Clinical trial NCT06815263: Listener Training for Improved Intelligibility of People With Parkinson's Disease
Official title: Listener Training for Improved Intelligibility of People With Parkinson's Disease
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Dysarthria, Hypokinetic
Keywords: Dysarthria
Parkinson&#39;s disease
Speech
Listener
Lead sponsor: Utah State University
Sponsor class: OTHER
Collaborators: name: National Institute on Deafness and Other Communication Disorders (NIDCD)
name: Florida State University
First posted: 2025-02-07
Enrollment: 360
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Listener training offers a promising avenue for improving communication for people with dysarthria due to Parkinson's disease by offsetting the intelligibility burden from the patient onto their primary communication partners. Here, we employ a repeated-measures, randomized controlled trial to establish the efficacy of listener training for patients with PD and their primary communication partners. This translational work will establish a new realm of clinical practice in which the intelligibility impairments in PD are addressed by training partners to better understand dysarthric speech, thus elevating communication outcomes and participation in daily life.

Detailed description: People with dysarthria due to Parkinson's disease (PD) frequently present with reduced intelligibility, which can have significant consequences, including reduced participation in situations involving communicating with others and resulting in social isolation.1-5 Few effective treatments exist to ease the intelligibility burden of dysarthria in PD, and most require significant cognitive and physical effort on the part of the speaker to achieve and maintain gains.6,7 Once people with PD have progressed beyond the early stages of the disease, and their cognitive and physical impairments limit their ability to use traditional speech therapy techniques, they are not realistic treatment candidates for current interventions; and no other interventions are available to support their communication. This is a serious and consequential gap in clinical care for people with PD. The current proposal addresses this critical gap by shifting the weight of behavioral change from the speaker to the listener, specifically key communication partners such as family. Indeed, for older adults, most of their time spent with others is spent with family members.8 Further, key partners of patients with PD wish to have a more significant and active role in communication rehabilitation.9,10 A listener-targeted remediation approach for intelligibility impairments in people with dysarthria and PD is firmly grounded in theoretical models of perceptual learning11-13 and rigorously supported by our decade-long research program targeting perceptual learning of dysarthric speech.14-30 To date, this line of investigation has chiefly targeted the theory of listener adaptation to the degraded signal; however, robust intelligibility improvements of up to 20 percent across studies have been observed.15 With a rigorous account of how and what listeners adapt to, we are ideally positioned to move this work from bench to bedside, establishing listener (i.e., perceptual) training as a clinical intervention to improve intelligibility in people with PD. Here, we establish the efficacy of listener training for patients with PD and their primary communication partners using a repeated-measures, randomized controlled trial (SA1). Immediate acquisition and retention of intelligibility improvements will be examined as a function of speaker severity. We then evaluate three theoretically and empirically-motivated communication benefits of listener training that extend beyond intelligibility, including listening effort, comprehension, and communicative participation (SA2). Finally, we engage stakeholder input to inform clinical implementation of listener training using qualitative semi-structured interviews (SA3) with patients with PD and their partners. This will provide insights into the effectiveness and feasibility of the intervention approach, ensuring that their needs and preferences are considered and that they feel empowered and motivated for a listener training approach. Thus, in three independent aims, this proposal will address a current void in our clinical toolbox, establishing a new realm of clinical practice in which communication challenges in PD are managed by training partners to better understand the degraded speech.

Eligibility criteria: Inclusion Criteria:

* Primary language is English
* 18 years or older
* medical diagnosis of Parkinson's disease (patient participants)
* speech diagnosis of hyperkinetic dysarthria, exhibiting hallmark characteristics (patient participants)

Exclusion Criteria:

* Severe cognitive impairment
* Less than 18 years of age
* Primary language other than English

Primary outcomes:
measure: Speech intelligibility
timeFrame: pretest, during training, immediate posttest, one week posttest, one month posttest
Secondary outcomes:
measure: Listening effort
timeFrame: Pretest, one week posttest, one month posttest
measure: Comprehension
timeFrame: Pretest, one week posttest, one month posttest
measure: Communicative Participation Item Bank
timeFrame: Pretest, one month posttest
Other outcomes:
Locations:
city: Tallahassee
country: United States
facility: Florida State University
state: Florida
city: Logan
country: United States
facility: Utah State University
state: Utah
Study officials:
affiliation: Utah State University
name: Stephanie Borrie, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Florida State University
name: Kaitlin Lansford, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Utah State University
name: Sarah Yoho Leopold, PhD
role: STUDY_DIRECTOR
References: