Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech
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| ClinicalTrials.gov Identifier: NCT02094014 |
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Recruitment Status :
Completed
First Posted : March 21, 2014
Last Update Posted : May 12, 2016
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Sponsor:
University of North Carolina, Chapel Hill
Collaborator:
National Institute on Deafness and Other Communication Disorders (NIDCD)
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill
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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 |
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 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 |
| Actual Primary Completion Date : | December 2015 |
| Actual Study Completion Date : | December 2015 |
Resource links provided by the National Library of Medicine
| Group/Cohort | Intervention/treatment |
|---|---|
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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 |
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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 |
Primary Outcome Measures :
- 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 :
- 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.
- 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.
Information from the National Library of Medicine
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| 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
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 |
| Responsible Party: | University of North Carolina, Chapel Hill |
| ClinicalTrials.gov Identifier: | NCT02094014 |
| 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:
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Perceptual masking Auditory stimulation Speech Language Verbal Fluency Disorders |
Additional relevant MeSH terms:
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Aphasia Stroke Apraxias Speech Disorders Language Disorders Communication Disorders Neurobehavioral Manifestations Neurologic Manifestations |
Nervous System Diseases Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Vascular Diseases Cardiovascular Diseases Psychomotor Disorders |