CHS: Small: Game for Cleft Speech Therapy

口面部裂隙(即唇裂、唇腭裂和孤立性腭裂，以及罕见的正中、侧裂和斜裂)是最常见的先天性畸形。在美国，平均每天约有20名患有口裂的婴儿出生，即每年7500名。对于腭裂，一个人无法使用正常的机制阻止气流通过鼻子；因此，腭裂的语音包含有空气从鼻子中泄漏出来的声音，被称为“鼻漏”。在控制语音学习的反复试验的世界里，孩子使用S/他唯一可用的工具来防止空气从鼻子里逸出；S/他在声门或喉咙的水平上阻止空气。这种机制被正常的声音用来做一个硬朗的“g”字，就像在“go”中一样。孩子用这个“声门停顿”来代替S/他不能正常发出的各种声音。因此，腭裂语音成为以声门停顿和不适当的鼻音逃逸为特征的声音的集合；这些异常的发音模式通常被称为代偿性发音障碍(CAD)，它们严重影响语音的可理解性。出于这个原因，矫正手术通常在10-12个月大的时候进行，目的是在孩子开始练习说话时提供一个更正常的解剖框架。然而，修复后的腭部继续受到不同程度的损害，包括典型的腭裂肌肉块和手术后正常疤痕组织的僵硬。在手术修复后大约一年的时间里，腭部功能会自发地改善到对大多数儿童来说足以选择性地防止鼻漏的程度。手术后矫正冠心病的语言治疗从两岁开始，通常持续很多年。纠正唇裂对孩子未来独立生活和充分参与社会的能力非常重要。尽管有记载的好处，但对于言语病理学家来说，在成功可能性最高的早期对儿童进行适当的言语产生培训是一个挑战，因为幼儿通常不太合作，有时不完全理解他们被要求做什么，而且往往不愿意做没有回报的言语作业，通常是在缺乏经验的父母的指导下，他们无法评估细微的进展(或缺乏)。PI在这项研究中的目标是了解帮助矫正后的腭裂儿童产生正常语音的最佳策略，并通过游戏促进这一过程，儿童可以在家里使用这些游戏，只需父母的最少帮助，同时允许将与儿童进展相关的数据实时传递给言语病理学家。项目成果将特别惠及服务不足人群中的儿童。裂隙语音语料库将使致力于裂隙语音检测的语音识别算法的研究人员受益，而新的语音引擎算法将有利于整个语音治疗。这项工作还将推动加州大学洛杉矶分校和加州大学CD分校在以人为中心的健康游戏和健康生活游戏中发展一个新的研究重点。该项目的一个重大科学贡献将是更深入地了解腭裂儿童的决定性特征，以及这些特征与语音和语音规则的原因之间的关系。技术贡献将是程序生成的游戏和语音引擎，以支持对患有矫正腭裂的儿童进行在家和独立管理的语音治疗，以及一种算法，使纵向语音数据管理和分析能够在每个参与者以及跨参与者的干预历史上实时进行。方法论的贡献将包括当语音识别系统被设计来拾取特定于唇裂的发音错误时的错误率的测量，以及一种由计算机科学家、工程师、发展心理学家、言语和语言病理学家、整形外科医生以及患有矫正的腭裂的儿童及其父母参与的语音治疗游戏的参与式设计的方法。

Orofacial clefts (i.e., cleft lip, cleft lip and palate, and isolated cleft palate, as well as the rare median, lateral [transversal], and oblique facial clefts) are among the most common congenital anomalies. Approximately 20 infants are born in the United States with orofacial clefts on an average day, or 7500 every year. With a cleft palate, one is unable to stop airflow through the nose using normal mechanisms; cleft palate speech therefore contains sounds with air leaking out of the nose, referred to as "nasal escape." In the world of trial-and-error that governs speech learning, the child uses the only tool s/he has available to keep air from escaping out of the nose; s/he holds it back at the level of the glottis or larynx. This mechanism is used by the normal voice to make a hard 'g' as in 'go.' The child uses this "glottal stop" as a substitute for a variety of sounds that s/he cannot create normally. Cleft palate speech thus becomes a collection of sounds characterized by glottal stops and inappropriate nasal escape; these anomalous articulation patterns are usually referred to as compensatory articulation disorder (CAD), and they severely affect speech intelligibility. For this reason, corrective surgery is commonly performed around 10-12 months of age, with the goal of providing a more normal anatomical framework by the time the child begins practicing speech. The repaired palate continues, however, to be variably impaired by the less-than-normal muscle bulk typical of cleft palates and by the stiffness of normal post-surgical scar tissue. Over perhaps one year following surgical repair, palatal function spontaneously improves to the point where in the majority of children it is adequate to selectively prevent nasal escape. Speech therapy after surgery to correct CAD begins at the age of two years and often continues for many years. Correcting cleft speech is important for the child's future ability to live independently and to participate fully in society. Despite the documented benefits, it is a challenge for speech pathologists to train children in proper speech production at an early age when the likelihood of success is highest, because young children are typically less cooperative, sometimes do not fully comprehend what they are being asked to do, and are often unwilling to do unrewarding speech homework, typically under the guidance of inexperienced parents who are unable to assess subtle progress (or lack thereof). The PI's goal in this research is to understand the best strategy for helping children with corrected cleft palate produce normalized speech, and to facilitate this process through games that children can use at home with minimal help from parents while allowing data relating to the child's progress to be delivered to speech pathologists in real time. Project outcomes will especially benefit children from underserved populations. A cleft speech corpus will benefit researchers working on speech recognition algorithms for cleft speech detection, and new speech engine algorithms will benefit speech therapy at large. The work will also spur development of a new research focus at UCSC and UCD in human-centered games for health and healthy living.A major scientific contribution of this project will be a deeper understanding of the determining characteristics of children with cleft palate and how these relate to the phonetic and phonological rule causes of cleft speech. The technological contributions will be the games and speech engines that are procedurally generated to support in-home and independently administered speech therapy for children with corrected cleft palate, and an algorithm that enables longitudinal voice data curation and analysis to be carried out in real time over the intervention history for every participant as well as across participants. Methodological contribution will include a measure of error rates when a speech recognition system is designed to pick up cleft-specific mispronunciations, and a method for conducting participatory design of games for speech therapy involving computer scientists, engineers, developmental psychologists, speech and language pathologists, plastic surgeons, and children with corrected cleft palate and their parents.