
selected acoustic measures correlated with a measure of
speech severity, which in this case was operationalized
with a speech intelligibility measure? Second, how well
do combinations of acoustic measures classify (a) dys-
arthria types, (b) disease type, and (c) speech severity
as indexed by speech intelligibility measures?
Method
Speakers
One hundred and seven subjects with dysarthria con-
sequent to Parkinson’s disease (males [M] = 29, females
[F] = 10), stroke (M = 21, F = 18), multiple system atrophy
(M = 11, F = 6), and traumatic brain injury (M = 7, F = 5)
were selected for the present study from the University of
Wisconsin—Madison Mayo Clinic dysarthria database,
which consists of digital speech recordings obtained at
the Mayo Clinic in Rochester, Minnesota. Parkinson’s
disease, stroke, and traumatic brain injury groups were
chosen for this study because they are the most frequent
etiologies associated with dysarthria in the United States
(Centers for Disease Control and Prevention, 2003; Duffy,
2005; National Institute of Neurological Disorders and
Stroke, 2001; National Stroke Association, 2002); the
group of speakers with multiple system atrophy was
chosen because of the availability of a relatively large
number of speakers with this diagnosis and the associ-
ation of this disease with different types of dysarthria.
Across all groups of speakers, participants ranged be-
tween 20 and 91 years of age (Mdn = 64.5 years). The
dysarthria diagnoses were made by a widely acknowl-
edged expert in the area (Duffy, 2005) who was aware of
each patient’s medical diagnosis (if it was known at the
time of the classification) but who identified the dysar-
thria type largely, if not entirely, on perceptual evaluation
of a patient’s speech (J. R. Duffy, personal communica-
tion, June 2, 2010). The dysarthria types he identified
included ataxic, spastic, hypokinetic, flaccid, hyperkinetic,
Unilateral Upper Motor Neuron (UUMN), and mixed.
Table 1 shows subject information, including the distri-
bution of dysarthria types for these 107 participants; the
mixed category pools that the different combinations
(e.g., spastic–flaccid, spastic–ataxic) used in the Mayo
System. Potential participants with language disorders,
apraxia of speech, or aprosodia were excluded from the
current study.
Procedure
The speech samples used in this study included
word and sentence recitations. Participants were asked
Kim et al.: An Acoustic Study of Dysarthria 419
 Table 1. Subject information including age, gender, dysarthria type, and scaled speech intelligibility.

Age range and median

Disease Gender (in parentheses) Dysarthria type Speech intelligibility

PD M = 29 38–81 (68) Hypokinetic (n = 34) Mild =19

F = 10 Mixed (n = 5) Moderate = 16
Hypokinetic–hyperkinetic: 3 Severe = 4
Hypokinetic–spastic: 1
Hypokinetic–ataxic: 1
Stroke M = 21 23–91 (71) UUMN (n = 18) Mild = 16
F = 18 Spastic (n = 4) Moderate = 14
Flaccid (n = 3) Severe = 9
Ataxic (n = 2)
Mixed (n = 12)
Ataxic–UUMN: 2
Ataxic–spastic: 5
Spastic–flaccid: 1
UUMN–spastic: 1
Ataxic–UUMN–spastic: 2
UUMN–spasitc–hypokinetic: 1
TBI M=7 20–51 (33.5) Flaccid (n = 2) Mild = 6
F=5 Hyperkinetic (n = 1) Moderate = 2
Mixed (n = 9) Severe = 4
Ataxic–hypokinetic: 3
Ataxic–spastic: 1
Flaccid–spastic: 1
Spastic–hypokinetic: 1
Ataxic–spastic–hyperkinetic: 1
Ataxic–hyperkinetic–spastic–flaccid: 1
MSA M = 11 46–71 (59) Ataxic (n = 7) Mild = 10
F=6 Hypokinetic (n = 3) Moderate = 5
Spastic (n = 1) Severe = 2
Mixed (n = 6)
Spastic–ataxic: 3
Hypokinetic–spastic: 2
Ataxic–hypokinetic–spastic: 1

Note. PD = Parkinson’s disease; TBI = traumatic brain injury; MSA = multiple system atrophy; UUMN = Unilateral
Upper Motor Neuron; M = male; F = female.

to produce each of six words (hail, shoot, sigh, sip, ship,
and wax) 10 times in a row. These words were selected
because of their acoustic characteristics and previous
demonstrations of their sensitivity to varying severi-
ties of dysarthria (R. D. Kent et al., 1989; Weismer, Kent,
Hodge, & Martin, 1988). The vocalic nuclei of some of these
words require relatively extensive changes in vocal tract
shape that were consistent with the sensitivity of formant
transitions to speech symptoms in dysarthria (Kim et al.,
2009). Other words were chosen for a specific type of anal-
ysis appropriate to analysis of consonant production (e.g.,
sip vs. ship for first-moment (M1) analysis; acoustic mea-
sures are explained later in this article). Among the 10 rep-
etitions for each word, the middle eight of the repetition
string were taken for analyses to eliminate possible
initial and final location effects.
For the sentence recitation task, all participants
recited the following five sentences in response to a
live-voice demonstration by the examiner: (a) “ Put the
high stack of cards on the table,” (b) “Combine all the in-
gredients in a large bowl,” (c) “The blue spot is on the
key,” (d) “The potato stew is in the pot,” and (e) “The
boiling tornado clouds moved swiftly.” These sentences
were used to obtain speech intelligibility data as well
as acoustic data. Three listeners who had a background
in speech-language pathology, but who were not expert
listeners of speech disorders in general or dysarthria
specifically (in the sense defined by Monsen, 1983, for
listeners of speakers with profound hearing impair-
ment), made judgments of speech intelligibility. Intel-
ligibility data were obtained using a direct magnitude
estimation technique (Gescheider, 1976). Inter- and

420 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
intralistener variability in selection of number scale was used to estimate the range of variation for F0 and
ranges was eliminated by following a procedure described intensity contours.
by Engen (1971). Ten subjects were randomly selected in order to ex-
The speech samples were collected in a quiet room amine intrajudge reliability for acoustic measurements.
with a high-quality microphone (SHURE SM 58) and a The correlation coefficient computed between the orig-
digital audiotape recorder (DAT; TASCAM DA-P1) at a inal and remeasured data (after 9 months) across all
sampling rate of 44.1 kHz and with 16-bit quantization. acoustic variables was .95, which suggested that the
After the utterances had been recorded on DAT, they measurements were repeatable and were made under
were analyzed using the speech analysis program TF32 a replicable set of criteria.
