The Effects of Elderspeak on the Mood of Older Adults with Dementia: A Preliminary Report

Barriers to effective and harmonious communication between caregivers and those affected with dementia are common and inevitable. An example of a common barrier is aphasia, which is a prevalent communication deficit associated with dementia. The social environment may further hinder harmonious communication through the use of well-intended, but ineffective speech patterns. Elderspeak (ES), which is infantilizing speech directed at older adults, is one such speech pattern that is commonly used in long-term care facilities (LTC) and is related to negative outcomes for older adults receiving it. Older adults with mild to moderate cognitive impairment who were residents at a LTC facility were exposed to two videos depicting a typical interaction between a nursing staff at a LTC facility and a resident. Prior to using the videos with older adults, they were validated for accuracy by nursing staff at a LTC facility. The videos depicted a “neutral” interaction (N-ES) and one that used elderspeak. Self-reports of mood were collected for older adults before and after each video. Behavioral observation of affect was collected while the older adults watched the videos. Qualitative interviews investigating preferences and opinions were administered after each video. Contrary to existing literature, results indicated that the participants in this study had similar emotional and behavioral responses to both videos. Further research is necessary in order to more fully determine what contextual variables affect how individuals with dementia respond to elderspeak

Decline of auditory-motor speech processing in older adults with hearing loss

Older adults often experience difficulties in understanding speech, partly because of age-related hearing loss. In young adults, activity of the left articulatory motor cortex is enhanced and it interacts with the auditory cortex via the left-hemispheric dorsal stream during speech processing. Little is known about the effect of ageing and age-related hearing loss on this auditory-motor interaction and speech processing in the articulatory motor cortex. It has been proposed that up-regulation of the motor system during speech processing could compensate for hearing loss and auditory processing deficits in older adults. Alternatively, age-related auditory deficits could reduce and distort the input from the auditory cortex to the articulatory motor cortex, suppressing recruitment of the motor system during listening to speech. The aim of the present study was to investigate the effects of ageing and age-related hearing loss on the excitability of the tongue motor cortex during listening to spoken sentences using transcranial magnetic stimulation and electromyography. Our results show that the excitability of the tongue motor cortex was facilitated during listening to speech in young and older adults with normal hearing. This facilitation was significantly reduced in older adults with hearing loss. These findings suggest a decline of auditory-motor processing of speech in adults with age-related hearing loss

When eye meets ear : an investigation of audiovisual speech and non-speech perception in younger and older adults

This dissertation addressed important questions regarding audiovisual (AV) perception. Study 1 revealed that AV speech perception modulated auditory processes, whereas AV non-speech perception affected visual processes. Interestingly, stimulus identification improved, yet fewer neural resources, as reflected in smaller event-related potentials, were recruited, indicating that AV perception led to multisensory efficiency. Also, AV interaction effects were observed of early and late stages, demonstrating that multisensory integration involved a neural network. Study 1 showed that multisensory efficiency is a common principle in AV speech and non-speech stimulus recognition, yet it is reflected in different modalities, possibly due to sensory dominance of a given task. Study 2 extended our understanding of multisensory interaction by investigating electrophysiological processes of AV speech perception in noise and whether those differ between younger and older adults. Both groups revealed multisensory efficiency. Behavioural performance improved while the auditory N1 amplitude was reduced during AV relative to unisensory speech perception. This amplitude reduction could be due to visual speech cues providing complementary information, therefore reducing processing demands for the auditory system. AV speech stimuli also led to an N1 latency shift, suggesting that auditory processing was faster during AV than during unisensory trials. This shift was more pronounced in older than in younger adults, indicating that older adults made more effective use of visual speech. Finally, auditory functioning predicted the degree of the N1 latency shift, which is consistent with the inverse effectiveness hypothesis which argues that the less effective the unisensory perception was, the larger was the benefit derived from AV speech cues. These results suggest that older adults were better "lip/speech" integrators than younger adults, possibly to compensate for age-related sensory deficiencies. Multisensory efficiency was evident in younger and older adults but it might be particularly relevant for older adults. If visual speech cues could alleviate sensory perceptual loads, the remaining neural resources could be allocated to higher level cognitive functions. This dissertation adds further support to the notion of multisensory interaction modulating sensory-specific processes and it introduces the concept of multisensory efficiency as potential principle underlying AV speech and non-speech perceptio

