Clinical trial NCT04897711: Perceptual Training to Improve Listeners' Ability to Understand Speech Produced by Individuals With Dysarthria
Official title: Perceptual Training for Improved Intelligibility of Dysarthric Speech
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dysarthria
Intelligibility, Speech
Keywords: dysarthria
motor speech disorders
intelligibility
perceptual training
Lead sponsor: Utah State University
Sponsor class: OTHER
Collaborators: name: National Institute on Deafness and Other Communication Disorders (NIDCD)
First posted: 2021-05-21
Enrollment: 217
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 300 listeners will be recruited and enrolled. Each participant will be randomly assigned to receive perceptual training with one of 5 speakers with dysarthria, such that 30-50 listeners will be assigned to each speaker with dysarthria. All listener participants will receive the perceptual training intervention.
Primary purpose: TREATMENT

Brief 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.

Eligibility criteria: 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

Primary outcomes:
measure: Pretest Transcription Accuracy
timeFrame: All outcomes were collected during a single data collection session, that lasted no more than 90 minutes. Pretest transcription accuracy is assessed at the pretest, immediately before a single session of perceptual training.
measure: Posttest Transcription Accuracy
timeFrame: All outcomes were collected during a single data collection session, lasting no longer than 90 minutes. Transcription accuracy at posttest was assessed at posttest, immediately after perceptual training.
Secondary outcomes:
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 A Borrie, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Florida State University
name: Kaitlin L Lansford, PhD
role: PRINCIPAL_INVESTIGATOR
References:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
citation: 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.