(Milenkovic, 2001).
All experimental procedures were approved by
the University of Wisconsin—Madison Human Subject Results
Committee. Speech Intelligibility Scores
The modulus-equalized speech intelligibility score
across the 107 speakers with dysarthria ranged from
Acoustic Analysis
0.58 to 1.63 (Mdn = 1.40). If listeners were actually doing
Acoustic measurements were made of (a) sentence ratio scaling, this suggests that intelligibility among these
duration, (b) vowel duration, (c) voiceless interval dura- speakers varied over a roughly 2.8:1 range (i.e., the most
tion, (d) first and second formant frequencies from four intelligible speaker was scaled as approximately 2.8 times
corner vowels, (e) M1 for fricatives (/s/ and /S/) during more intelligible than the least intelligible speaker).
three 50-ms-long windows approaching the vocalic nu- Speech intelligibility scores for individual disease groups
cleus (25-ms overlap between adjacent windows), (f ) tran- are displayed in Figure 1. The Parkinson’s disease group
sition duration and extent for F2 transitions, (g) F0 contour, had the highest mean intelligibility of the four groups,
and ( h) root-mean-square (RMS) intensity contour. and the stroke group had the lowest; t test results (ad-
Among these measures, the voiceless interval duration justed per comparison for an overall alpha level of .05)
was used as measured; the remaining measures were revealed that there were no significant differences in
used to derive the following variables for further sta- speech intelligibility among the clinical groups.
tistical analysis: (a) articulation rate, (b) Pairwise Var-
iability Index (PVI), (c) acoustic vowel space, (d) M1
difference between /s/ and /S/, (e) F2 slope, (f ) F0 range Figure 1. Box-and-whisker plot of intelligibility scores, plotted as
(maximum–minimum) of utterance, and (g) RMS inten- modulus-equalized values, for speakers with dysarthria in the four
disease groups. Mean values of each group are indicated by the
sity range of utterance. Except for the voiceless interval
dotted line within the box and median by the solid line. The left (lower
duration, these acoustic variables were selected based
value) edge of each box is the 25th percentile of the distribution;
on previous studies that have reported them to be useful the right (upper value) edge is the 75th percentile; the whiskers show
either for predicting intelligibility scores or characteriz- the lowest and highest nonoutlier observations, and the individual
ing the production deficit in dysarthric speech. Voiceless plotted points are outliers. PD = Parkinson’s disease; TBI = traumatic
interval duration was investigated as an alternative for brain injury; MSA = multiple system atrophy.
VOT because of recent concerns about the interpreta-
tion of the latter measure (Auzou et al., 2000) and its
sensitivity to age-related effects on speech production
(Weismer & Fromm, 1983). The PVI served as an es-
timate of the degree of scanning speech (see Low, Grabe,
& Nolan, 2000; Stuntebeck, 2002). Word materials were
used to derive M1 for the fricative pair (sip vs. ship) and
F2 slopes from vocalic nuclei (hail, wax, sigh, and shoot),
whereas sentence duration, vowel duration, voiceless
interval duration, acoustic vowel space, overall F0,
and RMS intensity range were measured from sentence
materials.
Tracking errors observed for formant trajectories
and F0 values (usually due to poor voice quality or sudden
phonation change) were manually modified using the in-
teractive editor in TF32. Considering possible outliers in
F0 and RMS intensity contours, the interquartile range

Kim et al.: An Acoustic Study of Dysarthria 421

 To estimate intrajudge reliability, each listener scaled
20 randomly selected samples twice. Kendall’s tau-b corre-
lation analyses reported significant interrater correlation
(r = .77, p < .01) and intrarater correlation (r = .71, p < .01).
Acoustic Measures Regressed Against
Speech Intelligibility
Relationships between speech intelligibility and
acoustic measures were determined by regression anal-
ysis. Regression analysis was conducted twice for each
acoustic variable. One set of analyses examined the gen-
eral relationships of acoustic variables to speech intelligi-
bility in speakers with dysarthria, pooled across disease
groups. The second set examined the same relationships
within each of the four disease groups (the regression
analyses were restricted to disease types; see the Dis-
cussion section). The results of this study suggested that
six of eight acoustic measures were significantly corre-
lated with intelligibility when data were pooled across all
disease groups (see Table 2). These variables include vowel
space, F2 slope, M1 difference between /s/ and /S/, voiceless
interval duration, articulation rate, and F0 range. All mea-
sures assumed to reflect segmental articulation (vowel
space, F2 slope, M1 difference for fricatives, and voice-
less interval duration) were regressed significantly on
speech intelligibility scores, as were two of four mea-
sures assumed to reflect prosodic features (articulation
rate and F0 range). Figures 2 and 3 display examples
of significant relationships of F2 slope and articulation
rate with scaled speech intelligibility.
It is noteworthy that some acoustic variables ap-
peared to make a significant contribution to speech in-
telligibility regardless of disease, whereas other variables
seemed to be more strongly related within a particular
Table 2. Results of regression analysis between acoustic variables
and scaled speech intelligibility for subjects across all disease groups.