Aging and Sex Influence Cortical Auditory-Motor Integration for Speech Control

It is well known that acoustic change in speech production is subject to age-related declines. How aging alters cortical sensorimotor integration in speech control, however, remains poorly understood. The present event-related potential study examined the behavioral and neural effects of aging and sex on the auditory-motor processing of voice pitch errors. Behaviorally, older adults produced significantly larger vocal compensations for pitch perturbations than young adults across the sexes, while the effects of sex on vocal compensation did not exist for both young and older adults. At the cortical level, there was a significant interaction between aging and sex on the N1-P2 complex. Older males produced significantly smaller P2 amplitudes than young males, while young males produced significantly larger N1 and P2 amplitudes than young females. In addition, females produced faster N1 responses than males regardless of age, while young adults produced faster P2 responses than older adults across the sexes. These findings provide the first neurobehavioral evidence that demonstrates the aging influence on auditory feedback control of speech production, and highlight the importance of sex in understanding the aging of the neuromotor control of speech production

Judging Communicative Competence: Investigating Age-Related Stereotypes in Speech-Language Pathology Students

The proportion of the US population over age 65 is projected to reach almost 80 million by the year 2040, doubling the numbers from 2000 (Administration on Aging, 2012). With the aging of the population, the incidence of age-related diseases and disorders like stroke and dementia is expected to increase, adding to the caseloads of speech-language pathologists (SLPs). Most SLPs, by contrast, are younger adults; over a quarter of SLPs in the US are under age 35 (ASHA, 2012). Thus, as the elderly population grows, more intergenerational communication encounters will occur between SLPs and their aging clients, increasing demands for cultural competence, specifically with regard to ageism. However, the field of speech-language pathology has seen little research into the impact of age-related stereotypes on service delivery (Armstrong & McKechnie, 2003). One’s interactions with people are implicitly shaped by stereotypes, widely held unconscious representations of groups of people (Devine, 1989). According to the Age Stereotypes in Interaction model (Hummert, 2012), there are three main factors that trigger stereotypes: the perceiver’s self-system, the context of the interaction, and physical traits. ‘Self-system’ refers to one’s beliefs and attitudes, which are themselves determined by one’s age, cognitive complexity, and past experiences (Hummert, 2012; Ryan, 2007). Stereotypes can be reinforced by the context in which intergenerational encounters occur. To illustrate, Hummert and colleagues (1998) found that younger adults used different language when speaking to older adults in the hospital vs an apartment. Aspects of physical appearance (e.g. grey hair, stooped posture) create an immediate impression of the older individual (Adams et al., 2012). Using photographs, Hummert and colleagues (1997) found that adults perceived to be older were stereotyped more negatively than younger-looking adults. Negative stereotypes may, in turn, affect older adult’s responses, resulting in a cycle of reinforced stereotypes and negative interactions (Ryan, 2007). Williams and colleagues (2009) found that nurses who used ‘elderspeak’ met with more resistance to care in their patients with dementia. To prevent such negative interactions, SLPs must become aware of the potential impact of implicit age-related stereotypes. The purpose of this study was to determine whether SLP students are influenced by age-related stereotypes when judging the communication of older adults

Speech-based interaction in an AAL context

International audiencePURPOSE The number of older persons in industrialized countries is steadily increasing. Seniors living alone are more numerous, and we must find solutions that will allow them to continue to stay at home comfortably and safely. Smart housings can be one of these solutions. One of the biggest challenges in ambient assisted living (AAL) is to develop smart homes that anticipate and respond to the needs of the inhabitants. Given the diverse profiles of the older adult population, it will therefore be essential to facilitate interaction with the smart home through systems that respond naturally to voice commands rather than using tactile interfaces. METHOD The first step in our study was to evaluate how well ambient assistive speech technology is received by the target population. We report on a user evaluation assessing acceptance and fear of this new technology. The experiment aimed at testing three important aspects of speech interaction: voice command, communication with the outside world, home automation system interrupting a person's activity. Participants were 7 older persons (71-88 years old), 7 relatives and 3 professional carers; the experiments were conducted in a smart home with a voice command using a Wizard-of-Oz technique. The second step in our study was related to the adaptation of speech recognition technologies to the older adult population. Judging by the literature this has not been extensively studied. In fact, it is known that industrialized speech recognition system models are not adapted to seniors but to other categories of the population. In order to do this we recorded a specific speech corpus (voice-age) with 7 older adults (70 to 89 years old) reading sentences (a total of 4 hours of speech). A second corpus (ERES38) of free talking (18 hours of speech) was recorded by 23 speakers (68-98 years old). These corpora were analyzed in a semi-automatic manner to reveal the aged-voice characteristics. RESULTS AND DISCUSSION Regarding the technical aspect, it appears that some phonemes are more affected by age than others. Thus, a specific adaptation of the acoustic models for ASR is required. Regarding the acceptance aspect, voice interfaces appear to have a great potential to ease daily living for older adults and frail persons and would be better accepted than other, more intrusive, solutions. By considering still healthy and independent older persons in the user evaluation, one interesting finding was overall acceptance provided the system is not conducive to a lazy lifestyle by taking control of everything. This particular concern must be addressed in the development of smart homes that support daily living by stressing the ability to control the daily routine rather than altering it. This study shows the great interest of voice interfaces to develop efficient solution to enable the growing number of older persons to continue to live in their own homes as long as possible

