The Use of Electropalatography in the Treatment of Apraxia of Speech

描述(由申请人提供) 这项提议旨在支持退伍军人事务部演讲语言病理学家Shannon Mauszycki博士作为一名独立的退伍军人事务部研究科学家的抱负。言语失用症(AOS)是一种可治疗的神经源性言语障碍，以发音困难、语速减慢和韵律障碍为特征。有关AOS患病率的数据有限，没有关于严重程度的信息。Duffy(2005)发现，在6101例神经性运动性语言障碍患者中，7.6%的患者主要诊断为AOS。最近的数据显示，AOS是12.2%的沟通障碍患者的主要诊断，但AOS倾向于更频繁地发生为继发性沟通障碍与失语症(Duffy，2007)。有效治疗运动性言语障碍，如AOS，需要彻底了解该障碍的生理、知觉和声学特征。有许多工具可以用来检查发音的生理方面。不幸的是，无论采用何种方法，涉及AOS的生理学研究数量有限。检查舌头在发音中的作用的一种方法是腭电(EPG)。EPG要求演讲者佩戴假腭板，这是一种定制的亚克力平板，嵌入了不同数量的电极，紧密贴合上腭部。电极检测舌头与上颚的接触，并允许实时记录、存储和显示接触，并能够向说话者提供视觉生物反馈。EPG已被广泛应用于各种言语障碍，如由腭裂、听力障碍和发育性言语延迟引起的言语障碍(Carter等人，2004；Dagenais，1992,1995；Fletcher等人，1991；Gibbon等人，2001)。研究人员使用舌头来品尝显示器，以提供视觉生物反馈来改善声音产生。到目前为止，EPG在AOS中的应用有限，尽管在一些病例研究报告中，初步研究在描述和改善紊乱的发音方面取得了有希望的结果。有关EPG治疗AOS疗效的实验数据目前尚不清楚。本研究的最初目的是考察随着时间的推移重复测量对AOS说话者的EPG和知觉语音测量的影响。为了正确评估治疗效果，了解这些措施随着时间的推移以及在反复暴露于说话障碍的情况下的稳定性是至关重要的。本研究的第二个目的是系统地考察EPG治疗作为一种视觉生物反馈手段对AOS说话者的效果。 公共卫生相关性： 项目简介：获得性言语失用(AOS)是一种神经性感觉运动性言语障碍，其严重程度从轻微的声音扭曲到无法产生任何有意义的言语。AOS的行为治疗已被证明可以改善言语产生，即使AOS被认为是慢性的。这项研究的第一个目的是考察随着时间的推移重复测量对一组AOS说话者的腭电(EPG)和知觉语音测量的影响。为了适当评估治疗的效果，重要的是要了解这些措施随着时间的推移对发音障碍患者的稳定性。本研究的第二个目的是系统地考察一组使用EPG作为生物反馈手段的AOS患者的治疗对言语产生的影响。这项研究与退伍军人管理局的使命相关，因为研究结果将有助于为患有运动性言语障碍的退伍军人开发临床适用的治疗方法。

DESCRIPTION (provided by applicant) This proposal seeks to support Dr. Shannon Mauszycki, a research speech-language pathologist in the VA Salt Lake City Health Care System in her aspirations to build a career as an independent VA research scientist. Apraxia of speech (AOS) is a treatable neurogenic speech disorder that is characterized by difficulties in sound production, reduced rate of speech, and disturbed prosody. Data regarding the prevalence of AOS are limited with no information regarding severity. Duffy (2005) found AOS was the primary diagnosis for 7.6% of 6101 cases of neurologic motor speech disorders. More recent data revealed AOS was the primary diagnosis for 12.2% of individuals with communication disorders, but AOS tends to occurs more frequently as a secondary communication disorder in conjunction with aphasia (Duffy, 2007). Effective treatment of a motor speech disorder such as AOS requires a thorough understanding of the physiological, perceptual, and acoustic characteristics of the disorder. A number of tools exist to examine physiologic aspects of articulation. Unfortunately, there have been a limited number of physiologic studies involving AOS conducted regardless of methodology. One method for examining the tongue's role in articulation is electropalatography (EPG). EPG involves the speaker wearing a pseudopalate, which is a custom made acrylic plate embedded with a varying number of electrodes that fits tightly against the upper palate. The electrodes detect tongue to palate contacts and allow contacts to be recorded, stored, and displayed in real time and is able to provide visual biofeedback to the speaker. EPG has had extensive application with a variety of speech disorders, such as those resulting from cleft palate, hearing impairment, and developmental speech delay (Carter et al., 2004; Dagenais, 1992, 1995; Fletcher et al., 1991; Gibbon et al., 2001). Investigators have used the tongue to palate displays to provide visual biofeedback to improve sound production. To date, there has been limited utilization of EPG with AOS, although preliminary investigations have yielded promising findings in a few case study reports in terms of describing as well as improving disordered articulation. Experimental data concerning the efficacy of EPG treatment for AOS are currently unavailable. The initial purpose of this research is to examine the impact of repeated measurement over time on EPG and perceptual speech measures in speakers with AOS. In order to appropriately evaluate the effects of treatment, it is critical to understand the stability of these measures over time and with repeated exposure with disordered speakers. The second purpose of this research is to systematically examine the effects of EPG treatment as a means of visual biofeedback for speakers with AOS. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE: Acquired apraxia of speech (AOS) is a neurogenic sensorimotor speech disorder that can range in severity from minor sound distortions to an inability to produce any meaningful speech. Behavioral treatments for AOS have been shown to result in improved speech production even when AOS is deemed chronic. The first purpose of this research is to examine the impact of repeated measurement over time on electropalatography (EPG) and perceptual speech measures in a group of speakers with AOS. In order to appropriately evaluate the effects of treatment, it is important to understand the stability of these measures over time with disordered speakers. The second purpose of this research is to systematically examine the effects of treatment on speech production for a group of speakers with AOS employing EPG as a means of biofeedback. This research has relevance to the mission of the VA, given that the results will aid in the development of clinically applicable treatments for veterans with motor speech disorders.