Sense of Effort and Articulatory Contact Pressure Associated with Talking by Individuals Using Tracheoesophageal Speech

Abstract

<b><i>Background/Aims:</i></b> The aims of this study were (1) to determine locations of increased effort in the body when talking using tracheoesophageal speech (TES); (2) to compare talking effort for participants using TES and those using laryngeal speech; (3) to compare tongue-palate contact pressure during talking for TES and laryngeal speech; and (4) to assess the relationship between talking effort and articulatory contact pressure (ACP). <b><i>Methods:</i></b> This cohort comparison study included 16 individuals using TES and 10 using laryngeal speech. Participants rated talking effort on a visual analog scale and then rated effort in the lungs, throat, oral cavity, brain (cognitive) and arm/shoulder. ACP for /t/, /d/, and /n/ produced in sentences was measured using a pressure sensor on the alveolar ridge. <b><i>Results:</i></b> Factor analysis of effort ratings across body locations by participants using TES revealed two latent variables associated with non-voice production locations and voice production. Ratings of effort and ACP were statistically significantly higher in participants using TES. The correlation between overall talking effort and ACP was strong and statistically significantly. <b><i>Conclusions:</i></b> The effort ratings suggest adults with functional TES experience talking as more effortful than adults with a larynx. Some increased effort was focused in the voice production process, but regions outside of voicing were also implicated.