A Pilot Therapy Program to Improve Phonetic Production in Aphasia

改善失语症语音产生的试点治疗计划

• 批准号: 8491045
• 负责人: Sheila E Blumstein
• 金额: $ 24.36万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-15 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8491045
• 关键词: Acoustics; Adult; Alveolar; Aphasia; Architecture; Basic Science; Boston; Brain; Categories; Chronic; Chronic Brain Damage; Clinical; Communication; Development; Diagnosis; Diagnostic; Disease; Event; Exposure to; Family; Foundations; Functional Magnetic Resonance Imaging; Goals; Individual; Knowledge; Language; Language Disorders; Language Therapy; Left; Maintenance; Measures; Modeling; Names; Neurologic; Output; Participant; Patients; Performance; Phase; Phonetics; Pre-Post Tests; Process; Production; Property; Protocols documentation; Recruitment Activity; Rehabilitation therapy; Research; Residual state; Shapes; Speech; Speech Disorders; Speech Intelligibility; Stimulus; Structure; Stuttering; System; Testing; Theft; Time; Training; United States; Voice; aphasic; base; design; improved; injured; lexical; novel; phonology; phrases; programs; public health relevance; relating to nervous system; sound; success; system architecture; willingness

DESCRIPTION (provided by applicant): One residual clinical feature of chronic aphasics is a speech output disorder. Nonfluent aphasics have limited speech output and articulatory implementation deficits in which the sounds of language produced are often distorted and hard to understand by listeners. Some fluent aphasics select the wrong sounds comprising a word, making successive attempts impacting the aphasic's willingness to speak. The goal of the current project is to apply basic research to the development and preliminary testing of a novel rehabilitation program, 'Therapy Program to Improve Phonetic Production' (TIPP), designed to improve the quality of the acoustic- phonetic output and ultimately the speech intelligibility of aphasic participants. TIPP builds off of basic research on the functional architecture of spoken word production in normals showing that articulatory implementation is influenced by the lexical properties of the stimulus; fMRI results showing the neural system recruited in such processing; and recent findings indicating spared properties of the functional architecture of spoken word production in aphasia. Five nonfluent aphasics who have speech output deficits, and five fluent aphasics who produce phonemic paraphasias, will participate. It is hypothesized that exposure to and modeling speech under different speaking conditions can shape and strengthen the lexical and sound shape representations of words; training with minimal pair words (tart vs. dart) will enhance the distinction between similar sounding words leading to strengthening phonetic and phonological representations and improved quality of the phonetic output; this strengthening will generalize to untrained words that share voicing with the trained words and will also have a cascading effect on accessing lexical representations leading to increased naming ability and spoken output fluency. TIPP is a 10 week, 2-session per week, protocol which includes a two part training phase, one in which the participant is trained to produce a set of alveolar stop consonant minimal pair target words embedded in a carrier phrase spoken with normal intonation but at a slowed pace, and the other in which the participant is trained to intone the same set of target words embedded in the carrier phrase, also at a slowed pace. To assess the program, acoustic analyses will be conducted to determine whether there is a greater distinction between voiced and voiceless stop consonants post-training, whether there are changes in the number of tokens successfully produced, the number of sound errors made, and the number of false starts or stutters, and where there are changes in intelligibility. Generalization and maintenance 2 and 6 monthspost- therapy will be assessed on a set of untrained labial and velar word tokens and on other language variables including naming and speech fluency. The number of adults who have a residual aphasia after a neurological event is in the millions, and the effects on their lives as well as their families are devastating. This research holds promise of establishing a new protocol to improve the quality and intelligibility of the speech output of aphasic participants leading to a substantive improvement in their communication abilities.

描述(申请人提供)：慢性失语症的一个残留临床特征是言语输出障碍。不流利的失语症患者言语输出有限，发音执行障碍，所产生的语言声音经常扭曲，难以被听者理解。一些流利的失语症患者选择了错误的发音组成一个单词，连续的尝试影响了失语症患者的说话意愿。当前项目的目标是将基础研究应用于开发和初步测试一种新的康复计划，即改善语音产生的治疗计划(TIPP)，旨在改善声学-语音输出的质量，并最终提高失语症患者的语音清晰度。TIPP建立在对正常人口语产生功能结构的基础研究的基础上，表明发音执行受到刺激的词汇属性的影响；fMRI结果显示在这种处理中招募的神经系统；以及最近的发现表明，失语症患者口语产生功能结构的备用特性。五名言语输出有缺陷的非流利失语症患者和五名流利失语症患者将参与其中。假设在不同的说话条件下接触语音并对其进行建模可以塑造和加强单词的词汇和声音形状表征；用最少的配对单词(tart vs.dart)训练将增强相似发音单词之间的区别，从而加强语音和语音表征，并改善语音输出的质量；这种加强将推广到与训练单词发音相同的未训练单词，并将在获得词汇表征方面产生级联效应，从而提高命名能力和口语输出流利性。TIPP是一种为期10周、每周2次的训练方案，它包括两个训练阶段，其中一个训练阶段训练参与者产生一组嵌入到以正常语调但以较慢的速度说出的载体短语中的肺泡化辅音最小对目标单词，以及另一个训练参与者进行声调训练 同样的一组目标词嵌入载体短语中，也是以较慢的速度。为了评估该计划，将进行声学分析，以确定训练后浊音和清音的停止辅音是否有更大的区别，成功产生的代号数量是否发生变化，声音错误的数量，错误开始或口吃的数量，以及可理解性在哪里发生变化。2个月和6个月的推广和维持--将根据一套未经训练的唇语和唇语单词以及包括命名和语言流利性在内的其他语言变量进行评估。在神经系统事件后残留失语的成年人有数百万人，对他们的生活和家庭的影响是毁灭性的。这项研究有望建立一种新的协议来提高语音质量和可理解性 失语症患者的言语输出使他们的交际能力有了实质性的提高。