Online assessment and enhancement of auditory perception for speech sound errors

项目概要/摘要 在发育性言语声音障碍中，影响言语准确性和可懂度的错误可能会造成 参与学术和社会环境的障碍[1，2]，可能造成终身后果[3]。之间 2-5%的说话者表现出持续到青春期甚至成年期的残余言语错误（RSE）[4， 5，6]，并被认为是特别具有挑战性的治疗。以前的文献已经建立了重要性， 语言-运动学习的认知目标和反馈，包括RSE [7，8]，但需要 为进一步的研究，以衡量听觉敏锐度和检查的影响，认知知觉训练在RSE。 此外，COVID-19大流行迫使研究人员重新评估某些做法，包括哪些做法可以 在网上有效地完成与人[9，10]。临床上，远程实践已被证明是安全的必要条件， 在社交距离期间提供言语治疗服务[11]。即使在大流行消退后，我们也可能 看到一个长期的转变，向在线收集研究数据和远程实践提供语音服务。 然而，迫切需要精心设计的研究来支持这些远程方法的有效性。 这个建议的总体目标是扩大我们对知觉-生产关系的基本理解 在评估涉及感知评估和认知增强训练的任务是否在 在线模式。我们专注于两个增强的治疗方法很容易适应远程实践 上下文，视觉-听觉生物反馈[12，13，14]和认知-感知训练[15，16，8]。我们将瞄准 有影响美式英语/r/发音错误的儿童，被认为是RSE的最常见形式。目的 1将收集/r/和/r/的两个理论激励听觉感知测量的在线规范性数据， 将通过与实验室收集的现有数据集进行比较来评估这些措施的有效性 设置.我们将管理相同的措施，我们的参与者与RSE，这将使我们能够分配他们 我们提出的两项治疗研究的证据。具有典型感知的个人将 分配到Aim 2研究，这是一项随机对照试验（RCT），旨在测量在线视觉-声学 相对于等待列表比较条件的生物反馈治疗。具有非典型感知的个体将 分配给目标3研究，该研究将测量在线认知知觉训练对 感知和生产领域。我们的中心假设是，这两种形式的认知强化训练 将与积极的治疗效果的背景下，远程实践服务交付。 这项研究将通过对生物反馈有效性的首次研究来推进证据基础 治疗和知觉训练中的远程练习的背景下。感知评估的在线工具 在这个项目中开发的培训将免费与临床医生和研究人员分享。拟议研究 因此，将为临床医生和受COVID-19影响的儿童提供直接的贝内，同时也使长期 新技术重塑了言语病理学的科学研究和治疗交付。

Project Summary/Abstract In developmental speech sound disorder, errors affecting the accuracy and intelligibility of speech can pose a barrier to participation in academic and social settings [1, 2], with potentially life-long consequences [3]. Between 2-5% of speakers exhibit residual speech errors (RSE) that persist through adolescence or even adulthood [4, 5, 6] and are considered particularly challenging to treat. Previous literature has established the importance of auditory-perceptual targets and feedback for speech-motor learning, including in RSE [7, 8], but there is a need for further research to measure auditory acuity and examine the effects of auditory-perceptual training in RSE. Furthermore, the COVID-19 pandemic has forced researchers to reassess certain practices, including what can be effectively accomplished online versus in person [9, 10]. Clinically, telepractice has proven essential for safe delivery of speech therapy services during social distancing [11]. Even after the pandemic subsides, we are likely to see a long-term shift toward online collection of research data and telepractice delivery of speech services. However, there is a pressing need for well-designed studies to support the validity of these remote approaches. The overall objective of this proposal is to expand our basic understanding of perception-production relations while evaluating whether tasks involving perceptual assessment and auditory-enhanced training are valid in the online modality. We focus on two auditory-enhanced treatment approaches readily adaptable to the telepractice context, visual-acoustic biofeedback [12, 13, 14] and auditory-perceptual training [15, 16, 8]. We will target children with errors affecting the American English /r/ sound, considered the most common form of RSE. Aim 1 will collect online normative data for two theoretically motivated measures of auditory perception for /r/ and will evaluate the validity of these measures by comparison with an existing dataset collected in the laboratory setting. We will administer the same measures to our participants with RSE, which will allow us to allocate them to our two proposed treatment studies in an evidence-based fashion. Individuals with typical perception will be assigned to the Aim 2 study, a randomized controlled trial (RCT) measuring the efficacy of online visual-acoustic biofeedback treatment relative to a waitlist comparison condition. Individuals with atypical perception will be allocated to the Aim 3 study, which will measure the effects of online auditory-perceptual training on outcomes in both perception and production domains. Our central hypothesis is that both forms of auditory-enhanced training will be associated with positive treatment effects in the context of telepractice service delivery. This research will advance the evidence base by contributing the first studies of the efficacy of biofeedback treatment and auditory-perceptual training in the telepractice context. The online tools for perceptual assessment and training developed in this project will be freely shared with clinicians and researchers. The proposed research will thus offer immediate benefit to clinicians and children affected by COVID-19 while also making a long-term contribution as new technologies reshape scientific research and treatment delivery in speech pathology.