Enhancing efficacy of speech modification strategies for pediatric dysarthria

项目摘要 构音障碍是一种神经运动性言语障碍， 脑瘫儿童的社会参与和沟通能力。 尽管其在CP儿童中流行，但几乎没有证据指导治疗。 儿童构音障碍全局语音修改策略（例如，用大嗓门或慢语速 率）已显示出改善这一人群的可理解性的希望;然而， CP在他们的沟通技巧和运动能力方面是异质的，他们并不都是这样。 从这些战略中受益。儿童言语矫正策略的有效性 由于缺乏比较不同策略疗效的研究， 以及对这些策略如何导致可理解性增益的理解不足。拟议 研究旨在通过比较三种语音修改的功效来解决这一需求。 战略，并通过确定“关键成分”的基础上的可理解性增益不同 语音修改条件。具体目标1将检查南极洲应力的影响， 新的，本地语音修改策略的可懂度和语音自然度， CP青少年，与两种全球言语矫正策略（大声说话和 慢速率）。我们假设，抗应激策略将产生相当于或更大的 与全球大声和缓慢相比， 战略布局具体目标2将确定最能预测儿童内的定量言语测量 在说话条件下的可懂度变化。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的可懂度增益 的任务表现。拟议的研究将提供有可能 导致发展一种新的，治疗压力的干预策略， 构音障碍此外，本研究对提高理论水平具有重要意义。 了解直接影响语音清晰度的因素，并可能 用于改善治疗技术的个性化并最大限度地提高语音效果 用于继发于脑瘫的构音障碍儿童。

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.