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Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech

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ClinicalTrials.gov Identifier: NCT02094014
Recruitment Status : Completed
First Posted : March 21, 2014
Last Update Posted : May 12, 2016
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:
Impaired speech production is a major obstacle to full participation in life roles by stroke survivors with aphasia and apraxia of speech. The proposed study will demonstrate the short-term effects of auditory masking on speech disfluencies and identify individual factors that predict a positive response, enabling future work to develop auditory masking as a treatment adjuvant targeting long-term improvement in speech. Providing an additional treatment option for adults with aphasia and apraxia of speech will have the clear benefit of improving quality of life and allowing individuals to participate more actively in their health care decisions through improved communication.

Condition or disease Intervention/treatment
Apraxia of Speech Aphasia Cerebrovascular Accident Behavioral: Normal Auditory Feedback Behavioral: Masked Auditory Feedback Behavioral: Altered Auditory Feedback

Detailed Description:
The objective of this research is to test the short-term effects of listening to noise (i.e. auditory feedback masking) on speech fluency in stroke survivors with aphasia and apraxia of speech. People with nonfluent types of aphasia frequently have apraxia of speech, which affects the motor programming of speech movements, causing distortions, slow rate, and speech disfluencies that impede the forward flow of communication. Speaking while listening to noise (e.g. auditory masking) is known to reduce disfluencies and increase speech rate in people who stutter. This method has been tested in people with aphasia, resulting in positive effects on speech production for a subset of those tested. The investigators contend that individuals who have apraxia of speech in addition to aphasia are most likely to benefit from auditory masking, but most previous studies did not test participants for apraxia of speech. In addition, though masking is most likely to affect speech disfluencies, previous studies did not measures disfluencies. The proposed work has two specific aims. Aim 1 will determine the short-term effect of auditory masking, provided on a single day, on speech fluency in stroke survivors with aphasia and apraxia of speech. Aim 2 will identify individual factors that predict a positive response, including presence of apraxia of speech, lesion characteristics, and type of aphasia (e.g. Broca's, Wernicke's). Voxel-based lesion analysis techniques will be used to determine sites of lesion associated with positive and negative response to auditory masking. Completion of this study will remove barriers to studying auditory masking as a technique for clinical intervention, but also as a research tool for behavioral neuroscientists probing the speech motor control system in speakers with aphasia and apraxia of speech.

Study Design

Study Type : Observational
Actual Enrollment : 46 participants
Observational Model: Case Control
Time Perspective: Cross-Sectional
Official Title: Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech
Study Start Date : March 2014
Primary Completion Date : December 2015
Study Completion Date : December 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Aphasia Noise
U.S. FDA Resources

Groups and Cohorts

Group/Cohort Intervention/treatment
Aphasic/Apraxic Participants

The aphasic/apraxic participant group will include 30 adults who have had strokes affecting their ability to communicate verbally, broadly classified as aphasic and including individuals with and without apraxia of speech (AOS).

Participants will speak under Masked Auditory Feedback, Altered Auditory Feedback, and Normal Auditory Feedback.

Behavioral: Normal Auditory Feedback
Participants will produce sentences under normal speaking conditions, able to hear their own speech.
Behavioral: Masked Auditory Feedback
Participants will produce sentences while listening to speech-shaped noise at 85 decibels (sound pressure level) to mask ability to hear their own speech.
Other Name: Masking Noise
Behavioral: Altered Auditory Feedback
Participants will produce sentences while listening to their speech shifted up one octave and delayed.
Other Name: Delayed and pitch-shifted feedback
Neurologically Healthy Participants

The neurologically healthy participant group will include 15 adults with no history of stroke or developmental speech or language disorder.

Participants will speak under Masked Auditory Feedback, Altered Auditory Feedback, and Normal Auditory Feedback.

Behavioral: Normal Auditory Feedback
Participants will produce sentences under normal speaking conditions, able to hear their own speech.
Behavioral: Masked Auditory Feedback
Participants will produce sentences while listening to speech-shaped noise at 85 decibels (sound pressure level) to mask ability to hear their own speech.
Other Name: Masking Noise
Behavioral: Altered Auditory Feedback
Participants will produce sentences while listening to their speech shifted up one octave and delayed.
Other Name: Delayed and pitch-shifted feedback


Outcome Measures

Primary Outcome Measures :
  1. Disfluency duration change with masking noise [ Time Frame: 1 day of the study ]
    Measured disfluency duration in sentences produced while listening to masking noise compared to speaking in quiet without noise.


Secondary Outcome Measures :
  1. Speech rate change with masking noise [ Time Frame: 1 day of the study ]
    Measured syllables per second in sentences produced while listening to masking noise compared to speaking in quiet without noise.

  2. Speech sound accuracy change with masking noise [ Time Frame: 1 day of the study ]
    Measured speech sound accuracy in sentences produced while listening to masking noise compared to speaking in quiet without noise.


Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Participants with aphasia (PWA) will be referred from existing referral sources (e.g. UNC Stroke registry, Triangle Aphasia Project), clinicians in the community, and the Carolina Data Warehouse for Health.
Criteria

Inclusion Criteria for Aphasic/Apraxic Participants:

  • Single left-hemisphere cerebrovascular accident
  • Speech errors are present, but participant is able to produce approximations of words or sentences by reading or repetition; < 90% and > 10% on Chapel Hill Multilingual Intelligibility Test (Haley, 2011)
  • Right-handed prior to stroke by report
  • Normal visual attention, acuity, and color vision
  • Pure-tone threshold <= 40 decibels in at least one ear

Exclusion Criteria for Aphasic/Apraxic Participants:

  • Predominating disorders of cognition or hearing (e.g. dementia, hearing impairment).
  • Presence of degenerative neurological illness (e.g. Parkinson's disease, amyotrophic lateral sclerosis, primary progressive aphasia).

Inclusion Criteria for Neurologically Healthy Participants:

  • Matched in age and sex to a participant with aphasia
  • score of 90% or higher on the single-word intelligibility test
  • Right-handed prior to stroke by report
  • Normal visual attention, acuity, and color vision
  • Pure-tone threshold <= 40 decibels in at least one ear

Exclusion Criteria for Neurologically Healthy Participants:

  • History of stroke
  • History of developmental speech or language disorder
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02094014


Locations
United States, North Carolina
University of North Carolina School of Medicine
Chapel Hill, North Carolina, United States, 27599-7190
Sponsors and Collaborators
University of North Carolina, Chapel Hill
National Institute on Deafness and Other Communication Disorders (NIDCD)
Investigators
Principal Investigator: Adam Jacks, Ph.D. University of North Carolina, Chapel Hill
More Information

Additional Information:
Responsible Party: University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier: NCT02094014     History of Changes
Other Study ID Numbers: 10-0503
R03DC011881 ( U.S. NIH Grant/Contract )
First Posted: March 21, 2014    Key Record Dates
Last Update Posted: May 12, 2016
Last Verified: May 2016

Keywords provided by University of North Carolina, Chapel Hill:
Perceptual masking
Auditory stimulation
Speech
Language
Verbal Fluency Disorders

Additional relevant MeSH terms:
Apraxias
Aphasia
Stroke
Speech Disorders
Language Disorders
Communication Disorders
Neurobehavioral Manifestations
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Psychomotor Disorders