Understanding and eliminating residual speech errors with acoustic biofeedback

通过声学生物反馈了解并消除残余言语错误

• 批准号: 8606675
• 负责人: Tara McAllister
• 金额: $ 15.04万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8606675
• 关键词: Accounting; Acoustics; Address; Affect; Age; Age-Years; Auditory; Auditory Perception; Behavior; Biofeedback; Case Study; Categories; Characteristics; Child; Childhood; Client; Clinical; Communication; Controlled Study; Diagnostic; Disease; Documentation; Effectiveness of Interventions; Exhibits; Feedback; Goals; Guidelines; Individual; Individual Differences; Intervention; Investigation; Knowledge; Learning; Measures; Methods; Modeling; Nursery Schools; Occupational; Outcome; Participant; Pattern; Perception; Performance; Population; Production; Public Health; Publishing; Relative (related person); Research; Residual state; School-Age Population; Selection for Treatments; Signal Transduction; Specific qualifier value; Speech; Speech Sound; Testing; Visual; Work; acoustic imaging; base; clinically significant; computer generated; conventional therapy; effectiveness measure; evidence base; evidence based guidelines; innovation; insight; meetings; motor learning; novel; public health relevance; research study; response; skills; social; sound; success; therapy design; traditional therapy; treatment effect; Accounting; Acoustics; Address; Affect; Age; Age-Years; Auditory; Auditory Perception; Behavior; Biofeedback; Case Study; Categories; Characteristics; Child; Childhood; Client; Clinical; Communication; Controlled Study; Diagnostic; Disease; Documentation; Effectiveness of Interventions; Exhibits; Feedback; Goals; Guidelines; Individual; Individual Differences; Intervention; Investigation; Knowledge; Learning; Measures; Methods; Modeling; Nursery Schools; Occupational; Outcome; Participant; Pattern; Perception; Performance; Population; Production; Public Health; Publishing; Relative (related person); Research; Residual state; School-Age Population; Selection for Treatments; Signal Transduction; Specific qualifier value; Speech; Speech Sound; Testing; Visual; Work; acoustic imaging; base; clinically significant; computer generated; conventional therapy; effectiveness measure; evidence base; evidence based guidelines; innovation; insight; meetings; motor learning; novel; public health relevance; research study; response; skills; social; sound; success; therapy design; traditional therapy; treatment effect

DESCRIPTION (provided by applicant): In children with speech sound disorder, deficits in spoken communication pose a barrier to academic and social participation. Of particular concern is the subset of children who exhibit atypical speech patterns that persist past the age of 9, termed residual speech errors (RE). Research to date has not established why speech errors resolve in some children but persist in others, and effective forms of intervention for RE have remained elusive. This gap gives rise to a long-term goal of establishing evidence-based therapy guidelines for RE while identifying factors that cause and maintain these errors. This study will focus on the subset of children with RE affecting the phoneme /r/ (RE-/r/). The first aim of this proposal is to compare treatment effect sizes produced by two forms of treatment for RE, acoustic biofeedback therapy and traditional articulatory therapy. Preliminary studies have shown that some children can eliminate RE using acoustic biofeedback (a dynamic visual representation of the speech signal), but the efficacy of biofeedback therapy for RE has never been evaluated with systematic experimental methods. To test the hypothesis that biofeedback therapy yields greater treatment gains than traditional therapy, both methods will be applied concurrently to different /r/ targets in an alternating treatments design with multiple baselines across behaviors. 16 children with RE-/r/ will complete 10 weeks of individual therapy. Aim 2 of this proposal will draw on principles of motor learning to explain how biofeedback can succeed in changing articulatory patterns that do not respond to other forms of practice. One hypothesis holds that errors persist when the speaker's internal auditory target for a sound is incorrect, and that biofeedback is effective because it provides knowledge of performance (KP) feedback to guide the speaker to a more accurate target. However, KP feedback has been shown to lose its advantage when the target is already well- specified. Therefore, the working hypothesis for Aim 2 is that children with a poorly specified auditory target for /r/ (i.e., poor perception of /r/) wll derive greater relative benefit from biofeedback therapy than children with good perception. To test this hypothesis, pre-treatment perceptual sensitivity will be measured with a synthetic 10-step acoustic continuum from /r/ to /w/, and the correlation between this measure and the difference in effect sizes calculated in Aim 1 will be evaluated. A significant negative correlatio, indicating that the advantage for biofeedback over traditional therapy is greater in children with poor perception, is anticipated. This research will be clinically significant because the results o Aim 1 will have immediate implications for the selection of therapy methods, and the results of Aim 2 will help clinicians match clients to the most appropriate therapy approach based on their individual characteristics. This study will also be theoretically significant because it is the firt to systematically apply principles of motor learning to investigate the mechanism by which biofeedback influences articulatory skill in children. In the long term, these findings will be par of a continuum of research that will illuminate the causes of RE while continuing to identify principles of intervention for the disorder.

描述（由申请人提供）：在言语障碍的儿童中，口语沟通缺陷构成了学术和社会参与的障碍。特别关注的是表现出持续超过9岁的非典型语音模式的儿童的子集，称为残留语音错误（RE）。迄今为止的研究尚未确定为什么某些儿童会出现语音错误，但仍在其他孩子中存在语音错误，而对RE的有效干预形式仍然难以捉摸。这一差距提出了一个长期目标，即确定RE的循证治疗指南，同时确定导致和维持这些错误的因素。这项研究将集中于重复影响音素/r/（re-/r/）的儿童的子集。该提案的第一个目的是比较通过两种形式的RE，声学生物反馈疗法和传统的关节疗法产生的治疗效果大小。初步研究表明，有些孩子可以使用声学生物反馈（语音信号的动态视觉表示）消除RE，但是从未通过系统的实验方法评估了生物反馈治疗对RE的疗效。为了检验以下假设，即生物反馈疗法比传统疗法获得更大的治疗疗法，两种方法都将同时应用于交替治疗设计中的不同 / r / r /靶标，跨行为具有多个基线。 16名重新/ R/的儿童将完成10周的个人治疗。该提案的目标2将借鉴运动学习原则，以解释生物反馈如何成功地改变对其他形式实践反应的发音模式。一个假设认为，当说话者的声音内部听觉目标不正确时，错误会持续存在，并且 该生物反馈很有效，因为它提供了性能知识（KP）反馈，以指导说话者到更准确的目标。但是，当目标已经得到很好的指定时，KP反馈已被证明失去了优势。因此，AIM 2的工作假设是， /r /（即 /r /r /）的指定听觉目标差的儿童比具有良好感知的儿童获得了生物反馈治疗的相对益处更大。为了检验这一假设，预处理感知灵敏度将通过 /r /to /w /的合成10步声连续性进行测量，并且将评估该度量与AIM 1中差异的差异之间的相关性。预计在感知差的儿童中，生物反馈比传统疗法的优势比传统疗法的优势更大。这项研究将在临床上具有重要意义，因为o目标1将对选择治疗方法产生直接影响，AIM 2的结果将帮助临床医生根据其个人特征将客户与最合适的治疗方法相匹配。这项研究在理论上也将是重要的，因为它是系统地应用运动学原理来研究生物反馈影响儿童发音技能的机制的原因。从长远来看，这些发现将是一项连续研究的基准，这些研究将阐明RE的原因，同时继续确定该疾病的干预原则。