Promoting Functional Communication Abilities in Aphasia with Virtual Reality

描述（由申请人提供）：失语症是一种后天性沟通障碍，影响口语、阅读和写作的能力。虽然常见于老年人，但它可以发生在所有年龄，无论种族或性别。随着医疗保健的改善，失语症患者的寿命延长，这对生活质量有影响。这一趋势影响了失语症康复的方法，促使研究人员和临床医生寻找方法来补充直接基于损伤的治疗方法，最大限度地发挥失语症患者（PWA）在自己的环境中使用剩余语言技能的潜力。我们的研究团队包括在语音病理学，虚拟现实，人机界面，对话系统和语音识别方面具有丰富专业知识的研究人员。我们的长期目标是通过用户友好的软件提供渐进式功能康复计划，该软件将通过经济可行和广泛的人群获得来改变医疗保健服务。本申请的具体目的是：1）开发能够识别失语症中常见的语言和语音模式的软件，2）开始测试人类-化身（虚拟人）口头交互，以实现与人类客户的交互式对话，以及3）比较虚拟临床医生-人类客户二人组和人类临床医生-人类客户二人组对话中语言产生的数量和质量。我们假设，从虚拟人的即时反应训练失语症患者将促进言语输出，这是相当的言语输出时，与临床医生在一个结构化的对话设置。在目标1中，我们扩展了临床医生和客户角色扮演的习惯治疗范式，开发了一个口语对话系统（SDS），具有单独定制的声学模型，语言和词汇模型，对话结构。SDS将与通过虚拟临床医生提供的面部动画集成。该系统将具有识别语音中的上下文和声音变化的能力，同时继续呈现有意义的关键词，以刺激失语症患者生成交互式语音。在软件开发阶段，我们将使用“绿野仙踪”范例，该范例具有计算机化图像，该图像模拟隐藏的人类生成的语音，以识别定制软件的一系列会话变体和关键词。在目标3中，我们将应用SDS与目标1中开发的虚拟临床医生。我们将评估（1）使用内容，语法和形态的定量和定性测量的人类临床医生-客户端二人组和虚拟临床医生-客户端二人组的语言输出，以及（2）使用实验室开发的问卷与化身和人类临床医生进行交互的接受性。对话期间的回应将被记录和数字化，数据将在基线和后续会议期间进行分析，以评估适当的内容和结构。这些研究的结果有可能开发一个虚拟的临床医生-人的互动系统，可以独立使用的失语症患者练习和提高功能性沟通技能。 公共卫生相关性：失语症是一种后天性的交流障碍，由脑损伤引起，影响说话和理解口语和书面语言的能力。医疗保健的改善使失语症患者的寿命更长，这对他们的生活质量有影响。本申请提出开发一种基于计算机的治疗方法，通过客户端虚拟临床医生对话，促进在日常生活中使用剩余的语言技能。

DESCRIPTION (provided by applicant): Aphasia is an acquired communication disorder that affects the ability to speak and understand spoken language, reading, and writing. Although common in the elderly, it can occur at all ages regardless of race or gender. With improved health care, people are living longer with aphasia, which has implications for quality of life. Thi trend has influenced approaches to aphasia rehabilitation, spurring researchers and clinicians to find ways to supplement direct impairment-based treatments with methods that maximize the potential of people with aphasia (PWA) to use residual language skils in their own environments. Our research team includes investigators with strong expertise in speech pathology, virtual reality, human-machine interfaces, dialogue systems, and speech recognition. Our long-term goal is to provide progressive functional rehabilitation programs through user-friendly software that will transform healthcare delivery by being both economically feasible and accessible to a broad spectrum of the population. The specific aims of this application are to: 1) develop software capable of identifying the language and speech patterns common in aphasia, 2) begin testing human-avatar (virtual human) verbal interactions to implement interactive dialogue with human clients, and 3) compare the quantity and quality of language production in dialogues of virtual clinician-human client dyads and human clinician-human client dyads. We hypothesize that training individuals with aphasia with immediate responses from virtual humans will promote verbal output that is comparable to verbal output when conversing with a clinician in a structured conversational setting. In Aim 1 we extend the customary treatment paradigm of clinician and client role-playing by developing a spoken dialogue system (SDS) that has individually customized acoustic models, language and lexical models, and dialogue structure. The SDS will be integrated with facial animation provided through a virtual clinician. This system will have the capability of recognizing context and sound variation in speech while continuing to present meaningful keywords in order to stimulate the generation of interactive speech by individuals with aphasia. During the software development phase, we will use a 'Wizard of Oz' paradigm that has a computerized image that simulates the speech generated by a hidden human in order to identify a range of conversational variations and key words for the customized software. In Aim 3, we will apply the SDS with the virtual clinician developed in Aim 1. We will evaluate (1) language output in human clinician-client dyads and virtual clinician-client dyads using quantitative and qualitative measures of content, syntax, and morphology, and (2) receptiveness to interaction with the avatar and human clinician with a laboratory-developed questionnaire. Responses during the conversations will be recorded and digitized, and data will be analyzed during baseline and follow-up sessions will be evaluated for appropriate content and structure. Results of these studies have the potential to develop a virtual clinician- human interaction system that can be used independently by people with aphasia to practice and improve functional communication skills. PUBLIC HEALTH RELEVANCE: Aphasia is an acquired communication disorder resulting from brain damage and affecting the ability to speak and understand spoken and written language. Improvements in healthcare have enabled people to live longer with aphasia, which has implications for their quality of life. This application proposes to develop a computer-based treatment approach that promotes use of residual language skills in everyday living situations through client-virtual clinician conversations.