Enhancing efficacy of speech modification strategies for pediatric dysarthria

项目总结 构音障碍是一种神经运动性言语障碍，对功能有负面影响。 为50%以上的脑瘫(CP)儿童提供交流和社会参与。 尽管它在CP儿童中很普遍，但几乎没有证据来指导治疗 儿童构音障碍。全局语音修改策略(例如，使用大嗓门或慢速 率)显示出改善这一人群的可理解性的希望；然而，患有 CP在沟通技能和运动能力上是不同的，他们并不都是 从这些战略中获益。儿童言语矫正策略的有效性研究 目前缺乏对不同策略的有效性进行比较的研究，这限制了CP的发展 以及对这些策略如何带来可理解性收益的理解不足。建议数 研究旨在通过比较三种语音修改的效果来满足这一需求 策略，并通过确定在不同的不同环境中获得的可理解性的基本要素 语音修改条件。具体目标1将考察强调重音的影响，a 基于清晰度和语音自然度的新型本地语音修改策略 患有脑性瘫痪的青少年与两种全球言语调节策略(大声说话和 低速)。我们假设强调重音策略将产生同等或更大的效果。 与全球音量和速度相比，可理解性提高和更高的自然度评级 战略。具体目标2将确定最能预测儿童内部情况的定量言语测量 不同说话条件下清晰度的变化。我们假设声学和运动学 清晰度的测量将比声学测量更好地预测儿童内部清晰度的提高 任务绩效。拟议的研究将提供有潜力的信息 导致开发一种新的、强调压力的儿童应激干预策略 构音障碍。此外，本研究对完善理论研究也具有重要意义。 对直接有助于提高语音清晰度的因素的理解，并可能 用于提高治疗技术的个别化并最大限度地提高语音效果 适用于继发于脑性瘫痪的构音障碍儿童。

PROJECT SUMMARY Dysarthria is a neuromotor speech disorder that negatively impacts functional communication and social participation for over 50% of children with cerebral palsy (CP). Despite its prevalence among children with CP, little evidence exists to guide treatment of dysarthria in children. Global speech modification strategies (e.g., using a loud voice or slow rate) have shown promise for improving intelligibility in this population; however, children with CP are heterogeneous in their communication skills and motor abilities, and they do not all benefit from these strategies. The effectiveness of speech modification strategies for children with CP is currently limited by a lack of research comparing the efficacy of different strategies and a poor understanding of how these strategies lead to intelligibility gains. The proposed research aims to address this need by comparing the efficacy of three speech modification strategies, and by identifying the “key ingredients” underlying intelligibility gains across different speech modification conditions. Specific Aim 1 will examine the effect of emphatic stress, a novel, local speech modification strategy on intelligibility and speech naturalness for adolescents with CP, compared to two global speech modification strategies (loud speech and slow rate). We hypothesize that the emphatic stress strategy will yield equivalent or greater intelligibility gains and higher naturalness ratings compared to the global loud and slow strategies. Specific Aim 2 will identify quantitative speech measures that best predict within-child changes in intelligibility across speaking conditions. We hypothesize that acoustic and kinematic measures of articulation will better predict within-child intelligibility gains than acoustic measures of task performance. The proposed research will provide information that has the potential to lead to development of a novel, emphatic stress intervention strategy for children with dysarthria. In addition, this research has important implications for improving theoretical understanding of factors that directly contribute to speech intelligibility gains, and could be leveraged to improve individualization of treatment techniques and maximize speech outcomes for children with dysarthria secondary to CP.