The effects of unison production on speech fluency in people with aphasia

许多旨在改善失语症患者言语输出的治疗方法都包括统一言语，让失语症患者与临床医生一起说话或录音。本研究的目的是确定个体和刺激物的特征，这些特征可以预测一致说话的好处程度，并研究这种好处的可能机制。这些知识很重要，因为了解谁能从这种常用的潜在强大的治疗成分中受益，在什么条件下受益，以及为什么受益，对于定制治疗以获得最大的治疗效果至关重要。齐声演讲使用两种不同的时间模式之一：(1)自然对话模式，用于日常对话；(2)韵律模式，遵循以节拍为基础的时间框架，如歌曲或某些诗歌。在这两种情况下，精确地将一个人的语言与另一个人的语言对齐（即，引导一个人的语言）需要预测：必须在听到和处理来自另一个人的相应输入之前制定运动命令。自然的对话时机要求说话者利用句法知识来配合对方，而韵律模式则允许说话者在不严重依赖句法知识的情况下预测演讲时机。考虑到许多pwa在处理语法（即语法错误）方面的能力受损，我们假设大多数pwa将从有韵律的句子中获得更多的好处，而不是会话时间模式。然而，pwa在语言、运动言语和计时技能方面存在很大的异质性，因此韵律和会话计时模式在个体之间可能具有不同程度的有效性。本研究的结果将展示个体特征和言语时间如何影响失语症患者是否能从齐声说话中受益，并将测试预测处理（如真正的言语诱导所证明的）是否对实现齐声说话的好处是必要的。

Many treatments designed to improve spoken output in persons with aphasia (PWAs) incorporate unison speech, having the person with aphasia speak along with the clinician or with a recording. The goal of this study is to determine the individual and stimulus characteristics that predict the degree of benefit from speaking in unison, and to investigate a possible mechanism for this benefit. This knowledge is important because understanding who benefits from this commonly used and potentially powerful therapy component, under which conditions they benefit, and why they do, is critical for customizing therapy for maximum therapeutic efficiency. Unison speech is conducted using one of two different timing patterns: (1) a natural conversational pattern, which is used in everyday conversations, or (2) a metrical pattern, which follows a beat-based timing framework, as in songs or some poems. In either case, precisely aligning one’s speech with that of another person (i.e., entraining one’s speech) requires prediction: motor commands must be formulated before the corresponding input from the other person has been heard and processed. While natural conversational timing requires the speaker to make use of syntactic knowledge to align with the other person, a metrical pattern allows a speaker to predict speech timing without relying heavily on syntactic knowledge. Given that many PWAs have an impaired ability to process syntax (i.e., agrammatism), we hypothesize that most PWAs will benefit more from speaking in unison to sentences with metrical vs. conversational timing patterns. However, there is great heterogeneity in linguistic, motor speech, and timing skills across PWAs, so metrical and conversational timing patterns are likely to have different degrees of effectiveness across individuals. Results from this study will demonstrate how individual characteristics and speech timing affect whether or not a person with aphasia benefits from speaking in unison, and will test whether predictive processing, as evidenced by true speech entrainment, is necessary for a benefit of unison speech production to be realized.