Variable Gender/Window r2
Vowel space M .28*
F ns
F2 slope M .51**
F .46**
M1 difference for /s/ – /S/ 1st window .34**
2nd window .33**
3rd window .34**
Voiceless interval duration .30**
Articulation rate .56**
F0 interquartile range .38**
Intensity interquartile range ns
Pairwise Variability Index ns
*p < .05. **p < .01.
422 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
disease group (see Table 2). For example, F2 slope was
regressed significantly on speech intelligibility scores for
all four disease groups, whereas articulation rate was sig-
nificant for all clinical groups except PD, and F0 range
was significant only for the stroke group. Not surprisingly,
t test results indicated that significant acoustic predic-
tors of speech intelligibility common to all four disease
groups (e.g., F2 slope) showed no significant differences
among diseases, whereas those predictors specific to a cer-
tain disease (e.g., articulation rate) showed significant
differences among diseases.
Classification Analysis
For classification purposes, participants were grouped
by (a) disease, (b) dysarthria type, and (c) speech intelli-
gibility level. The goal of the classification analysis was to
answer the second research question: Which grouping, if
any, results in the best prediction of group membership
by speech acoustic measures? In theory, classification of
patients under any of the three groupings could be non-
systematic, suggesting that the predictor variables failed
to produce a significant discriminant function because
the variables were poorly chosen, the grouping variable
was poorly conceived, or as a result of some combination
of the former and latter. On the other hand, significant
classification functions for all groupings would suggest
that any one or all of the grouping variables have theo-
retical and/or clinical relevance.
Subjects were coded according to their disease, dys-
arthria type, and severity as follows. Disease coding was
made following medical records, and dysarthria type was
coded based on the perceptual judgment of an acknowl-
edged expert as described in the Method section; this
expert classification resulted in seven dysarthria types
(ataxic, flaccid, spastic, hypokinetic, hyperkinetic, UUMN,
and mixed [the latter as defined previously]). For sever-
ity coding, subjects were divided into three groups of
operationally defined, nonoverlapping levels of speech
intelligibility: mild, moderate, and severe. The severe
group was defined as speakers with speech intelligibility
scores from 0.58 to 1.17 (Mdn = 1.09, n = 19), the mod-
erate group was from 1.22 to 1.39 (Mdn = 1.34, n = 37),
and the mild group was from 1.40 to 1.63 (Mdn = 1.51,
n = 51).
Classification analysis was conducted twice using
SPSS Version 16.0 for each single acoustic variable and
for all eight acoustic variables. The classification results
for each single acoustic variable are displayed in Table 3.
The values in the table cells indicate the percentage of
subjects who were classified identically with their orig-
inal group. For example, when subjects were classified
solely by articulation rate, 49.5% of the subjects were
classified identically with their original etiology groups,
27.2% of the subjects with their original dysarthria types,
Figure 2. The relationships between second formant frequency (F2) slope of the word wax and speech intelligibility scores: male (M) speakers
with dysarthria (left) and female (F) speakers with dysarthria (right). **p < .01.
and 51.5% with their original severity groups. Among the
eight acoustic variables, seven showed the greatest num-
ber of subjects classified identically when severity was the
classification variable. When all eight acoustic variables
were combined for the discriminant function, however,
the results were slightly different (see Table 4). When the
stepwise discriminant function was performed by pool-
ing male and female talkers, subjects were significantly
classified with their original group by etiology (68.6%),
F(6, 190) = 9.97, p < .01; severity (54.9%), F(2, 97) = 8.74,
p < .01; and type of dysarthria (31.7%), F(6, 93) = 4.55,
p < .01. For male speakers, the greatest number of sub-
jects was classified with their original severity group,
whereas for female speakers, the greatest number of
Figure 3. Scatter plot of articulation rate and speech intelligibility
scores. **p < .01.
patients was classified with their etiology group. For
acoustic variables that are obviously affected by gender
(e.g., formant frequencies), both regression and dis-
criminant analyses were conducted separately for male
and female speakers.
Although the focus of this study was on classification
accuracy, and not on the individual acoustic variables
contributing to the significant discriminant functions,
the analysis showed that different sets of acoustic vari-
ables contributed to the classification of etiology, type,
and severity (see Table 4). Articulation rate, voiceless in-
terval duration, and intensity range contributed to etiol-
ogy classification, whereas articulation rate and F0 range
contributed to type classification. For severity classifica-
tion, F2 slope, F0 range, and vowel space made signifi-
cant contributions to the discriminant function.
Classification analysis was performed a final time
with only three types of dysarthria (hypokinetic, ataxic,
and UUMN; 59 of 107 speakers) because of reserva-
tions about unbalanced number of categories (for sever-
ity, etiologies, and types of dysarthria), as well as the
mixed type of dysarthria that was heterogeneous with
respect to dysarthria type. Results showed that the clas-
sification rate by types of dysarthria improved when the
number of types was reduced from seven to three. How-
ever, more subjects were still classified correctly when
coded by severity (62.2%) than when coded by type of
dysarthria (59.3%) or etiology (56.1%).
Discussion
One goal of this study was to identify a set of acoustic
variables that predict speech intelligibility for diverse
types of dysarthria and diseases that cause dysarthria
Kim et al.: An Acoustic Study of Dysarthria 423
 Table 3. Classification analysis result for each single acoustic variable.

% F2 VS M1 VID AR dB F0 PVI

Etiology All 36.3 All 35.0 38.6 51.0 49.5 33.0 33.0 32.0
M 47.6 M 17.2
F 56.4 F 38.5
Type All 36.3 All 22.3 37.6 17.6 27.2 19.4 31.1 19.4
M 34.9 M 23.4
F 53.8 F 20.5
Severity All 58.8 All 45.6 58.4 46.1 51.5 42.7 41.7 32.0
M 66.7 M 50.0
F 56.4 F 46.2

Note. Numbers in the table indicate the number of subjects who were correctly identified by discriminant anlaysis as
original categories. For second formant slope (F2) and vowel space (VS), results are reported with separation between male
and female speakers. Each acoustic variable is indicated in abbreviated form. M1 = first-moment difference; VID = voiceless
interval duration; AR = articulation rate; dB = intensity range; F0 = fundamental frequency range; PVI = Pairwise
Variability Index.

