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: 8616744
• 负责人: Sheila E Blumstein
• 金额: $ 20.31万
• 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 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8616744
• 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）：慢性失语症的残留临床特征之一是言语输出障碍。非流利失语症具有有限的言语输出和发音执行缺陷，其中产生的语言声音通常是扭曲的，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说话的意愿。当前项目的目标是将基础研究应用于一种新型康复计划的开发和初步测试，“改善语音生产治疗计划”（TIPP），旨在提高失语症患者的语音输出质量，并最终提高其语音清晰度。TIPP建立在对正常人口语单词生成功能结构的基础研究之上，表明发音执行受刺激的词汇特性的影响；fMRI结果显示神经系统在这种处理过程中被招募；最近的研究结果表明，失语症中口语生成的功能结构保留了一些特性。五名有语言输出缺陷的非流利失语症患者，以及五名有音位失读症的流利失语症患者，将参与其中。假设在不同的说话条件下接触和模仿语音可以塑造和加强单词的词汇和语音形状表征；使用最小对词（tart和dart）训练可以增强发音相似词之间的区别，从而加强语音和语音表征，提高语音输出的质量；这种强化将推广到未训练的单词，这些单词与训练过的单词有相同的发音，并且在获取词汇表征方面也会产生级联效应，从而提高命名能力和口语输出的流畅性。TIPP是一个为期10周，每周2次的方案，包括两个部分的训练阶段，其中一个阶段是训练参与者用正常语调慢速说出一组嵌入在载体短语中的肺泡停辅音最小对目标单词，另一个阶段是训练参与者用语调说话