Simplified Ultrasound Biofeedback for Speech Remediation

项目摘要 超声生物反馈疗法(UBT)在说话过程中提供了舌头的实时图像，已经显示出希望 在治疗残存语音障碍方面。然而，UBT的临床应用受到固有困难的限制。 解释语音过程中快速变化的舌头变形的实时超声图像。对病人来说 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 在多个会话中。尤其是对于年轻的患者，这种丰富、复杂的视觉反馈会引导注意力 在内部，已知的方向会降低肢体和口腔运动期间的表现和冲动力控制 任务。此外，由于语音障碍往往与认知或行为障碍并存，许多患者 永远不会掌握舌头超声图像的解释。因此，UBT的巨大前景并没有得到 因为它的反馈过于复杂、误导和模棱两可。 关于内隐运动学习的科学研究表明，如果(1)说话者在以下方面得到指导，UBT将会得到改善 更简单的视觉反馈和(2)简化涉及外部注意力焦点。对这些内容的反馈 众所周知，品质有助于快速、有力地学习感觉运动技能。这些原则在城市轨道交通中的应用 预计将为语音障碍患者提供极大的好处。这个项目的主要目标是 将UBT和运动学习方面的最新进展转化为一种新的简化超声生物反馈系统 以便更好地临床治疗残存语音障碍。 我们提出的系统将把超声波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，以使舌头运动更接近目标运动 模式。我们将专注于临床上最复杂和最令人沮丧的声音/r/和/L/的补救 语言治疗。一种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/r/和/L/制作过程中舌部的不同运动。我们 将使用统计聚类分析来确定指示正确生产的多个生物反馈目标。这些 目标将用于原型简化的UBT系统，使用简单、引人入胜的视觉反馈来 通过高度激励、游戏化的界面，引导患者正确的舌头运动。我们的 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系统的假设更多 比标准UBT更有效，最有效的生物反馈目标将是那些促进更大 舌动辨证。最终的结果将是对超声成像的最新进展的翻译 语音、实时图像处理和基于生物反馈的运动学习成为一种新的临床UBT工具， 将极大地推进残留语音障碍的治疗。

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.