and to examine whether different predictors are required slope significant for each disease group, but its effect size
for different diseases associated with dysarthria. A second (i.e., the variance accounted for) was the greatest of all
goal was to assess classification accuracy of speakers with acoustic variables. This is consistent with the results of
dysarthria using acoustic measures as input variables and previous studies that have reported F2 slope as one the
three different classification variables. The relationship most sensitive indices of vocal tract function for speech
of the findings of this study to these two goals is dis- production—as measured by intelligibility ratings—in
cussed in the section that follows. neurodegenerative diseases such as amyotrophic lateral
sclerosis (R. D. Kent et al., 1989; Weismer et al., 1992)
and Parkinson’s disease (Weismer, 1991). F2 slope, there-
Which Acoustic Variables Predict fore, seems to be an indicator of dysarthria severity, as
indexed by speech intelligibility scores, for speech motor
Speech Intelligibility? control deficits in general (i.e., independent of dysarthria
All segmental variables showed significant relation- type and etiology; see Weismer & Kim, 2010).
ships with intelligibility. This is consistent with the only In contrast to F2 slope, an exemplar of a “nonuni-
other study known to us that has compared the impact of versal” predictor is articulation rate. Articulation rate
segmental and suprasegmental variables on speech intel- was a strong predictor of intelligibility in the pooled
ligibility (de Bodt, Hernández-Díaz, & Van de Heyning, analysis but was not a significant predictor of speech
2002). Among the six variables that had a significant intelligibility for speakers with Parkinson’s disease,
relationship with intelligibility when regression anal- who were exclusively diagnosed with hypokinetic dys-
yses were performed with all speakers pooled, only F2 arthria. As reported in several studies, speakers with
slope appeared to be significantly regressed on speech in- Parkinson’s disease (or speakers with hypokinetic dys-
telligibility when analyses were performed within etiol- arthria) can have speech rate similar to or faster than
ogy groups (Parkinson’s disease, stroke, traumatic brain (and sometimes slower) that of healthy speakers. This
injury, and multiple system atrophy). Not only was F2 may create a ceiling effect on a possible relationship be-
tween articulation rate and intelligibility in this group
(Goberman & McMillan, 2005; Weismer, 1984). In other
Table 4. Classification analysis result for combination of words, there is more margin for the relationship between
eight variables. two factors to vary on the low side of typical articulation
rate than to vary on the high side (Turner & Weismer,
Contributing factors 1993). Perhaps a reasonable explanation is that faster-
% All Male Female to classification than-typical articulation rates do not associate with
lowered intelligibility in the same way as do slower-
Etiology 68.6 56.3 73.7 AR, VID, dB
Type 31.7 39.1 41.0 AR, F0
than-typical rates, the latter of which clearly covaried
Severity 54.9 68.3 53.8 F2 slope, F0, VS with speech intelligibility in the current study. Alterna-
tively, or in addition to this, because so many studies

424 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
have found essentially normal rates in Parkinson’s dis-
ease, the measure may not be expected to predict var-
iation in speech intelligibility for this group.
F2 slope and articulation rate as predictors of speech
severity are also different in another way. Both variables
are connected to overall speech severity, but the relation-
ship between articulation rate and speech severity, even
excluding speakers with Parkinson’s disease, may be
slightly more complicated. Whereas articulation rate
decreases with speech severity, as indexed by intelligi-
bility, it may also decrease as a result of speaker com-
pensation to achieve greater intelligibility. In this sense,
slowing of articulation rate may reflect influences with
opposite effects on speech intelligibility—one effect due
to severity, the other due to attempted “correction” for the
effects of severity. Compensation for shallow F2 slopes,
on the other hand, reflects an attempt to move articu-
latory behavior in the same direction as lesser severity:
Increased transition “speed” is both compensatory and
associated with lesser severity (greater intelligibility).
Because of these considerations, theories of motor speech
disorders and clinical practice may need to treat F2 slope
and articulation rate differently. Although there is evi-
dence that speakers with dysarthria can change artic-
ulation rate on command (e.g., Van Nuffelen, de Bodt,
Vanderwegen, Van de Heyning, & Wuyts, 2010), a sim-
ilar demonstration of voluntary control over F2 slope for
syllables with large vocalic transitions does not exist for
speakers with dysarthria.
It is not surprising that the majority of acoustic var-
iables covaried with speech intelligibility scores in this
study, especially considering the wide range of speech
intelligibility scores for the speakers with dysarthria and
the large number of participants in the study. Across
speakers, it is clearly a matter of the degree to which an
acoustic variable is affected by dysarthria, rather than
whether the variable is affected. The fact that all vari-
ables are expected to covary with speech intelligibility,
especially when intelligibility varies over a wide range,
does not necessarily mean the covariation would be the
same for different disease groups or dysarthria types.
The current analyses were restricted to disease type
because similar analyses using dysarthria type would
have been partially (and in some cases largely) redun-
dant because of the substantial overlap between disease
and dysarthria type in many (but not all) cases (Duffy,
2006). Of course, it is possible that an analysis of acous-
tic predictors of speech intelligibility within a group of
patients having a single disease but multiple types of
dysarthria (e.g., head injury or corticobasal degeneration;
see Duffy, 2006) would reveal dysarthria-type–specific
predictors of intelligibility. The present results cannot an-
swer this question definitively but only suggest that the
results would not differ much from those reported here.
