Therapeutic Approaches to Dysarthria: Acoustic and Perceptual Correlates

描述(由申请人提供)：我们研究的长期目标是开发一个基于声学的、解释构音障碍的沟通障碍的模型，可以用来指导和证明治疗决定的合理性。为此，拟议的第一阶段治疗项目将调查语音和喉上声学测量语音、可理解性和说话条件之间的关系，作为帕金森病和多发性硬化症继发的构音障碍的干预策略。第一个融资周期的研究表明，元音的清晰度在缓慢的条件下最大，辅音的清晰度和清晰度在大的条件下最大。喉上声学测量也只解释了清晰度变化的一部分。尽管知觉-声学理论(Perkell等人，2000年)预测了这样的结果，但鼓励减慢速率和增加强度的语音模式是否会比仅与降低速率或增加响度相关的语音模式在声学-语音清晰度和可理解性方面产生改善尚不清楚。拟议的项目通过将构音障碍的语音模式效应的研究扩展到清晰的语音来测试感知-声学理论的这一预测和其他预测，这是一种鼓励减慢速度和增加强度的语音模式。还将研究发声行为的声学测量对清晰度的贡献，以及声学-语音清晰度的测量。响亮、慢、清晰、甚至快的语音模式被用于治疗构音障碍，以最大限度地提高可理解性，但缺乏比较组研究。改善我们对与这些语音模式相关的声觉变化的理解的研究将加强治疗技术的科学基础，并可能揭示特定语音模式的声觉优势，这将决定首选的治疗方法--循证实践的关键考虑因素。需要评估的主要假设是，在与增加努力相关的条件下，可理解性和声学-语音辨别力将最大化，如SPL所指，并鼓励放慢语速，而语音功能将在与增加努力相关的条件下最大化。这一假设是由知觉-声学理论提出的，该理论假设在努力和声音知觉充分性以及发音速度和准确性之间进行权衡。

DESCRIPTION (provided by applicant): The long term goal of our research is to develop an acoustically-based, explanatory model of the communication deficit in dysarthria that can be used to guide and justify treatment decisions. Toward this end, the proposed Phase I treatment project will investigate the relationship among phonatory and supralaryngeal acoustic measures of speech, intelligibility, and speaking conditions used as intervention strategies for dysarthria secondary to Parkinson disease and Multiple Sclerosis. Studies from the first funding cycle indicated that vowel distinctiveness was maximized in a Slow condition while consonant distinctiveness and intelligibility were maximized in a Loud condition. Supralaryngeal acoustic measures also accounted for only a portion of the variance in intelligibility. Whether a speech mode encouraging a slowed rate and increased intensity would yield improvements in acoustic-phonetic distinctiveness and intelligibility above those associated with rate reduction or increased loudness alone is unknown, although the Perceptual-Acoustic Theory (Perkell et al., 2000) predicts such an outcome. The proposed project tests this and other predictions of the Perceptual-Acoustic Theory by extending the study of speech mode effects in dysarthria to Clear speech, a speech mode encouraging a slowed rate and increased intensity. The contribution of acoustic measures of phonatory behavior to intelligibility as well as measures of acoustic-phonetic distinctiveness also will be studied. Loud, Slow, Clear, and even Fast speech modes are used therapeutically to maximize intelligibility in dysarthria, yet comparative group studies are lacking. Research that improves our understanding of acoustic-perceptual changes associated with these speech modes would strengthen the scientific bases of treatment techniques and may reveal acoustic-perceptual advantages of a given speech mode that will determine preferred therapies - key considerations for evidence based practice. The overarching hypothesis to be evaluated is that intelligibility and acoustic-phonetic distinctiveness will be maximized in conditions associated with increased effort, as indexed by SPL, and for which a slowed rate is encouraged, whereas phonatory function will be maximized in conditions associated with increased effort. This hypothesis is suggested by the Perceptual-Acoustic Theory, which posits a trade-off between effort and acoustic-perceptual adequacy as well as articulatory rate and accuracy.