Perceptual Training to Improve Listeners' Ability to Understand Speech Produced by Individuals With Dysarthria
Condition: Dysarthria; Intelligibility, Speech
MeSH terms: Dysarthria
Study type: Interventional

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.
    

Detailed 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.
    

Intervention name(s): Perceptual Training
Intervention type(s): Behavioral
Intervention description(s): 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.
Other intervention name(s): Familiarization
Intervention model: Single Group Assignment
Intervention model description: 400 listeners will be recruited and enrolled. Each participant will be randomly assigned to receive perceptual training with one of 20 speakers with dysarthria, such that 20 listeners will be assigned to each speaker with dysarthria. All listener participants will receive the perceptual training intervention.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: dysarthria; motor speech disorders; intelligibility; perceptual training