EFFECTS OF AGING ON MIDBRAIN AND CORTICAL SPEECH-IN-NOISE PROCESSING

Older adults frequently report that they can hear what they have been told but cannot understand the meaning. This is particularly true in noisy conditions, where the additional challenge of suppressing irrelevant noise (i.e. a competing talker) adds another layer of difficulty to their speech understanding. Hearing aids improve speech perception in quiet, but their success in noisy environments has been modest, suggesting that peripheral hearing loss may not be the only factor in the older adult’s perceptual difficulties. Recent animal studies have shown that auditory synapses and cells undergo significant age-related changes that could impact the integrity of temporal processing in the central auditory system. Psychoacoustic studies carried out in humans have also shown that hearing loss can explain the decline in older adults’ performance in quiet compared to younger adults, but these psychoacoustic measurements are not accurate in describing auditory deficits in noisy conditions. These results would suggest that temporal auditory processing deficits could play an important role in explaining the reduced ability of older adults to process speech in noisy environments. The goals of this dissertation were to understand how age affects neural auditory mechanisms and at which level in the auditory system these changes are particularly relevant for explaining speech-in-noise problems. Specifically, we used non-invasive neuroimaging techniques to tap into the midbrain and the cortex in order to analyze how auditory stimuli are processed in younger (our standard) and older adults. We will also attempt to investigate a possible interaction between processing carried out in the midbrain and cortex

Investigating Clear Speech Adaptations in Spontaneous Speech Produced in Communcative Settings

In order to investigate the clear speech adaptations that individuals make when communicating in intelligibility-challenging conditions, it would seem essential to examine speech that is produced in interaction with a conversational partner. However, much of the literature on clear speech adaptations has been based on the analysis of sentences that talkers were instructed to read clearly. In this chapter, we review methods for eliciting spontaneous speech in interaction for the purpose of investigating clear speech phenomena. We describe in more detail the Diapix task (Van Engen et al., 2010) and DiapixUK picture pairs (Baker & Hazan, 2011) which have been used in the production of large corpora investigating clear speech adaptations. We present an overview of the analysis of spontaneous speech and clear speech adaptations from the LUCID corpora that include spontaneous speech recordings from children, young and older adults

Investigating Clear Speech Adaptations in Spontaneous Speech Produced in Communicative Settings

In order to investigate the clear speech adaptations that individuals make when communicating in intelligibility-challenging conditions, it would seem essential to examine speech that is produced in interaction with a conversational partner. However, much of the literature on clear speech adaptations has been based on the analysis of sentences that talkers were instructed to read clearly. In this chapter, we review methods for eliciting spontaneous speech in interaction for the purpose of investigating clear speech phenomena. We describe in more detail the Diapix task (Van Engen et al., 2010) and DiapixUK picture pairs (Baker & Hazan, 2011) which have been used in the production of large corpora investigating clear speech adaptations. We present an overview of the analysis of spontaneous speech and clear speech adaptations from the LUCID corpora that include spontaneous speech recordings from children, young and older adults

Older adults' comprehension of speech as interactive domestic alarm system output: A field study

Please contact the publisher for further reprinting or re-use.A rapidly ageing population has led to the development of Interactive Domestic Alarm Systems (IDASs) to assist older adults with independent living. This research considers the use of speech as IDAS output and the impact the domestic environment may have on older adults’ comprehension of speech outputs. This paper introduces IDASs, the benefits of employing speech as a mode of system output and the critical design issue of user comprehension. Extending previous laboratory studies (see Lines & Hone, 2002a, Lines & Hone, 2002b, Lines & Hone, 2002c) a field investigation is reported that considers older adults’ comprehension of speech gender and speech type [natural/synthetic] within the domestic environment. The main findings are discussed and future research directions explored