Pathological speech such as Oesophageal Speech (OS) is difficult to understand due to the presence of undesired artefacts and lack of normal healthy speech characteristics. Modern speech technologies and machine learning enable us to transform pathological speech to improve intelligibility and quality. We have used a neural network based voice conversion method with the aim of improving the intelligibility and reducing the listening effort (LE) of four OS speakers of varying speaking proficiency. The novelty of this method is the use of synthetic speech matched in duration with the source OS as the target, instead of parallel aligned healthy speech. We evaluated the converted samples from this system using a collection of Automatic Speech Recognition systems (ASR), an objective intelligibility metric (STOI) and a subjective test. ASR evaluation shows that the proposed system had significantly better word recognition accuracy compared to unprocessed OS, and baseline systems which used aligned healthy speech as the target. There was an improvement of at least 15% on STOI scores indicating a higher intelligibility for the proposed system compared to unprocessed OS, and a higher target similarity in the proposed system compared to baseline systems. The subjective test reveals a significant preference for the proposed system compared to unprocessed OS for all OS speakers, except one who was the least proficient OS speaker in the data set.

Communication is a huge challenge for oesophageal speakers, be it for interactions with fellow humans or with digital voice assistants. We aim to quantify these communication challenges (both human–human and human–machine interactions) by measuring intelligibility and Listening Effort (LE) of Oesophageal Speech (OS) in comparison to Healthy Laryngeal Speech (HS). We conducted two listening tests (one web-based, the other in laboratory settings) to collect these measurements. Participants performed a sentence recognition and LE rating task in each test. Intelligibility, calculated as Word Error Rate, showed significant correlation with self-reported LE ratings. Speaker type (healthy or oesophageal) had a major effect on intelligibility and effort. More LE was reported for OS compared to HS even when OS intelligibility was close to HS. Listeners familiar with OS reported less effort when listening to OS compared to nonfamiliar listeners. However, such advantage of familiarity was not observed for intelligibility. Automatic speech recognition scores were higher for OS compared to HS.