Listener Attitudes toward Speech Supplementation

E Hanson, D Beukelman, S Fager, C Ullman


Speech supplementation strategies can provide substantial intelligibility gains for people with dysarthria.  Strategies include alphabet supplementation in which the speaker points to the first letter of each word as the sentence is spoken, and topic supplementation in which the speaker points to a word representing the topic as the sentence is spoken. However, the benefits can only be realized if an individual is willing to use supplemented speech, and if listeners accept it.


The purpose of this study was to investigate listener attitudes toward speech supplementation.  Four listener groups of 15 people each were used, including family members of brain injury survivors, speech-language pathologists, allied health professionals, and members of the general public.  Questions regarding attitudes were specific to the effectiveness and acceptability of four speaking conditions: habitual speech, clear speech, topic supplemented speech, and alphabet supplemented speech.  The speaker-participants were all survivors of traumatic brain injury (TBI) with mild to severe dysarthria.


Listeners in 3 of the 4 groups found alphabet supplementation more acceptable and effective than any of the other conditions. Correlations between intelligibility scores and acceptable/effectiveness measures showed a negative relationship for alphabet supplementation, suggesting that as supplemented intelligibility improves, acceptance of alphabet supplementation decreases.