Speech Perception Assessment and Training System for Aphasia Rehabilitation

描述（由申请人提供）：该项目将测试计算机化的言语感知评估和训练系统（SPATS-AR）作为一种新型失语症康复选择的可行性。SPATS-AR将通过修改现有的软件来开发，这些软件已被发现在改善听力受损的听众（SPATS-HI）和成人英语学习者（SPATS-ESL）的语音识别方面取得了成功。将确定为适应失语症康复系统所需的修改，并评估修改后系统的潜力。该项目特别注重提高语言感知能力。这有望更广泛地提高语言理解能力，因为言语感知障碍似乎对更高水平的语言产生级联效应，对单词和句子的理解产生负面影响。SPATS提供了客观的，自动化的培训，在识别的英语口语，音节成分的积木，并在识别自然口语有意义的句子。识别音节成分（起始、核心和结尾）的培训旨在为客户提供攻击困难单词和监控自己讲话的必要技能。这些声音已经根据它们的词汇和文本出现频率的重要性进行了排名。有三个特点在培训中证明是有效的：（a）根据项目的重要性和客户的业绩逐步介绍项目;（B）自适应项目选择，这是一种选择培训项目的专有方法;并且，在本发明中，（c）“回应后重新聆讯”一个选项，允许客户端比较目标声音与一个错误的。与成分训练交错是一个独特的句子测试和训练系统，它提供了自上而下的认知实践（例如，工作记忆）和自下而上的语言技能。重要的是，在失语症中，已经发现理解问题不仅与语言处理困难（在亚词汇、词汇和/或句法水平）有关，而且与伴随的认知缺陷（例如，工作记忆（Working Memory）因此，SPATS似乎非常适合针对失语症中经常受损的听力、阅读和认知技能。在第一阶段，轻度到中度失语症的参与者将从印第安纳州大学言语和听力诊所招募。预计音节组成任务将需要通过使用更小的声音集合来大大简化。句子任务需要通过添加具有更简单句法结构的新句子、增加信噪比以及简化目标词和陪衬词的显示来进行修改。该策略将是开始的刺激和程序类似于现在使用的ESL和HI人群，然后改变程序的表现所决定的失语症客户。预计在第二阶段最后确定的SPATS-AR将是一个有价值的康复选择，不仅因为其内容，而且因为其在家练习的远程康复潜力。 公共卫生相关性：本计画将测试电脑化语言知觉评估与训练系统（SPATS）作为一种新型失语症治疗方案的可行性。SPATS已被证明在训练听力受损的听众和英语作为第二语言的学习者方面是有效的，以提高他们识别英语语音和识别自然说出的有意义的句子的能力。SPATS的一个版本，专门设计用于满足失语症患者的需要，有可能提高这些人的单词识别，理解和认知技能，并提供远程康复的选择，可能会提高治疗的效率，促进在家里的做法，并带来治疗活动，那些不能定期参加语音语言治疗会议。

DESCRIPTION (provided by applicant): This project will test the feasibility of a computerized speech perception assessment and training system (SPATS-AR) as a novel aphasia rehabilitation option. SPATS-AR will be developed by modifying existing software that has been found to be successful in improving speech recognition by hearing-impaired listeners (SPATS-HI) and by adult learners of English (SPATS-ESL). The modifications needed to adapt the system for aphasia rehabilitation will be identified and the potential of the modified system will be evaluated. The project has a special focus on improving speech-perception capacities. This has the promise of improving language comprehension skills more broadly as speech-perception impairments appear to have a cascading effect on higher levels of language, negatively impacting comprehension of words and sentences. SPATS provides objective, automated training in the identification of the building blocks of spoken English, syllable constituents, and in the recognition of naturally spoken meaningful, sentences. Training in identifying the constituents of syllables (onsets, nuclei, and codas) is designed to give clients necessary skills for attacking difficult words and monitoring their own speech. These sounds have been ranked in their importance based on their lexical and textual frequencies of occurrence. Three special features have proven effective in training: (a) the graduated introduction of items based the item's importance and the client's performance; (b) Adaptive Item Selection (AIS), a proprietary method of selecting items for training; and, (c) the "post-response rehearing" option that allows the client to compare the target sound with the one mistaken for it. Interleaved with constituent training is a unique sentence testing and training system, which gives practice in top-down cognitive (e.g., working memory) and bottom-up linguistic skills. Importantly, in aphasia, comprehension problems have been found to be related to not only linguistic processing difficulties (at sublexical, lexical, and/or syntactic levels), but also to concomitant cognitive deficits (e.g., attention, working memory). Thus, SPATS appears well suited to target the listening, reading, and cognitive skills that are frequently compromised in aphasia. In Phase I, participants with mild to moderate aphasia will be recruited from the Indiana University Speech and Hearing Clinic. It is anticipated that the syllable constituent tasks will need to be greatly simplified by the use of smaller sets of sounds. The sentence task will need to be modified by adding new sentences with simpler syntactic constructions, increasing the signal-to-noise ratios, and simplifying the display of target and foil words. The strategy will be to begin with stimuli and procedures similar to those now used with ESL and HI populations and then alter the procedures as dictated by the performance of aphasic clients. It is anticipated that SPATS-AR, as finalized in Phase II, will be a valuable rehabilitative option not only because of its content but also because of its telerehabilitation potential for at-home practice. PUBLIC HEALTH RELEVANCE: This project will test the feasibility of a computerized Speech Perception Assessment and Training System (SPATS) as a novel aphasia treatment protocol. SPATS has proven effective in training both hearing- impaired listeners and learners of English as a second language to improve their ability both to identify English speech sounds and to recognize naturally spoken, meaningful sentences. A version of SPATS specifically designed to meet the needs of individuals with aphasia has the potential to improve these individuals' word recognition, comprehension, and cognitive skills and to offer a telerehabilitation option that may increase the efficiency of therapy, foster at-home practice, and bring treatment activities to those unable to regularly attend speech-language therapy sessions.