Classification of Dysarthria
Since the appearance of the Mayo System, most acous-
tic studies have sought to discover acoustic correlates that
quantify perceptual features of dysarthria as described
by Darley et al. (1969a, 1969b) within a single disease or
dysarthria type. More specifically, acoustic studies have
been conducted to establish a set of acoustic character-
istics that describe overall speech characteristics per-
taining to a certain disease or dysarthria type, rather
than comparing these characteristics across disease or
dysarthria types. However, as a substantial amount of
speech acoustic data have been collected from persons
with various types of dysarthria, it is apparent that a
common set of acoustic characteristics is exhibited in
multiple types of dysarthria. The presence of acoustic
commonalities is not surprising because many of the per-
ceptual dimensions in the Darley et al. studies are shared
across dysarthria types, as documented by Darley et al.
(1969a) and subsequent studies (Zeplin & Kent, 1996). It
is the clusters of dimensions that are thought to distin-
guish among types of dysarthria, not individual perceptual
dimensions. Perceptual clusters are likely to be associated
with multiple acoustic indices, and perhaps it is not sur-
prising that a particular acoustic measure would show
severity-related variations within several different types
of dysarthria. A single measure may be common to dif-
ferent dysarthria types even though its combination with
other measures may be a unique feature of a particular
dysarthria type.
For example, studies have shown more shallow F2
slopes for transitions of speakers with motor speech dis-
orders, regardless of the etiology and type of dysarthria
(Kim et al., 2009). This phenomenon is interesting con-
sidering the dissimilarity of the typical underlying neuro-
pathology in diseases such as Parkinson’s disease and
stroke. Acoustic similarity across etiologies and types of
dysarthria has also been found for vowel space, speak-
ing rate, VOT, and even tone production in Mandarin
(evidence reviewed by Weismer, 2006). The current study
adds two more acoustic similarities across the four eti-
ology groups in this investigation, including reduced in-
tensity range and the M1 difference between /s/ and /S/.
Accumulating data support the view that different
neuropathophysiologies may give rise to similar man-
ifestations at the speech acoustic surface and, by
inference, at the level of neuromotor control of speech
production (presumably including motor commands and
resulting movements of speech mechanism structures).
Even with different underlying neuropathologies, there
are probably a constrained number of ways in which
performance of the speech mechanism can deteriorate
when affected by neurological disease. These constraints
presumably result in the core set of acoustic features
Kim et al.: An Acoustic Study of Dysarthria 425
observed across different types of dysarthria, as described
previously.
However, the fact that highly trained clinicians or
persons with a small amount of intense training can make
some reliable distinctions between the different dysarthria
types (Zyski & Weisiger, 1987) indicates there is percep-
tual information (and presumably associated acoustic
signal properties) that distinguishes among dysarthria
types. The current findings indicate that articulation
rate is a feature that makes speakers with Parkinson’s
disease (typically associated with hypokinetic dysarthria)
distinguishable from other etiologies/types of dysarthria.
In addition to (or as part of ) faster articulation rates,
speakers with Parkinson’s disease also showed shorter
voiceless interval durations compared with other etiolo-
gies; like speaking rate, voiceless interval duration was
not significantly correlated with speech intelligibility.
Voiceless interval duration is probably another acoustic
manifestation of a relatively normal or fast speaking rate
(based on the significant correlation between these two
variables, r = .53, p < .0001), and both are apparently
unique features of hypokinetic dysarthria associated with
Parkinson’s disease.
This observation that only the articulation rate–
Parkinson’s disease group pair was distinguishable from
other etiologies—and some evidence suggesting that
speakers with Parkinson’s disease (and, presumably,
hypokinetic dysarthria) are identified with greater accu-
racy than are speakers with other dysarthria types (Zyski
& Weisiger, 1987)—hints at the possibility that listeners
may tend to seek only a small number of critical cues for
auditory–perceptual judgments of dysarthria type, rather
than use combined information from the entire speech
signal. Zeplin and Kent (1996) argued that the ratings of
certain perceptual features may be more reliable than
others. If the acoustic findings of the current study have
perceptual salience, one such reliable and salient feature
may be a faster-than-normal or normal speaking rate.
In other words, only one or a small number of speech
characteristics—such as strain-strangled voice in com-
bination with slow rate and reduced pitch and loudness
variability in spastic dysarthria, normal or fast articu-
lation rate in combination with reduced loudness and
reduced pitch, and loudness variability in hypokinetic
dysarthria—may be the real cues that are pathognomic
for a specific type of dysarthria. When these critical fea-
tures are missing or subdued and only the common speech
characteristics are available to listeners, the judgments
become less certain and less compatible with the assumed
underlying neuropathology–dysarthria type. For example,
imprecise consonants is the deviant speech dimension
suggested by Darley et al. (1969a, 1969b) to be exhibited
in most types of dysarthria. Possibly, imprecise conso-
nants would not cue any particular type of dysarthria
426 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
unless it could be shown that the nature of consonant
imprecision is dysarthria specific.
One of the goals of the present study was to evaluate
the classification of speakers with dysarthria using speech
acoustic measures and the alternative grouping variables
of dysarthria type, disease type (etiology), and speech se-
verity. Regardless of the grouping variable, classifica-
tion by discriminant function analysis was significant,
suggesting that disease type and speech severity may
have as much theoretical and clinical relevance to dys-
arthria as the dysarthria type specified by the Mayo
System and its recent refinements. Moreover, when all
speakers were pooled for classification analysis, the results
(see Tables 3 and 4) indicate that the best classification
was obtained when disease type was the grouping var-
iable. The poorest classification performance was ob-
tained when the grouping variable was dysarthria type.
Classification accuracy by severity of speech involve-
ment (indexed rather coarsely by speech intelligibility
scores) was closer to classification by disease. Taken to-
gether, these results seem to suggest not that dysarthria
type is an undesirable grouping variable but that it is no
more desirable or necessary than the two other classi-
fication variables explored here, at least when classifi-
cation is based on specific acoustic variables. This is an
important finding because it may bear on the way in
which future experiments on dysarthria choose to group
speakers for presumed homogeneity. These results sug-
gest that blocking of participants on dysarthria type, or a
requirement that dysarthria type be reported even when
disease type is known, may not provide additional in-
sight to interpretation of speech production or percep-
tion data obtained from speakers with dysarthria.
