An interventional study of Perceptual Training in Dysarthria and Intelligibility, Speech, sponsored by Utah State University. Completed at 2 sites in United States. Open to participants aged 18 Years to 80 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-09-19.
Sponsored by Utah State University · Not applicable, Interventional, and Treatment
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.
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.
60 studies on the registry are indexed under Dysarthria; 19 are open to participants now.
This study's enrollment of 217 is above the median of 39 across 44 interventional studies indexed under Dysarthria.
Browse Dysarthria studies →Utah State University is the lead sponsor of 39 studies on the registry; 5 are open to participants now.
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*Native speakers of American English
Exclusion Criteria:
To examine the effect of perceptual training with different speakers with dysarthria, we use a standard three-phase perceptual training protocol involving pretest, training, and posttest phases. Speech samples from a single speaker with dysarthria are utilized for all three phases. In this arm, listener participants were assigned to Speaker 1 (mixed flaccid-spastic dysarthria due to amyotrophic lateral sclerosis)
Behavioral: Perceptual Training
To examine the effect of perceptual training with different speakers with dysarthria, we use a standard three-phase perceptual training protocol involving pretest, training, and posttest phases. Speech samples from a single speaker with dysarthria are utilized for all three phases. In this arm, listener participants were assigned to Speaker 2 (Ataxic dysarthria due to cerebellar degeneration)
Behavioral: Perceptual Training
To examine the effect of perceptual training with different speakers with dysarthria, we use a standard three-phase perceptual training protocol involving pretest, training, and posttest phases. Speech samples from a single speaker with dysarthria are utilized for all three phases. In this arm, listener participants were assigned to Speaker 3 (hypokinetic dysarthria due to Parkinson's disease)
Behavioral: Perceptual Training
To examine the effect of perceptual training with different speakers with dysarthria, we use a standard three-phase perceptual training protocol involving pretest, training, and posttest phases. Speech samples from a single speaker with dysarthria are utilized for all three phases. In this arm, listener participants were assigned to Speaker 4 (Ataxic dysarthria due to cerebellar degeneration)
Behavioral: Perceptual Training
To examine the effect of perceptual training with different speakers with dysarthria, we use a standard three-phase perceptual training protocol involving pretest, training, and posttest phases. Speech samples from a single speaker with dysarthria are utilized for all three phases. In this arm, listener participants were assigned to Speaker 5 (hypokinetic dysarthria due to Parkinson's disease)
Behavioral: Perceptual Training
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.
Also known as: Familiarization
Pretest Transcription Accuracy
A percentage words correct (PWC) score is tabulated for each listener at pretest. A higher score reflects greater speaker intelligibility (i.e., understanding).
Time frame: 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.
Posttest Transcription Accuracy
A percentage words correct (PWC) score is tabulated for each listener at posttest. Higher scores reflect greater speaker intelligibility (i.e., understanding).
Time frame: 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.
Due to COVID-19 limitations at the time of recruitment, initial efforts were focused on recruiting participants 18-50 years. We recruited participants from the Tallahassee, FL and Logan, UT communities. In the later stages of this project, we focused recruitment efforts on older participants aged 55-80 years from the Tallahassee community.
| Milestone | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 |
|---|---|---|---|---|---|
| Started | 49 | 54 | 53 | 32 | 27 |
| Completed | 49 | 54 | 53 | 32 | 27 |
| Not completed | 0 | 0 | 0 | 0 | 0 |
A percentage words correct (PWC) score is tabulated for each listener at pretest. A higher score reflects greater speaker intelligibility (i.e., understanding).
| percentage of words correct | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 |
|---|---|---|---|---|---|
| Pretest Transcription Accuracy | 77.8 ± 5.4 | 35.3 ± 7.7 | 52.9 ± 7.1 | 30 ± 10.6 | 49.2 ± 15.4 |
A percentage words correct (PWC) score is tabulated for each listener at posttest. Higher scores reflect greater speaker intelligibility (i.e., understanding).
