Computer-based Speech Practice for Dysarthria: A Preliminary Investigation

描述（由申请人提供）：构音障碍是继中风和创伤性脑损伤（TBI）等获得性神经系统疾病之后常见的运动语言障碍。构音障碍是残疾的主要来源，因为它造成沟通困难，对就业和重新融入家庭和社区构成重大障碍。患有构音障碍的个体需要长期进行大量的语言练习，以便进行运动学习，从而提高他们的沟通能力。然而，为构音障碍患者提供广泛的语言练习机会以恢复功能性语言以有效地参与工作、家庭和社区环境所需要的语言治疗的财政支持有限。因此，开发更有效的方法来支持和补充构音障碍患者接受的有限语言治疗服务是至关重要的。本研究进一步推进了NCMRR/NICHD的使命，即通过使用补充语音识别（SSR）程序开发一种新的方法来进行构音障碍的语音练习，从而通过康复来提高残疾人的独立性和福祉。SSR是由研究小组开发的，它利用语音识别技术来管理严重的诵读困难，作为一种辅助写作程序。这项研究将提供初步的数据，以支持未来将SSR发展成电脑化的语音练习系统。目标1将侧重于发展声学操作困难语音样本的技术能力，以提供实践模型。具体来说，该项目将通过用典型的性别匹配、典型的年龄/性别匹配和合成的性别匹配样本替换扭曲或遗漏的辅音音素来操纵中度至重度构音障碍患者的语音产生。目标2将通过操纵语音样本来确定SSR的识别准确性。pi假设不同的操作策略将产生可比性的识别准确性结果，因为他们有识别严重扭曲和非扭曲语音的能力的经验。这一结果将通过确定应该关注哪些操作策略来产生功能性语音练习目标，从而将SSR发展成为语音练习工具，从而推动开发团队的未来方向。最后，Aim 3将记录15个试验治疗阶段中言语表现的初步变化，以确定SSR在长期言语实践中的潜在作用。pi假设患有中度至重度构音障碍的个体会表现出目标练习单词的语音清晰度的提高，并且在使用SSR时，他们的语音产生会在声学上发生变化。本研究将采用三水平研究设计，包括摩尔水平（使用受试者重复测量方差分析的群体分析）、中间水平和分子水平（个人详细案例研究）分析。本研究目标的达成，将为开发一套自动化语音刺激操作的计算机练习程序奠定基础。

DESCRIPTION (provided by applicant): Dysarthria is a common motor speech disorder following acquired neurologic conditions such as stroke and traumatic brain injury (TBI). Dysarthria is a major source of disability as it causes difficulty with communication and poses significant barriers to employment and re-integration into the home and community. Individuals with dysarthria require extensive speech practice over time in order for motor learning to occur to improve their ability to communicate. However, there is limited financial support for speech therapy to provide individuals with dysarthria the extensive speech practice opportunities required to regain functional speech for productive participation in work, home and community settings. Thus, it is critical that more effective approaches be developed to support and supplement the limited speech therapy services individuals with dysarthria receive. This study furthers the mission of the NCMRR/NICHD to enhance the independence and well-being of persons with disability through rehabilitation by developing a novel approach to speech practice for dysarthria using the Supplemented Speech Recognition (SSR) program. The SSR has been developed by the research team and utilizes speech recognition technology that can manage severely dysarthric speech as an assistive writing program. This investigation will provide the preliminary data to support the future development of the SSR into a computerized speech practice system. Aim 1 will focus on developing the technical ability to acoustically manipulate dysarthric speech samples to provide a practice model. Specifically, this project will manipulate the speech productions of individuals with moderate to severe dysarthria by replacing distorted or omitted consonant phonemes with typical gender-matched, typical age/gender-matched, and synthetic gender-matched samples. Aim 2 will identify the recognition accuracy of the SSR with manipulated speech samples. The PIs hypothesize that the different manipulation strategies will yield comparable recognition accuracy results due to their experience with its ability to recognize severely distorted as well as non-distorted speech. The result of this will drive the future direction of the development team by identifying which manipulation strategy to focus on to produce functional speech practice targets to develop the SSR into a speech practice tool. Finally, Aim 3 will document the preliminary changes in speech performance across 15 trial therapy sessions to identify the potential role of SSR in long-term speech practice. The PIs hypothesize that individuals with moderate to severe dysarthria will demonstrate increases in speech intelligibility of target practice words and that their speech productions will change acoustically while using the SSR compared to their habitual productions. This study will utilize a three-level research design that includes molar (group analysis using a within subjects repeated measures ANOVA), intermediate, and molecular (individual detailed case studies) levels of analysis. Achievement of the aims of this project will lay the groundwork for the development of a computer practice program that automates the speech stimuli manipulations for functional speech practice. PUBLIC HEALTH RELEVANCE: Individuals with speech impairment (dysarthria) due to traumatic brain injury (TBI), stroke, and other neurologic conditions require extensive amounts of speech practice in order to recover functional communication abilities to participate fully in work, home, and community settings. However, due to challenges with reimbursement for speech therapy services, support for extensive and long-term speech practice is limited. New intervention strategies that augment traditional speech therapy services and support continuous, long-term speech practice are needed. This project will provide the preliminary data for the development of a computer-based speech practice tool designed specifically to support extensive and long-term speech practice for individuals with moderate to severe dysarthria.