Toward a Dysarthria Management Model for Linguistically and Culturally Diverse Groups: Foreign Born Immigrants
试验速览
- 阶段
- 不适用
- 状态
- 进行中(未招募)
- 入组人数
- 32
- 试验地点
- 2
- 主要终点
- Speech Intelligibility Score on a Visual Analogue Scale
研究概览
简要总结
This study develops and conduct a small-scale clinical trial study in which the linguistic and cultural diversity of the participants is considered. Speech therapy and counseling services are provided to both patients with Parkinson's disease and their caregivers.
详细描述
Attention has been increasingly paid to the "culturally and linguistically diverse (CLD)" communities which typically include dialectal users of English, monolingual and multilingual speakers of minority languages, and bilingual speakers of English and a minority language. However, among these, monolingual speakers of minority languages living in the US have been nearly excluded from dysarthria management. Most of these are first-generation immigrants who are well documented to have limited access to financial and medical services and have poorer health outcomes including communication difficulties. This creates critical health disparities in the field of communication rehabilitation.
This study will (1) examine effects of speech therapy on PD patients' speech acoustics and intelligibility, (2) examine effects of the intervention program on communication participation and well-being of both PD patients and their families. Our primary outcome measures, speech intelligibility and acoustic measures, are hypothesized to show improvements. Acoustic predictors of speech intelligibility are expected to include acoustic vowel space and voice onset time. These hypotheses are based on literature reporting (1) positive changes in speech function after intensive treatment programs focusing on vocal effort and hyperarticulation and (2) language-specific contributors to speech intelligibility in PD. Our secondary outcome measures include (1) communication participation and (2) well-being measures which will be obtained from both PD patients and family members. Based on previous research, the measures are hypothesized to show improved communication participation and well-being in both PD patients and their families following therapy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Due to the interactive nature of rehabilitation, masking the intervention to patients and research investigators is impossible. Therefore, we will blind the separate outcome assessors, who will not be involved in the treatment procedures to minimize bias.
入排标准
- 年龄范围
- 25 Years 至 85 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Medical diagnosis of PD
- •No history of other neurological disease
- •Native speaker of Korean
- •Age between 25 and 85
- •Diagnosis of dysarthria secondary to PD from an SLP
- •Self-reported typical hearing
- •Access to high-speed internet for therapy sessions
排除标准
- •A score of 23 or below on the Korean Montreal Cognitive Assessment
- •Evidence of voice-speech disorders not-related to PD
- •Received speech therapy for PD-related problems in the past one year
- •Have no family members to participate in the project.
研究组 & 干预措施
No Intervention:Waitlist control
No intervention programs (speech therapy, counseling) will be provided.
Intervention: Behavioral, remote speech rehabilitation and counseling
Speech therapy will replicate the dose prescribed by many treatment programs including LSVT LOUD, LSVT ARTIC and Be Clear, consisting of 16 sessions of 50-60 minutes duration delivered over four weeks. Participants will also be set 15 to 20 minutes of daily home practice. Family education/training will take place once a week over 4 weeks, including two components: family counseling (30 min) and family conversation training (30 min). Family counseling aims to increase the PD families' knowledge about PD in general and to identify goals and potential solutions to problems which cause emotional turmoil. Family conversation training which aims to increase the PD families' knowledge about PD-related communication problems and to raise awareness of their communication patterns, and to support the development of functional strategies. All activities will remotely occur (using Zoom).
干预措施: Remote speech rehabilitation (Behavioral)
结局指标
主要结局
Speech Intelligibility Score on a Visual Analogue Scale
时间窗: Immediately after and 6 months after treatment
Speech intelligibility will be estimated using the visual analogue scale method. Listeners will rate the degree to which they understood the speech recordings on a continuous line. The two ends will be labeled, totally unintelligible and completely intelligible, respectively. Higher scores indicate more intelligible.
Vowel Space Area (kHz)
时间窗: Immediately after and 6 months after treatment
Two acoustic measures will be measured as Primary Outcome. The first one is the size of vowel space area, which has been frequently reported to correlate with speech intelligibility in people with Parkinson's disease.
Speaking Rate (syl/s)
时间窗: Immediately after and 6 months after treatment
The second acoustic measures to be included as Primary Outcome is speaking rate. This will be reported as the number of syllables produced in one second.
次要结局
- Dysarthria Impact Profile (DIP)(Immediately after and 6 months after treatment)
- Quality of Family Life Scale(Immediately after and 6 months after treatment)
- Perceived Stress Scale(Immediately after and 6 months after treatment)
- Quality of Family Life Scale(Immediately after and 6 months after treatment)
- Perceived Stress Scale(Immediately after and 6 months after treatment)
- Dysarthria Impact Profile (DIP)(Immediately after and 6 months after treatment)
- Everyday Communication Measure(Immediately after and 6 months after treatment)
研究者
Yunjung Kim
Principal Investigator
Florida State University
