Rhythmic Entrainment in Bilingual Speakers With Dysarthria

Study Overview
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Brief Summary
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The objectives of this study are to determine i) the effect of rhythmic entrainment of speech with hand gestures and auditory rhythmic cues on intelligibility and speech naturalness in Spanish-accented speakers of English in two pathology groups: ataxic dysarthria and hypokinetic dysarthria secondary to idiopathic Parkinson's disease; and ii) the extent to which speech rate and effort are control parameters of entrainment. These objectives will be achieved with the following specific aims: Specific Aim 1: Determine the effect of three rates of hand gestures and auditory rhythmic cues and the degree to which learning and carry-over occur. Specific Aim 2: Determine the effect of increased speech effort, operationalized as clear speech, and the interaction effect of clear speech with hand gestures and auditory rhythmic cues. Specific Aim 3: Investigate the perception of speech rhythm and its relationship to entrainment.

Detailed Description
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The objectives of this study are to determine i) the effect of rhythmic entrainment of speech with hand gestures and auditory rhythmic cues on intelligibility and speech naturalness in Spanish-accented speakers of English in two pathology groups: ataxic dysarthria and hypokinetic dysarthria secondary to idiopathic Parkinson's disease; and ii) the extent to which speech rate and effort are control parameters of entrainment. These objectives will be achieved with the following specific aims: Specific Aim 1: Determine the effect of three rates of hand gestures and auditory rhythmic cues and the degree to which learning and carry-over occur. Specific Aim 2: Determine the effect of increased speech effort, operationalized as clear speech, and the interaction effect of clear speech with hand gestures and auditory rhythmic cues. Specific Aim 3: Investigate the perception of speech rhythm and its relationship to entrainment. The protocol calls for 12 talkers to participate in a single case experimental design: 6 Spanish-accented speakers of English and 6 native English speakers, and each language group consisting of 2 healthy controls, 2 adults diagnosed with ataxic dysarthria and 2 adults diagnosed with hypokinetic dysarthria secondary to idiopathic Parkinson's disease. Sixty monolingual healthy adult listeners will rate intelligibility, accentedness, and ease of understanding.

Official Title
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Rhythmic Entrainment in Bilingual Speakers With Dysarthria

Conditions
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Ataxia, Parkinson Disease

Intervention / Treatment
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* Behavioral: Auditory
* Behavioral: Gestures


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of idiopathic Parkinson's disease (4) or dysarthria secondary to ataxia (4) or healthy (4) monolingual speaker of American English (6) or native speaker of Spanish who speaks English with a Spanish accent (6) age 21 or older Exclusion Criteria: Cognitive impairment that prevents participation in the therapy Fluent speakers of languages other than English or Spanish younger than 21 years

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Single case experimental design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gestures<br>Use of hand gestures to improve speech rhythm and speech production | Behavioral: Gestures<br>* Use of gestures to improve speech production<br>|
| Experimental: Auditory<br>Use of auditory cues to improve speech rhythm and speech production | Behavioral: Auditory<br>* Use of auditory cues to improve speech production<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intelligibility | Intelligibility = the accuracy with which a listener understands a speaker. It will be measured by having the subjects undergoing the therapy (the talkers) read 28 phrases using accompanying gesture or auditory cues and listeners will transcribe the sentences. The number of words accurately transcribed / the number of words in the phrase = intelligibility score for each phrase per listener | immediately upon completion of the therapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ease of understanding | Ease of understanding = the ease with which listeners understand the speakers. It will be measured by having the subjects undergoing the therapy (the talkers) read 28 phrases using accompanying gesture or auditory cues and listeners will rate how easy it is to understand the talkers using a 0 to 9 visual analog scale with 0 = very easy and 9= very hard, for each phrase per listener | Immediately upon completion of the therapy | 
| Speech naturalness | Speech naturalness = the degree to which the listeners consider the speakers to have natural or unnatural speech. It will be measured by having the subjects undergoing the therapy (the talkers) read 28 phrases using accompanying gesture or auditory cues and listeners will rate how natural-sounding the talker sounds by using a 0 to 9 visual analog scale with 0 = very natural and 9 = very unnatural, for each phrase per listener | immediately upon completion of the therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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speech rhythm, speech therapy