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DysarthriaNCT04897711

Perceptual Training to Improve Listeners' Ability to Understand Speech Produced by Individuals With Dysarthria

A study testing Perceptual Training in people with Dysarthria and Intelligibility, Speech, run by Utah State University at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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… Read more about this study

Who is it for?
Ages 18 to 80 yearsHealthy volunteers can take part
Conditions the study is for
Dysarthria, Intelligibility, Speech
What is being tested?
Perceptual Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
217 participants
Where
2 sitesUnited States
Study dates
26 Apr 2021to 1 Jul 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Native speakers of American English

Who cannot join

  • No self-reported history of speech impairment
  • No self-reported history of language impairment
  • No self-reported history of cognitive impairment

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Utah State University

    Logan, Utah, 84322

  • Florida State University

    Tallahassee, Florida, 32301

Other trials in United States

About this study

Official title: Perceptual Training for Improved Intelligibility of Dysarthric Speech

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.

Read the 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.

Being tested
Perceptual Training
Keywords
dysarthria, motor speech disorders, intelligibility, perceptual training
Medical subject headings
Dysarthria, Speech Intelligibility

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Perceptual TrainingBehavioural

    Also called Familiarization

    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.

Study groups in NCT04897711
Study groupRoleWhat they receive
Perceptual training with a speaker with dysarthria - Amyotrophic Lateral Sclerosis (ALS)ExperimentalTo 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)
Receives: Behavioral: Perceptual Training
Perceptual training with a speaker with dysarthria - Ataxic 1ExperimentalTo 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)
Receives: Behavioral: Perceptual Training
Perceptual training with a speaker with dysarthria - Parkinson's disease (PD) 1ExperimentalTo 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)
Receives: Behavioral: Perceptual Training
Perceptual training with a speaker with dysarthria - Ataxic 2ExperimentalTo 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)
Receives: Behavioral: Perceptual Training
Perceptual training with a speaker with dysarthria - Parkinson's disease (PD) 2ExperimentalTo 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)
Receives: Behavioral: Perceptual Training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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).

    Measured: 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.

  2. 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).

    Measured: 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.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 May 2021
  2. Study start26 Apr 2021
  3. Primary completion1 Jul 2023
  4. Study completion1 Jul 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
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.
Masking
None (open label)
Enrolment
217 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04897711
Sponsor's protocol ID
11110
Other IDs
R21DC018867
Status last verified
Sep 2024
First submitted
10 May 2021
Last updated
19 Sep 2024
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
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.

Publications

  • 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.

    PubMed 29857710
  • 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.

    PubMed 31747531
  • 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.

    PubMed 28241307
  • 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.

    PubMed 27145295
  • 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.

    PubMed 24009401
  • 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.

    PubMed 29075754
  • 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.

    PubMed 29305612
  • 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.

    PubMed 33508210
  • 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.

    PubMed 32437259
  • 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.

    PubMed 33831307
  • 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.

    PubMed 30710955

Questions about this trial

What is this clinical trial studying?

A study testing Perceptual Training in people with Dysarthria and Intelligibility, Speech, run by Utah State University at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Sep 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pretest Transcription Accuracy (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.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04897711, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Sep 2024.

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