The Use of Electropalatography in the Treatment of Apraxia of Speech

描述（由申请人提供） 这项提案旨在支持香农Mauszycki博士，在湖城卫生保健系统的研究语音语言病理学家在她的愿望，建立一个职业生涯作为一个独立的VA研究科学家。 言语失用症（AOS）是一种可治疗的神经源性言语障碍，其特征是发声困难、语速降低和韵律紊乱。 关于AOS患病率的数据有限，没有关于严重程度的信息。 Duffy（2005）发现AOS是6101例神经性运动性言语障碍中7.6%的主要诊断。最近的数据显示，AOS是12.2%的交流障碍患者的主要诊断，但AOS往往作为继发性交流障碍与失语症一起更频繁地发生（Duffy，2007）。 有效治疗运动性言语障碍（如AOS）需要彻底了解该障碍的生理、感知和声学特征。 存在许多工具来检查发音的生理方面。不幸的是，无论采用何种方法，涉及AOS的生理学研究数量有限。 检查舌头在发音中的作用的一种方法是腭电描记术（EPG）。EPG涉及佩戴伪腭板的扬声器，伪腭板是一种定制的丙烯酸板，嵌入了不同数量的电极，紧密贴合上腭。 电极检测舌头与腭的接触，并允许接触被记录、存储和真实的显示，并且能够向说话者提供视觉生物反馈。 EPG已经广泛应用于各种言语障碍，例如由腭裂、听力损伤和发育性言语延迟引起的言语障碍（Carter等人，2004; Dagenais，1992，1995;弗莱彻等人，1991年; Giovanni等人，2001年）。研究人员已经使用舌头到腭显示器来提供视觉生物反馈，以改善声音的产生。 迄今为止，EPG与AOS的使用有限，尽管初步调查在一些病例研究报告中在描述和改善发音障碍方面取得了令人鼓舞的结果。 目前还没有关于EPG治疗AOS疗效的实验数据。本研究的主要目的是探讨重复测量对AOS患者的EPG和感知言语测量的影响。 为了适当地评估治疗的效果，关键是要了解这些措施的稳定性随着时间的推移，并与紊乱的扬声器反复曝光。 本研究的第二个目的是系统地研究EPG治疗作为一种视觉生物反馈手段对AOS说话者的效果。 公共卫生相关性： 项目叙述：获得性言语失用症（AOS）是一种神经源性感觉运动性言语障碍，其严重程度从轻微的声音失真到无法产生任何有意义的言语。AOS的行为治疗已被证明可以改善言语产生，即使AOS被认为是慢性的。 本研究的第一个目的是探讨随着时间的推移重复测量对一组AOS说话者的腭电图（EPG）和知觉言语测量的影响。 为了适当地评估治疗的效果，重要的是要了解这些措施随着时间的推移与紊乱的扬声器的稳定性。 本研究的第二个目的是采用EPG作为生物反馈的手段，系统地研究治疗对一组AOS说话者言语产生的影响。 这项研究与退伍军人事务部的使命有关，因为研究结果将有助于为运动性语言障碍的退伍军人开发临床适用的治疗方法。

DESCRIPTION (provided by applicant) This proposal seeks to support Dr. Shannon Mauszycki, a research speech-language pathologist in the VA Salt Lake City Health Care System in her aspirations to build a career as an independent VA research scientist. Apraxia of speech (AOS) is a treatable neurogenic speech disorder that is characterized by difficulties in sound production, reduced rate of speech, and disturbed prosody. Data regarding the prevalence of AOS are limited with no information regarding severity. Duffy (2005) found AOS was the primary diagnosis for 7.6% of 6101 cases of neurologic motor speech disorders. More recent data revealed AOS was the primary diagnosis for 12.2% of individuals with communication disorders, but AOS tends to occurs more frequently as a secondary communication disorder in conjunction with aphasia (Duffy, 2007). Effective treatment of a motor speech disorder such as AOS requires a thorough understanding of the physiological, perceptual, and acoustic characteristics of the disorder. A number of tools exist to examine physiologic aspects of articulation. Unfortunately, there have been a limited number of physiologic studies involving AOS conducted regardless of methodology. One method for examining the tongue's role in articulation is electropalatography (EPG). EPG involves the speaker wearing a pseudopalate, which is a custom made acrylic plate embedded with a varying number of electrodes that fits tightly against the upper palate. The electrodes detect tongue to palate contacts and allow contacts to be recorded, stored, and displayed in real time and is able to provide visual biofeedback to the speaker. EPG has had extensive application with a variety of speech disorders, such as those resulting from cleft palate, hearing impairment, and developmental speech delay (Carter et al., 2004; Dagenais, 1992, 1995; Fletcher et al., 1991; Gibbon et al., 2001). Investigators have used the tongue to palate displays to provide visual biofeedback to improve sound production. To date, there has been limited utilization of EPG with AOS, although preliminary investigations have yielded promising findings in a few case study reports in terms of describing as well as improving disordered articulation. Experimental data concerning the efficacy of EPG treatment for AOS are currently unavailable. The initial purpose of this research is to examine the impact of repeated measurement over time on EPG and perceptual speech measures in speakers with AOS. In order to appropriately evaluate the effects of treatment, it is critical to understand the stability of these measures over time and with repeated exposure with disordered speakers. The second purpose of this research is to systematically examine the effects of EPG treatment as a means of visual biofeedback for speakers with AOS. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE: Acquired apraxia of speech (AOS) is a neurogenic sensorimotor speech disorder that can range in severity from minor sound distortions to an inability to produce any meaningful speech. Behavioral treatments for AOS have been shown to result in improved speech production even when AOS is deemed chronic. The first purpose of this research is to examine the impact of repeated measurement over time on electropalatography (EPG) and perceptual speech measures in a group of speakers with AOS. In order to appropriately evaluate the effects of treatment, it is important to understand the stability of these measures over time with disordered speakers. The second purpose of this research is to systematically examine the effects of treatment on speech production for a group of speakers with AOS employing EPG as a means of biofeedback. This research has relevance to the mission of the VA, given that the results will aid in the development of clinically applicable treatments for veterans with motor speech disorders.