If the relatively nonunique classification performance
by dysarthria type in the current investigation can be
shown to extend to additional predictor variables (includ-
ing physiological, acoustic, and perceptual variables),
the contemporary categorization of motor speech disor-
ders may have to be reconceptualized, at least with re-
spect to the development of a theoretical framework for
understanding the disorder and its effect on spoken lan-
guage and its understanding. On the other hand, there
are several reasons to view the implications of the cur-
rent classification results in a conservative way. First,
the identification of dysarthria type was performed by
a single person, albeit one with substantial experience
in the classification of motor speech disorders using the
Mayo System. Perhaps some form of expert panel con-
sideration, with extended listening to speech samples
and explicit rubrics concerning the components of par-
ticular dysarthria types, would produce a classification
of type with greater reliability. Another approach to over-
coming the problems with perceptual ratings and classi-
fication is to use a computerized system that operates on
acoustic metrics. Such a system developed by Carmichael
(2007) combines an expert system and a pretrained multi-
layer perceptron. This system produced good classifica-
tion results under certain conditions. Second, the results
of the different classification analyses reported in Tables 3
and 4 cannot be regarded as fully independent estimates
of different classification performance. After all, dysar-
thria type is often (but not always) linked with disease
(etiology) type, and different diseases may be more or less
likely to produce greater speech severity in the kinds of
utterances from which the acoustic measures were ex-
tracted (e.g., persons with Parkinson’s disease are often
highly intelligible in prepared utterances even when not
so intelligible in spontaneous speech, whereas persons
with amyotrophic lateral sclerosis may be equally intel-
ligible in both forms of utterance). Finally, the acoustic
measures used in the current investigation were relatively
extensive and were selected for their known sensitivity to
dysarthria but clearly were not broad enough in scope to
rule out the possibility that a critical classifying measure
was omitted from the analyses. Perhaps a more extensive
set of measures would capture specific speech production
phenomena that are the basis for the presumed validity
and reliability of the dysarthria classification system orig-
inally advanced by Darley et al. (1969a). For example, Liss
et al. (2009) recently demonstrated that acoustic metrics
of speech rhythm classified persons having four different
types of dysarthria with an impressive degree of accu-
racy (roughly 70%–80% correct classification, depending
on the stringency of the classification criteria). The cur-
rent study did not include the variety of rhythm mea-
sures used in the Liss et al. classification exercise, which
may explain the better classification performance in the
latter study. It must be pointed out, however, that in Liss
et al., the dysarthria-type classifications of participants
were chosen specifically from among a much larger group
of potential participants to have rhythm characteristics
typical of the cardinal dysarthria types presumed to be
associated with four different diseases (see Liss et al.,
2009, p. 1336, and J. M. Liss, personal communication,
December 29, 2009).
Participants in the current study were chosen only
because they had neuromotor diseases known to produce
dysarthria. The classification success in Liss et al. (2009)
is, at best, roughly 10% better than the classification by
disease in the current study and may decrease for a less
selected set of participants. It is also possible that the
classification results of Liss et al. were better than those
of the present study because they used a normalized ver-
sion of the PVI (see White & Mattys, 2007), in contrast to
the raw PVI measure of the current investigation. Clearly,
additional investigations with participants having differ-
ent disease types, and possibly different dysarthria types,
as well as additional measures are required to make pro-
gress on the issue of what makes speakers with dysarthria
similar to one another and what makes them different
from each other.
Acknowledgment
This study was supported by National Institute on Deafness
and Other Communication Disorders Grant DC00319 and
2006 New Century Scholarships from the American Speech-
Language-Hearing Foundation. We thank Joseph R. Duffy
of the Mayo Clinic, Rochester, Minnesota, for performing the
dysarthria-type classifications used in this study.
References
Ackermann, H., & Hertrich, I. (1997). Voice onset time
in ataxic dysarthria. Brain and Language, 56, 321–333.
Ackermann, H., Hertrich, I., & Hehr, T. (1995). Oral
diadochokinesis in neurological dysarthrias. Folia
Phoniatrica et Logopaedica, 47, 15–23.
Ansel, B. M., & Kent, R. D. (1992). Acoustic–phonetic
contrasts and intelligibility in the dysarthria associated
with mixed cerebral palsy. Journal of Speech and Hearing
Research, 35, 296–308.
Auzou, P., Ozsancak, C., Morris, R. J., Jan, M., Eustache,
F., & Hannequin, D. (2000). Voice onset time in aphasia,
apraxia of speech and dysarthria: Review. Clinical Linguistics
& Phonetics, 14, 131–150.
Canter, G. (1963). Speech characteristics of patients with
Parkinson’s disease. I. Intensity, pitch, and duration.
Journal of Speech and Hearing Disorders, 28, 221–229.
Carmichael, J. N. (2007). Introducing objective acoustic
metrics for the Frenchay Dysarthria Assessment procedure.
(Unpublished doctoral dissertation). University of Sheffield,
United Kingdom.
Centers for Disease Control and Prevention. (2003).
Traumatic brain injury. Retrieved from http://www.cdc.gov/
ncipc /factsheets/tib.htm.
Chiu, M. J., Chen, R. C., & Tseng, C. Y. (1996). Clinical
correlates of quantitative acoustic analysis in ataxic
dysarthria. European Neurology, 46, 310–314.
Darley, F. L., Aronson, A. E., & Brown, J. R. (1969a).
Differential diagnostic patterns of dysarthria. Journal
of Speech and Hearing Research, 12, 246–269.
Darley, F. L., Aronson, A. E., & Brown, J. R. (1969b).
Clusters of deviant speech dimensions in the dysarthrias.