| percentage of words correct | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 |
|---|---|---|---|---|---|
| Posttest Transcription Accuracy | 84.4 ± 3.6 | 50 ± 7.1 | 57.8 ± 7.8 | 42.2 ± 12.7 | 51.2 ± 14.8 |
Collected over This is a benign behavioral intervention administered in a single session (day) of 90 minutes.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Perceptual Training With Dysarthric Speaker 1 | 0/49 (0%) | 0/49 (0%) | 0/49 (0%) |
| Perceptual Training With Dysarthric Speaker 2 | 0/54 (0%) | 0/54 (0%) | 0/54 (0%) |
| Perceptual Training With Dysarthric Speaker 3 | 0/53 (0%) | 0/53 (0%) | 0/53 (0%) |
| Perceptual Training With Dysarthric Speaker 4 | 0/32 (0%) | 0/32 (0%) | 0/32 (0%) |
| Perceptual Training With Dysarthric Speaker 5 | 0/27 (0%) | 0/27 (0%) | 0/27 (0%) |
| Age, Categorical(Participants) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 49 | 54 | 53 | 7 | 2 | 165 |
| >=65 years | 0 | 0 | 0 | 25 | 25 | 50 |
| Age, Continuous(years) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Mean | 22.3 ± 7.3 | 22.9 ± 6.3 | 21.5 ± 2.9 | 69.28 ± 4.95 | 70.22 ± 4.93 | 35 ± 22 |
| Sex: Female, Male(Participants) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Female | 37 | 43 | 43 | 20 | 20 | 163 |
| Male | 12 | 11 | 10 | 12 | 7 | 52 |
| Ethnicity (NIH/OMB)(Participants) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Hispanic or Latino | 10 | 8 | 12 | 0 | 0 | 30 |
| Not Hispanic or Latino | 39 | 46 | 41 | 32 | 27 | 185 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 | 0 |
| Asian | 4 | 0 | 0 | 0 | 0 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 | 0 |
| Black or African American | 1 | 4 | 3 | 0 | 3 | 11 |
| White | 44 | 49 | 49 | 32 | 23 | 197 |
| More than one race | 0 | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 1 | 1 | 0 | 1 | 3 |
| Working memory(scores on a scale) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Mean | 104 ± 12 | 104 ± 10 | 102 ± 13 | 104 ± 15 | 109 ± 17 | 104 ± 13 |
| Words-in-Noise(decibels) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Mean | 5.6 ± 1.7 | 5.28 ± 1.5 | 4.8 ± 1.1 | 7.9 ± 4.3 | 8.2 ± 4.2 | 6.4 ± 3.3 |
| Inhibitory control(Scores on a scale) | Perceptual Training With Dysarthric Speaker 1 | Perceptual Training With Dysarthric Speaker 2 | Perceptual Training With Dysarthric Speaker 3 | Perceptual Training With Dysarthric Speaker 4 | Perceptual Training With Dysarthric Speaker 5 | Total |
|---|---|---|---|---|---|---|
| Mean | 93 ± 14 | 94 ± 15 | 90 ± 17 | 98 ± 11 | 96 ± 13 | 94 ± 15 |
3 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — Results of the proposed research will be disseminated through conference presentations and manuscripts submitted to academic journals. In addition, the de-identified data will be available for public access via a data repository at the University of Michigan (ICPSR). The study will be registered in ClinicalTrials.gov within 21 days of enrollment of the first participant. Results will be submitted within 1 year of completion of the study. Informed consent documents will contain a statement concerning posting of information to ClinicalTrials.gov. Utah State University's Investigator Handbook (Chapter 9) outlines a policy for reporting all ClinicalTrials.gov information, specifically stating that it is the PI's responsibility to do so according to NIH policy.
Supporting information: Study protocol, Statistical analysis plan, Analytic code
Time frame: Within one year of completion
Access criteria: Information related to the protocol and statistical analysis plan will be shared in future publications. The analytic code will be shared via the Open Science website, with the link included in associated publications.
This study is completed, as verified in Sep 2024. You cannot join it, but the record below documents what was studied.
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