Therapeutic Approaches to Dysarthria: Acoustic and Perceptual Correlates

描述（由申请人提供）：我们研究的长期目标是建立一个基于声学的，可解释构音障碍中沟通缺陷的模型，该模型可用于指导和证明治疗决策。为此，拟议的I期治疗项目将研究语音和咽上声学测量、可理解性和说话条件之间的关系，作为帕金森病和多发性硬化症继发构音障碍的干预策略。从第一个资助周期开始的研究表明，元音的独特性在慢音条件下最大，而辅音的独特性和可理解性在大声条件下最大。咽上声学测量也只占可理解性差异的一部分。尽管感知声学理论（Perkell et al., 2000）预测了这样的结果，但一种鼓励放慢语速和增加强度的语音模式是否会比那些单独降低语速或增加响度的语音模式更能提高声学-语音的独特性和可理解性还不得而知。拟议的项目通过将对构音障碍的语音模式影响的研究扩展到清晰语音（一种鼓励慢速和增加强度的语音模式）来测试这一理论和感知声学理论的其他预测。语音行为的声学测量对可理解性的贡献以及声学-语音独特性的测量也将被研究。大声、慢速、清晰甚至快速的语音模式在治疗上被用于最大限度地提高构音障碍的可理解性，但缺乏比较的群体研究。研究提高了我们对与这些语音模式相关的声知觉变化的理解，将加强治疗技术的科学基础，并可能揭示给定语音模式的声知觉优势，这将决定首选的治疗方法-基于证据的实践的关键考虑因素。要评估的首要假设是，可理解性和声学-语音独特性将在与增加的努力相关的条件下最大化，如SPL所示，并且鼓励慢速，而发音功能将在与增加的努力相关的条件下最大化。这一假设是由感知声学理论提出的，该理论假设了努力和声学感知充分性以及发音速度和准确性之间的权衡。

DESCRIPTION (provided by applicant): The long term goal of our research is to develop an acoustically-based, explanatory model of the communication deficit in dysarthria that can be used to guide and justify treatment decisions. Toward this end, the proposed Phase I treatment project will investigate the relationship among phonatory and supralaryngeal acoustic measures of speech, intelligibility, and speaking conditions used as intervention strategies for dysarthria secondary to Parkinson disease and Multiple Sclerosis. Studies from the first funding cycle indicated that vowel distinctiveness was maximized in a Slow condition while consonant distinctiveness and intelligibility were maximized in a Loud condition. Supralaryngeal acoustic measures also accounted for only a portion of the variance in intelligibility. Whether a speech mode encouraging a slowed rate and increased intensity would yield improvements in acoustic-phonetic distinctiveness and intelligibility above those associated with rate reduction or increased loudness alone is unknown, although the Perceptual-Acoustic Theory (Perkell et al., 2000) predicts such an outcome. The proposed project tests this and other predictions of the Perceptual-Acoustic Theory by extending the study of speech mode effects in dysarthria to Clear speech, a speech mode encouraging a slowed rate and increased intensity. The contribution of acoustic measures of phonatory behavior to intelligibility as well as measures of acoustic-phonetic distinctiveness also will be studied. Loud, Slow, Clear, and even Fast speech modes are used therapeutically to maximize intelligibility in dysarthria, yet comparative group studies are lacking. Research that improves our understanding of acoustic-perceptual changes associated with these speech modes would strengthen the scientific bases of treatment techniques and may reveal acoustic-perceptual advantages of a given speech mode that will determine preferred therapies - key considerations for evidence based practice. The overarching hypothesis to be evaluated is that intelligibility and acoustic-phonetic distinctiveness will be maximized in conditions associated with increased effort, as indexed by SPL, and for which a slowed rate is encouraged, whereas phonatory function will be maximized in conditions associated with increased effort. This hypothesis is suggested by the Perceptual-Acoustic Theory, which posits a trade-off between effort and acoustic-perceptual adequacy as well as articulatory rate and accuracy.