Journal of Speech and Hearing Research, 12, 462–496.
Darley, F. L., Aronson, A. E., & Brown, J. R. (1975). Motor
speech disorders. Philadelphia, PA: W. B. Saunders.
de Bodt, M. S., Hernández-Díaz, H. M., & Van de
Heyning, P. H. (2002). Intelligiblity as a linear combination
of dimensions in dysarthric speech. Journal of Communi-
cation Disorders, 35, 283–292.
Duffy, J. R. (2005). Motor speech disorders: Substrates,
differential diagnosis, and management. St. Louis, MO:
Mosby.
Duffy, J. R. (2006). History, current practice, and future
trends and goals. In G. Weismer (Ed.), Motor speech dis-
orders (pp. 7–56). San Diego, CA: Plural.
Kim et al.: An Acoustic Study of Dysarthria 427
Engen, T. (1971). Psychophysics. II. Scaling methods. In
J. Kling & L. Riggs (Eds.), Woodworth and Schlosberg’s
experimental psychology (pp. 47–86). New York, NY: Holt,
Rinehart, & Winston.
Fonville, S., van der Worp, H. B., Maat, P., Aldenhoven, M.,
Algra, A., & van Gijn, J. (2008). Accuracy and inter-observer
variation in the classification of dysarthria from speech
recordings. Journal of Neurology, 255, 1545–1548.
Forrest, K., Weismer, G., & Turner, G. S. (1989). Kinematic,
acoustic, and perceptual analyses of connected speech
produced by Parkinsonian and normal geriatric adults.
The Journal of the Acoustical Society of America, 85,
2608–2622.
Gescheider, G. A. (1976). Psychophysics: Method and theory.
Hillsdale, NJ: Erlbaum.
Goberman, A., Coelho, C., & Robb, M. (2005). Prosodic
characteristics of Parkinsonian speech: The effect of levodopa-
based medication. Journal of Medical Speech-Language
Pathology, 13, 51–68.
Goberman, A., & McMillan, J. (2005). Relative speech
timing in Parkinson disease. Contemporary Issues in
Communication Sciences and Disorders, 32, 22–29.
Guerra, E. C., & Lovely, D. F. (2003). Suboptimal classifier
for dysarthria assessment: Lecture notes in computer
science. In A. Sanfeliu & José Ruiz-Shulcloper (Eds.),
Progress in pattern recognition, speech and image analysis
(pp. 314–321). Berlin/Heidelberg: Springer.
Kent, J. F., Kent, R. D., Rosenbek, J. C., Weismer, G.,
Martin, R., Sufit, R., & Brooks, B. R. (1992). Quantitative
description of the dysarthria in women with amyotrophic
lateral sclerosis. Journal of Speech and Hearing Research,
35, 723–733.
Kent, R. D., & Kim, Y.-J. (2008). Acoustic analysis of speech.
In M. J. Ball, M. R. Perkins, N. Müller, & S. Howard (Eds.),
Handbook of clinical linguistics (pp. 360–380). Hoboken,
NJ: Wiley-Blackwell.
Kent, R. D., Kent, J. F., Duffy, J. R., Thomas, J. E.,
Weismer, G., & Stuntebeck, S. (2000). Ataxic dysarthria.
Journal of Speech, Language, and Hearing Research,
43, 1275–1289.
Kent, R. D., Kent, J. F., Weismer, G., Martin, R., Sufit,
R. L., Brooks, B. R., & Rosenbek, J. C. (1989). Relation-
ships between speech intelligibility and the slope of sec-
ond formant transitions in dysarthric subjects. Clinical
Linguistics & Phonetics, 3, 347–358.
Kim, Y.-J., Weismer, G., Kent, R. D., & Duffy, J. R. (2009).
Statistical models of F2 slope in relation to severity of
dysarthria. Folia Phoniatrica et Logopaedica, 61, 329–335.
Hertrich, I., & Ackermann, H. (1994). Acoustic analysis of
speech timing in Huntington’s disease. Brain and Language,
47, 182–196.
Liss, J. M., White, L., Mattys, S. L., Lansford, K., Lotto,
A. J., Spitzer, S. M., & Caviness, J. N. (2009). Quanti-
fying speech rhythm abnormalities in the dysarthrias.
Journal of Speech, Language, and Hearing Research, 52,
1334–1352.
Liu, H.-M., Tseng, C.-H., & Tsao, F.-M. (2000). Percep-
tual and acoustic analysis of speech intelligibility in
Mandarin-speaking young adults with cerebral palsy.
Clinical Linguistics & Phonetics, 14, 447–464.
428 Journal of Speech, Language, and Hearing Research • Vol. 54 • 417–429 • April 2011
Low, E. L., Grabe, E., & Nolan, F. (2000). Quantitative char-
acterizations of speech rhythm: Syllable-timing in Singapore
English. Language and Speech, 43, 377–401.
Ludlow, C. L., Connor, N. P., & Bassich, C. J. (1987).
Speech timing in Parkinson’s and Huntington’s disease.
Brain and Language, 32, 195–214.
McRae, P. A., Tjaden, K., & Schoonings, B. (2002). Acoustic
and perceptual consequences of articulatory rate change
in Parkinson disease. Journal of Speech, Language, and
Hearing Research, 45, 35–50.
Milenkovic, P. (2001). TF 32 [Computer program]. Madison,
WI: University of Wisconsin—Madison.
Monsen, R. B. (1983). The oral speech intelligibility of hearing-
impaired talkers. Journal of Speech and Hearing Disorders,
48, 286–296.
Morris, R. J. (1989). VOT and dysarthria: A descriptive study.
Journal of Communication Disorders, 22, 23–33.
Mulligan, M., Carpenter, J., Riddel, J., Delaney, M. K.,
Badger, G., Krusinski, P., & Tandan, R. (1994). Intelli-
gibility and the acoustic characteristics of speech in amyo-
trophic lateral sclerosis (ALS). Journal of Speech and
Hearing Research, 37, 496–503.
