Therapeutic Approaches to Dysarthria: Acoustic and Perceptual Correlates

构音障碍的治疗方法：听觉和知觉的相关性

• 批准号: 9334170
• 负责人: KRIS TJADEN
• 金额: $ 51.73万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-01-15 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9334170
• 关键词: Acoustics; Address; Affect; Age; American; Articulation; Clinical; Comparative Study; Development; Dysarthria; Employment; Evidence based practice; Frequencies; Funding; Genetic Transcription; Goals; Gold; Idiopathic Parkinson Disease; Individual; Instruction; Knowledge; Leisure Activities; Machine Learning; Measures; Methods; Mission; Modeling; Multiple Sclerosis; National Institute on Deafness and Other Communication Disorders; Nature; Orthography; Outcome; Parkinson Disease; Procedures; Production; Publishing; Quality of life; Research; Secondary to; Societies; Speech; Techniques; Therapeutic; Variant; Work; base; clear speech; comparative; experience; hearing impairment; improved; indexing; innovation; predictive modeling; public health relevance; sex; social; treatment program

 DESCRIPTION (provided by applicant): 90% of the 1.5 million Americans living with idiopathic Parkinson's disease (PD) and 50% of the 500,000 Americans living with Multiple Sclerosis (MS) will experience dysarthria. Dysarthria has devastating consequences for life quality and participation in society due to its effects on employment, leisure activities and social relationships. Knowledge of therapy techniques for maximizing perceived speech adequacy, as indexed by the gold standard perceptual construct of intelligibility is thus of vital importance. Owing to the scarcity of impartial comparative studies, the choice of one technique over others is often based on trial and error or reflects clinician bias, both of which are at odds with evidence-based practice. This project has sought to address this critical gap in knowledge regarding the comparative merits of dysarthria treatment techniques since its inception. Toward this end, published studies from the past funding cycle compared the acoustic and perceptual merits of three common, global dysarthria treatment techniques including 1) rate manipulation, 2) an increased vocal intensity and 3) clear speech in MS and PD as well as age and sex matched neurotypical talkers. Global treatment techniques by their very nature elicit co-occurring acoustic changes (e.g., duration, segmental articulation). Because an explanatory, acoustically-based model of intelligibility is lacking, the acoustic change(s) causing or explainin the improved perceptual outcomes of global treatment techniques are unknown. Determining the acoustic variables explaining intelligibility variation in dysarthria would not only tremendousy advance theoretical understanding of intelligibility but also would strengthen the scientific basis for treatment. Treatment focused on those acoustic variables explanatory for improved intelligibility may further accelerate progress in therapy. Importantly, research from the previous funding cycle suggests the promise of speech analysis-resynthesis for identifying segmental and suprasegmental acoustic variables explanatory for intelligibility in dysarthria. Building upon this work, the overarching goal of the continuation is to contribute towards development of an acoustically-based explanatory model of intelligibility. Our approach 1) employs established perceptual procedures and acoustic measures, 2) uses an innovative analysis-resynthesis technique that permits conclusions concerning the explanatory relationship between acoustic changes accompanying dysarthria therapy techniques and intelligibility, and 3) leverages methods from machine learning to build a predictive model of intelligibility from acoustics. The impact of this work is in its contribution to 1) advancing conceptual understanding of intelligibility, 2) strengthening the scientific basis for treatment, and 3) optimizing clinical implementation of dysarthria therapy techniques.

 描述（由申请人提供）：150万患有特发性帕金森病（PD）的美国人中的90%和50万患有多发性硬化症（MS）的美国人中的50%将经历构音障碍。构音障碍由于其对就业、休闲活动和社会关系的影响，对生活质量和社会参与产生破坏性后果。知识的治疗技术，最大限度地提高感知的言语充分性，作为索引的黄金标准的感知结构的可理解性是至关重要的。由于缺乏公正的比较研究，选择一种技术而不是其他技术往往是基于试验和错误或反映临床医生的偏见，这两者都与循证实践不一致。该项目自成立以来一直试图解决有关构音障碍治疗技术的比较优点的知识方面的这一关键差距。为此，在过去的资助周期中发表的研究比较了三种常见的整体构音障碍治疗技术的声学和感知优点，包括1）速率操纵，2）增加声音强度和3）MS和PD以及年龄和性别匹配的神经典型谈话者的清晰语音。整体治疗技术就其本质而言引起共同发生的声学变化（例如，持续时间，节段性关节）。由于缺乏解释性的、基于声学的可懂度模型，导致或解释全局治疗技术的改善的感知结果的声学变化是未知的。确定解释构音障碍可懂度变化的声学变量不仅会极大地推进对可懂度的理论理解，而且会加强科学基础 接受治疗治疗集中在改善可懂度的声学变量解释，可能会进一步加速治疗的进展。重要的是，以前的研究 资金周期表明，语音分析-再合成的承诺，以确定节段和超节段的声学变量解释构音障碍的可懂度。在这项工作的基础上，继续的首要目标是为开发基于声学的可理解性解释模型做出贡献。我们的方法1）采用既定的感知程序和声学测量，2）使用创新的分析-再合成技术，该技术允许关于伴随构音障碍治疗技术的声学变化与可懂度之间的解释关系的结论，以及3）利用机器学习方法建立声学可懂度的预测模型。这项工作的影响在于其对以下方面的贡献：1）推进对可懂度的概念理解，2）加强治疗的科学基础，3）优化构音障碍治疗技术的临床实施。