Understanding and eliminating residual speech errors with acoustic biofeedback

通过声学生物反馈了解并消除残余言语错误

• 批准号: 8606675
• 负责人: Tara McAllister
• 金额: $ 15.04万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8606675
• 关键词: Accounting; Acoustics; Address; Affect; Age; Age-Years; Auditory; Auditory Perception; Behavior; Biofeedback; Case Study; Categories; Characteristics; Child; Childhood; Client; Clinical; Communication; Controlled Study; Diagnostic; Disease; Documentation; Effectiveness of Interventions; Exhibits; Feedback; Goals; Guidelines; Individual; Individual Differences; Intervention; Investigation; Knowledge; Learning; Measures; Methods; Modeling; Nursery Schools; Occupational; Outcome; Participant; Pattern; Perception; Performance; Population; Production; Public Health; Publishing; Relative (related person); Research; Residual state; School-Age Population; Selection for Treatments; Signal Transduction; Specific qualifier value; Speech; Speech Sound; Testing; Visual; Work; acoustic imaging; base; clinically significant; computer generated; conventional therapy; effectiveness measure; evidence base; evidence based guidelines; innovation; insight; meetings; motor learning; novel; public health relevance; research study; response; skills; social; sound; success; therapy design; traditional therapy; treatment effect

DESCRIPTION (provided by applicant): In children with speech sound disorder, deficits in spoken communication pose a barrier to academic and social participation. Of particular concern is the subset of children who exhibit atypical speech patterns that persist past the age of 9, termed residual speech errors (RE). Research to date has not established why speech errors resolve in some children but persist in others, and effective forms of intervention for RE have remained elusive. This gap gives rise to a long-term goal of establishing evidence-based therapy guidelines for RE while identifying factors that cause and maintain these errors. This study will focus on the subset of children with RE affecting the phoneme /r/ (RE-/r/). The first aim of this proposal is to compare treatment effect sizes produced by two forms of treatment for RE, acoustic biofeedback therapy and traditional articulatory therapy. Preliminary studies have shown that some children can eliminate RE using acoustic biofeedback (a dynamic visual representation of the speech signal), but the efficacy of biofeedback therapy for RE has never been evaluated with systematic experimental methods. To test the hypothesis that biofeedback therapy yields greater treatment gains than traditional therapy, both methods will be applied concurrently to different /r/ targets in an alternating treatments design with multiple baselines across behaviors. 16 children with RE-/r/ will complete 10 weeks of individual therapy. Aim 2 of this proposal will draw on principles of motor learning to explain how biofeedback can succeed in changing articulatory patterns that do not respond to other forms of practice. One hypothesis holds that errors persist when the speaker's internal auditory target for a sound is incorrect, and that biofeedback is effective because it provides knowledge of performance (KP) feedback to guide the speaker to a more accurate target. However, KP feedback has been shown to lose its advantage when the target is already well- specified. Therefore, the working hypothesis for Aim 2 is that children with a poorly specified auditory target for /r/ (i.e., poor perception of /r/) wll derive greater relative benefit from biofeedback therapy than children with good perception. To test this hypothesis, pre-treatment perceptual sensitivity will be measured with a synthetic 10-step acoustic continuum from /r/ to /w/, and the correlation between this measure and the difference in effect sizes calculated in Aim 1 will be evaluated. A significant negative correlatio, indicating that the advantage for biofeedback over traditional therapy is greater in children with poor perception, is anticipated. This research will be clinically significant because the results o Aim 1 will have immediate implications for the selection of therapy methods, and the results of Aim 2 will help clinicians match clients to the most appropriate therapy approach based on their individual characteristics. This study will also be theoretically significant because it is the firt to systematically apply principles of motor learning to investigate the mechanism by which biofeedback influences articulatory skill in children. In the long term, these findings will be par of a continuum of research that will illuminate the causes of RE while continuing to identify principles of intervention for the disorder.

描述（由申请人提供）：对于患有言语障碍的儿童，口语交流缺陷对学业和社会参与构成障碍。特别值得关注的是，9 岁以后仍然表现出非典型言语模式的儿童子集，称为残余言语错误 (RE)。迄今为止的研究尚未确定为什么某些儿童的言语错误会得到解决，而另一些儿童的言语错误却会持续存在，而且针对言语错误的有效干预形式仍然难以捉摸。这一差距催生了一个长期目标，即建立 RE 的循证治疗指南，同时确定导致和维持这些错误的因素。本研究将重点关注 RE 影响音素 /r/ (RE-/r/) 的儿童子集。该提案的首要目的是比较两种 RE 治疗形式（声学生物反馈疗法和传统发音疗法）产生的治疗效果大小。初步研究表明，一些儿童可以利用声学生物反馈（语音信号的动态视觉表示）消除RE，但生物反馈治疗RE的疗效从未用系统的实验方法进行评估。为了检验生物反馈疗法比传统疗法产生更大治疗效果的假设，两种方法将同时应用于交替治疗设计中的不同/r/目标，并具有跨行为的多个基线。 16 名 RE-/r/ 儿童将完成 10 周的个体治疗。该提案的目标 2 将利用运动学习原理来解释生物反馈如何成功改变对其他形式的练习没有反应的发音模式。一种假设认为，当说话者对声音的内部听觉目标不正确时，错误就会持续存在，并且 生物反馈之所以有效，是因为它提供了表现知识（KP）反馈来指导说话者达到更准确的目标。然而，当目标已经明确指定时，KP 反馈已被证明会失去其优势。因此，目标 2 的工作假设是，对 /r/ 听觉目标不明确（即对 /r/ 的感知较差）的儿童将比感知良好的儿童从生物反馈治疗中获得更大的相对益处。为了检验这一假设，将使用从 /r/ 到 /w/ 的合成 10 步声学连续体来测量治疗前的感知灵敏度，并将评估该测量值与目标 1 中计算的效果大小差异之间的相关性。预计存在显着的负相关关系，表明生物反馈相对于传统疗法在感知能力差的儿童中具有更大的优势。这项研究将具有临床意义，因为目标 1 的结果将对治疗方法的选择产生直接影响，而目标 2 的结果将帮助临床医生根据客户的个体特征为他们匹配最合适的治疗方法。这项研究也具有重要的理论意义，因为它是首次系统地应用运动学习原理来研究生物反馈影响儿童发音技能的机制。从长远来看，这些发现将成为一系列研究的一部分，这些研究将阐明 RE 的原因，同时继续确定该疾病的干预原则。