National Institute of Neurological Disorders and
Stroke. (2001). Huntington’s disease: Hope through
research. Retrieved from http://www.ninds.nih.gov/
health_and_medical /pubs/Huntington_disease-htr.htm.
National Stroke Association. (2002). All about stroke.
Retrieved from http://www.stroke.org.
Nishio, M., & Niimi, S. (2001). Speaking rate and its com-
ponents in dysarthric speakers. Clinical Linguistics &
Phonetics, 15, 309–317.
Ozawa, Y., Shiromoto, O., Ishizaki, F., & Watamori, T.
(2001). Symptomatic differences in decreased alternating
motion rates between individuals with spastic and with
ataxic dysarthria: An acoustic analysis. Folia Phoniatrica
et Logopaedica, 53, 67–72.
Ozsancak, C., Auzou, P., Jan, M., & Hannequin, D. (2001).
Measurement of voice onset time in dysarthric patients:
Methodological considerations. Folia Phoniatrica et
Logopaedica, 53, 48–57.
Solomon, N. P., & Hixon, T. J. (1993). Speech breathing
in Parkinson’s disease. Journal of Speech and Hearing
Research, 36, 294–310.
Stuntebeck, S. (2002). Acoustic analysis of the prosodic
properties of ataxic speech (Unpublished master’s thesis).
University of Wisconsin—Madison.
Tjaden, K., & Wilding, G. E. (2004). Rate and loudness
manipulations in dysarthria: Acoustic and perceptual find-
ings. Journal of Speech, Language, and Hearing Research,
47, 766–783.
Turner, G. S., & Weismer, G. (1993). Characteristics of
speaking rate in the dysarthria associated with amyotrophic
lateral sclerosis. Journal of Speech and Hearing Research,
36, 1134–1144.
Van der Graaf, M., Kuiper, T., Zwinderman, A., Van de
Warrenburg, B., Poels, P., Offeringa, A., . . . de Visser, M.
(2009). Clinical identification of dysarthria types among
neurologists, residents in neurology, and speech therapists.
European Neurology, 61, 295–300.
Van Nuffelen, G., de Bodt, M., Vanderwegen, J., Van de
Heyning, P., & Wuyts, F. (2010). Effect of rate control on
speech production and intelligibility in dysarthria. Folia
Phoniatrica et Logopaedica, 62, 110–119.
Wang, Y.-T., Kent, R. D., Duffy, J. R., & Thomas, J. E.
(2005). Dysarthria associated with traumatic brain injury:
Speaking rate and emphatic stress. Journal of Communi-
cation Disorders, 38, 231–260.
Weismer, G. (1984). Articulatory characteristics of
Parkinsonian dysarthria. In M. R. McNeil, J. C. Rosenbek,
& A. Aronson (Eds.), The dysarthrias: Physiology–acoustic–
perception–management (pp. 101–130). San Diego, CA:
College-Hill.
Weismer, G. (1991). Assessment of articulatory timing. In
J. Cooper (Ed.), NIDCD Monograph #1: Assessment of speech
and voice production: Research and clinical applications
(pp. 83–95). Bethesda, MD: National Institutes of Health.
Weismer, G. (1997). Motor speech disorders. In W. J.
Hardcastle & J. Laver (Eds.), The handbook of phonetic
sciences (pp. 191–219). Cambridge, MA: Blackwell.
Weismer, G. (2006). Philosophy of research in motor speech
disorders. Clinical Linguistics & Phonetics, 20, 315–349.
Weismer, G., & Fromm, D. (1983). Acoustic analysis of
geriatric utterances: Segmental and nonsegmental charac-
teristics that relate to laryngeal function. In M. Bless & J. H.
Abbs (Eds.), Vocal fold physiology: Contemporary research and
clinical issues (pp. 317–332). San Diego, CA: College-Hill.
Weismer, G., Jeng, J., Laures, R., Kent, R., & Kent, J.
(2001). Acoustic and intelligibility characteristics of
sentence production in neurogenic speech disorders.
Folia Phoniatrica et Logopaedica, 53, 1–18.
Weismer, G., & Kim, Y.-J. (2010). Classification and taxon-
omy of motor speech disorders: What are the issues? In
B. Maassen & P. H. H. M. van Lieshout (Eds.), Speech motor
control: New developments in basic and applied research
(pp. 229–241). Oxford, England: Oxford University Press.
Weismer, G., Martin, R., Kent, R. D., & Kent, J. F. (1992).
Formant trajectory characteristics of males with amyotrophic
lateral sclerosis. The Journal of the Acoustical Society of
America, 91, 1085–1098.
Weismer, G., Kent, R. D., Hodge, M., & Martin, R. (1988).
The acoustic signature for intelligibility test words. The
Journal of the Acoustical Society of America, 84, 1281–1291.
White, L., & Mattys, S. (2007). Calibrating rhythm: First
language and second language studies. Journal of Phonetics,
35, 501–522.
Zeplin, J., & Kent, R. D. (1996). Reliability of auditory–
perceptual scaling of dysarthria. In D. A. Robin, K. Y.
Yorkston, & D. R. Beukelman (Eds.), Disorders of motor
speech (pp. 145–154). Baltimore, MD: Brooks.
Ziegler, W., & von Cramon, D. (1986). Spastic dysarthria
after acquired brain injury: An acoustic study. British
Journal of Disorders of Communication, 21, 173–187.
Zyski, B. J., & Weisiger, B. E. (1987). Identification of
dysarthria types based on perceptual analysis. Journal of
Communication Disorders, 20, 367–378.
Kim et al.: An Acoustic Study of Dysarthria 429
Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-
Hearing Association and its content may not be copied or emailed to multiple sites or posted to a listserv
without the copyright holder's express written permission. However, users may print, download, or email
articles for individual use.