Simplified Ultrasound Biofeedback for Speech Remediation

项目摘要 超声波生物反馈疗法（UBT），在说话时提供舌头的实时视图，已经显示出希望 治疗残余语音障碍然而，UBT的临床效用受到固有困难的限制， 解读说话时舌头变形快速变化的实时超声波图像。患者 为了从这些图像中获得有效的反馈，临床医生必须提供广泛的解释和指导 在多个会议上。特别是对于年轻的患者，这种丰富、复杂的视觉反馈会引导注意力 在内部，已知在肢体和口腔运动期间降低性能和冲击力控制的方向 任务此外，由于言语声音障碍通常与认知或行为困难共存，许多患者 从来没有掌握舌超声图像的解释。因此，UBT的巨大承诺并没有被 意识到这一点是因为它的反馈太复杂、误导和模棱两可。 对内隐运动学习的科学研究表明，如果（1）说话者被以下因素引导， 更简单的视觉反馈和（2）简化从事外部注意力的焦点。反馈这些 已知这些品质有助于快速、稳健的感觉运动技能学习。将这些原则应用于UBT 预计将为那些有言语声音障碍的人提供巨大的好处。该项目的主要目标是 将UBT和运动学习的最新进展转化为新的简化的超声生物反馈系统， 以便更好地临床治疗残余语音障碍。 我们提出的系统将把超声捕捉到的复杂的舌头运动转化为简化的 实时反馈显示，为每个用户定制，以驱动舌头运动更接近目标运动 模式.我们将专注于修复/r/和/l/，临床上最复杂和最令人沮丧的声音 语言治疗基于实时超声处理的舌运动跟踪新方法 图像，我们将自动表征在/r/和/l/生产期间舌头部分的差异化运动。我们 将采用统计聚类分析来识别指示正确生产的多个生物反馈目标。这些 目标将用于一个简化的UBT原型系统，该系统采用简单、引人入胜的视觉反馈， 通过高度激励性的游戏化界面引导患者进行正确的舌头运动。我们 简化的UBT系统将在试点临床试验中得到验证，测试简化的UBT更多的假设 比标准的UBT有效，最有效的生物反馈目标将是那些促进更大的 舌运动的分化。最终的结果将是翻译的最新进展，超声成像， 语音、实时图像处理和基于生物反馈的运动学习整合到一种新型临床UBT工具中， 将极大地推进对残余语音障碍的治疗。

Project Summary Ultrasound biofeedback therapy (UBT), offering a real-time view of the tongue during speech, has shown promise in treating residual speech sound disorders. However, the clinical utility of UBT is limited by the inherent difficulty of interpreting real-time ultrasound images of rapidly changing tongue deformations during speech. For patients to receive effective feedback from these images, clinicians must provide extensive explanation and orientation over multiple sessions. Especially for younger patients, this rich, complex visual feedback directs attention internally, a direction known to reduce performance and impulse force control during limb and oral movement tasks. Further, since speech sound disorders often coexist with cognitive or behavioral difficulties, many patients never master interpretation of tongue ultrasound images. Thus, the tremendous promise of UBT has not been realized because its feedback is too complex, misdirected, and ambiguous. Scientific studies on implicit motor learning suggest UBT would be improved if (1) speakers are guided by simpler visual feedback and (2) the simplification engages an external attentional focus. Feedback with these qualities is known to facilitate rapid, robust sensorimotor skill learning. Application of these principles into UBT is expected to provide great benefits to those with speech-sound disorders. The major goal of this project is to translate these recent advances in UBT and motor learning into a new simplified ultrasound biofeedback system for better clinical treatment of residual speech sound disorders. Our proposed system will transform the complex tongue movements captured by ultrasound into simplified real-time feedback displays, customized for each user to drive tongue movements closer to goal movement patterns. We will concentrate on remediation of /r/ and /l/, the most complex and frustrating sounds in clinical speech therapy. Using a novel method for tongue motion tracking based on processing of real-time ultrasound images, we will automatically characterize differentiated motion of tongue parts during /r/ and /l/ production. We will employ statistical cluster analysis to identify multiple biofeedback targets indicating correct production. These targets will be employed in a prototype simplified UBT system employing simple, engaging visual feedback to guide patients toward correct tongue movement, presented by a highly motivating, gamified interface. Our simplified UBT system will be validated in a pilot clinical trial, testing the hypotheses that simplified UBT is more effective than standard UBT, and that the most effective biofeedback targets will be those promoting greater differentiation of tongue motion. The end result will be translation of recent advances in ultrasound imaging of speech, real-time image processing, and biofeedback-based motor learning into a novel clinical UBT tool that will greatly advance treatment of residual speech sound disorders.