Perceptual Training to Improve Listeners' Ability to Understand Speech Produced by Individuals With Dysarthria

Dysarthria Clinical Trial

Official title:

Perceptual Training for Improved Intelligibility of Dysarthric Speech

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04897711
• Other study ID #: 11110
• Secondary ID: R21DC018867
• Status: Completed
• Phase: N/A
• Start date: April 26, 2021
• Est. completion date: July 1, 2023

Study information

• Verified date: August 2023
• Source: Utah State University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

There exist very few effective treatments that ease the intelligibility burden of dysarthria. Perceptual training offers a promising avenue for improving intelligibility of dysarthric speech by offsetting the communicative burden from the speaker with dysarthria on to their primary communication partners-family, friends, and caregivers. This project, utilizing advanced explanatory models, will permit identification of speaker and listener parameters, and their interactions, that allow perceptual training paradigms to be optimized for intelligibility outcomes in dysarthria rehabilitation. This work addresses this critical gap in clinical practice and sets the stage for extension of dysarthria management to listener-targeted remediation-advancing clinical practice and enhanced communication and quality of life outcomes for this population.

Description:

There exist very few effective treatments that ease the intelligibility burden of dysarthria, and all of these require cognitive and physical effort on the part of the speaker to achieve and maintain gains. Therefore, individuals with intelligibility deficits whose cognitive and physical impairments limit their ability to modify their speech are currently not viable treatment candidates. This constitutes a significant health disparity that disproportionately affects those clinical populations with developmental, cognitive, and/or significant neuromuscular impairment.

To address this critical gap in current dysarthria management, the weight of behavioral change is shifted from the speaker to the listener. While a novel concept for dysarthria management, the idea is firmly rooted in the field of psycholinguistics and supported by a programmatic body of research showing that listener-targeted perceptual training paradigms (wherein listeners are familiarized with the degraded speech signal and provided with an orthographic transcription of what the speaker is saying) result in statistically and clinically significant intelligibility gains in dysarthria. Further, preliminary evidence suggests that these intelligibility outcomes may be influenced by hypothesis-driven speaker parameters, such as acoustic predictability of speech rhythm cues, and listener parameters, such as expertise in rhythm perception.

A requisite next step to bringing listener-targeted perceptual training closer to clinical implementation, and the overarching goal of this clinical trial, is the systematic and rigorous analysis of the speaker and listener parameters, and their interactions, that modulate, and in some cases optimize, perceptual training benefits of intelligibility improvement. To achieve this aim, an existing database of dysarthric speech (20 speakers with dysarthria) and a large cohort of listeners (n = 400) across two well-established testing sites, Utah State University and Florida State University are utilized. Thus, the key deliverable resulting from this work will be explanatory models that account for the unique and joint contributions of speaker and listener parameters on the magnitude of intelligibility improvement following perceptual training with dysarthric speech.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 373
• Est. completion date: July 1, 2023
• Est. primary completion date: July 1, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

*Native speakers of American English

Exclusion Criteria:

• No self-reported history of speech impairment

• No self-reported history of language impairment

• No self-reported history of cognitive impairment

Related Conditions & MeSH terms

• Dysarthria
• Intelligibility, Speech

Intervention

Behavioral:
• Perceptual Training
Each listener is familiarized/trained with a single speaker with dysarthria. Pretest/posttest transcription data will be used to build explanatory models of intelligibility improvement.

Locations

Country	Name	City	State
United States	Utah State University	Logan	Utah
United States	Florida State University	Tallahassee	Florida

Sponsors (2)

Lead Sponsor	Collaborator
Utah State University	National Institute on Deafness and Other Communication Disorders (NIDCD)

Country where clinical trial is conducted

United States, 

References & Publications (11)

Borrie SA, Barrett TS, Yoho SE. Autoscore: An open-source automated tool for scoring listener perception of speech. J Acoust Soc Am. 2019 Jan;145(1):392. doi: 10.1121/1.5087276. — View Citation

Borrie SA, Lansford KL, Barrett TS. A Clinical Advantage: Experience Informs Recognition and Adaptation to a Novel Talker With Dysarthria. J Speech Lang Hear Res. 2021 May 11;64(5):1503-1514. doi: 10.1044/2021_JSLHR-20-00663. Epub 2021 Apr 8. — View Citation

Borrie SA, Lansford KL, Barrett TS. Generalized Adaptation to Dysarthric Speech. J Speech Lang Hear Res. 2017 Nov 9;60(11):3110-3117. doi: 10.1044/2017_JSLHR-S-17-0127. — View Citation

Borrie SA, Lansford KL, Barrett TS. Rhythm Perception and Its Role in Perception and Learning of Dysrhythmic Speech. J Speech Lang Hear Res. 2017 Mar 1;60(3):561-570. doi: 10.1044/2016_JSLHR-S-16-0094. — View Citation

Borrie SA, Lansford KL, Barrett TS. Understanding dysrhythmic speech: When rhythm does not matter and learning does not happen. J Acoust Soc Am. 2018 May;143(5):EL379. doi: 10.1121/1.5037620. — View Citation

Borrie SA, McAuliffe MJ, Liss JM, Kirk C, O'Beirne GA, Anderson T. Familiarisation conditions and the mechanisms that underlie improved recognition of dysarthric speech. Lang Cogn Process. 2012 Sep 1;27(7-8):1039-1055. doi: 10.1080/01690965.2011.610596. — View Citation

Hirsch ME, Lansford KL, Barrett TS, Borrie SA. Generalized Learning of Dysarthric Speech Between Male and Female Talkers. J Speech Lang Hear Res. 2021 Feb 17;64(2):444-451. doi: 10.1044/2020_JSLHR-20-00313. Epub 2021 Jan 28. — View Citation

Lansford KL, Borrie SA, Barrett TS, Flechaus C. When Additional Training Isn't Enough: Further Evidence That Unpredictable Speech Inhibits Adaptation. J Speech Lang Hear Res. 2020 Jun 22;63(6):1700-1711. doi: 10.1044/2020_JSLHR-19-00380. Epub 2020 May 20. — View Citation

Lansford KL, Borrie SA, Barrett TS. Regularity Matters: Unpredictable Speech Degradation Inhibits Adaptation to Dysarthric Speech. J Speech Lang Hear Res. 2019 Nov 20;62(12):4282-4290. doi: 10.1044/2019_JSLHR-19-00055. Print 2019 Dec 18. — View Citation

Lansford KL, Borrie SA, Bystricky L. Use of Crowdsourcing to Assess the Ecological Validity of Perceptual-Training Paradigms in Dysarthria. Am J Speech Lang Pathol. 2016 May 1;25(2):233-9. doi: 10.1044/2015_AJSLP-15-0059. — View Citation

Lansford KL, Luhrsen S, Ingvalson EM, Borrie SA. Effects of Familiarization on Intelligibility of Dysarthric Speech in Older Adults With and Without Hearing Loss. Am J Speech Lang Pathol. 2018 Feb 6;27(1):91-98. doi: 10.1044/2017_AJSLP-17-0090. — View Citation

* Note: There are 11 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Transcription accuracy	A percentage words correct (PWC) score is tabulated for each listener at pretest	Transcription accuracy is assessed at pretest, immediately before perceptual training.
Primary	Transcription accuracy	A percentage words correct (PWC) score is tabulated for each listener at posttest	Transcription accuracy is assessed at posttest, immediately after perceptual training.