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However, little is known about which speech features contribute to these restrictions. This study evaluated the effects of common speech symptoms in PALS (reduced overall speaking rate, slowed articulation rate, and increased pausing) on communicative participation restrictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants completed surveys (the Communicative Participation Item Bank\u2010short form; the self\u2010entry version of the ALS Functional Rating Scale\u2010Revised) and recorded themselves reading the Bamboo Passage aloud using a smartphone app. Rate and pause measures were extracted from the recordings. The association of various demographic, clinical, self\u2010reported, and acoustic speech features with communicative participation was evaluated with bivariate correlations. The contribution of salient rate and pause measures to communicative participation was assessed using multiple linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty seven people living with ALS participated in the study (mean age\u2009=\u200961.1\u2009years). Acoustic and self\u2010report measures of speech and bulbar function were moderately to highly associated with communicative participation (Spearman rho coefficients ranged from <jats:italic>r<\/jats:italic><jats:sub><jats:italic>s<\/jats:italic><\/jats:sub>\u2009=\u20090.48 to <jats:italic>r<\/jats:italic><jats:sub><jats:italic>s<\/jats:italic><\/jats:sub>\u2009=\u20090.77). A regression model including participant age, sex, articulation rate, and percent pause time accounted for 57% of the variance of communicative participation ratings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Even though PALS with slowed articulation rate and increased pausing may convey their message clearly, these speech features predict communicative participation restrictions. The identification of quantitative speech features, such as articulation rate and percent pause time, is critical to facilitating early and targeted intervention and for monitoring bulbar decline in ALS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28170","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T11:44:08Z","timestamp":1717501448000},"page":"217-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The relationship of rate and pause features to the communicative participation of people living with <scp>ALS<\/scp>"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0849-1441","authenticated-orcid":false,"given":"Kathryn P.","family":"Connaghan","sequence":"first","affiliation":[{"name":"Speech and Social Interaction Lab, MGH Institute of Health Professions  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1464-1373","authenticated-orcid":false,"given":"Jordan R.","family":"Green","sequence":"additional","affiliation":[{"name":"Speech and Feeding Disorders Lab, MGH Institute of Health Professions  Boston Massachusetts USA"},{"name":"Program in Speech and Hearing Bioscience and Technology, Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-6521","authenticated-orcid":false,"given":"Marziye","family":"Eshghi","sequence":"additional","affiliation":[{"name":"Speech, Physiology, and Neurobiology of Aging and Dementia Lab, MGH Institute of Health Professions  Boston Massachusetts USA"},{"name":"Athinoula A. 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Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Okada","sequence":"additional","affiliation":[{"name":"Speech and Social Interaction Lab, MGH Institute of Health Professions  Boston Massachusetts USA"},{"name":"Speech and Feeding Disorders Lab, MGH Institute of Health Professions  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9058-4331","authenticated-orcid":false,"given":"Stephen A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Arizona  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6613-8668","authenticated-orcid":false,"given":"Jukka\u2010Pekka","family":"Onnela","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Harvard University  Boston Massachusetts 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