Listener training study wins grant to help patients communicate
The NIH awarded researchers $2.6 million for the Parkinson's project
A research project that’s designed to help improve communication for people with Parkinson’s disease by focusing on listener training has been awarded a $2.6 million, five-year grant from the National Institutes of Health (NIH).
The funding will help researchers implement a structured listener training program and test its effectiveness in a clinical trial enrolling people with Parkinson’s and their primary communication partners, such as their spouse, family, or friends. The grant was given to a team of researchers led by Stephanie Borrie, PhD, professor of communicative disorders at Utah State University, in collaboration with Kaitlin Lansford, PhD, professor in the School of Communication Sciences and Disorders at Florida State University.
“We have been working on understanding how to change this in the lab for years and it’s finally reached the point of taking this science to the real world and establishing new evidenced-based treatment tools for clinical use,” Borrie said in a university news story.
Vocal issues and speech difficulties, from an unusually soft and quiet voice to poor articulation and a monotonous rhythm, are common symptoms of Parkinson’s disease, and are often associated with motor-based impairments that make speech difficult to understand, a condition called dysarthria.
“Traditional speech treatments for people with Parkinson’s disease focus on the person with Parkinson’s disease,” Borrie said. “But these speaker training treatments (e.g., strategies like talking louder and speaking more clearly) require substantial cognitive and physical effort on the part of the speaker to achieve and maintain gains. Therefore, patients with intelligibility deficits who cannot behaviorally modify their speech are not viable candidates for current speech interventions.”
Aiding the listener — and the speaker
As part of the project, the researchers are focusing on a new approach to help with speech intelligibility, or how well the person who is speaking can be understood, by focusing on how listeners can better understand the speech of patients.
“What if we didn’t try and make the person with dysarthria … speak better, but instead we make their communication partner understand better?” Borrie said. “You’ve probably all experienced or observed this naturally in your own lives. You’re chatting to a parent and their kid comes up and says something completely unintelligible, and you think, what was that? And the parent says, ‘Oh, he wants an ice cream.’ The parent has adapted their representation of language to account for the ambiguous speech sounds. Our research has shown that we can use these adaptation mechanisms to help communication partners better understand someone with a neurological speech disorder.”
Over the last decade, the researchers have focused on listener training and demonstrated that, after training, there was a 20% improvement in speech intelligibility. This is considered to exceed what is regarded as a clinically significant 5 to 12% gain for people with speech disorders caused by neurological diseases.
The structured listener training program, which involves recording patients’ speech and providing their communication partners training sessions on a computer with headphones using a communication skills software program designed by the research team.
The program can be done in the clinic and at home, which will let more participants enroll in what will be a large, randomized controlled trial to assess its effectiveness at improving speech intelligibility and other measures of communication interactions.
“Across a number of studies, we have demonstrated improvements to intelligibility following listener training,” Lansford said. “We anticipate finding similar results in this critical clinical trial. But we do not yet know how listener training will impact measures such as listening effort, comprehension, and participation in communicative interactions.”
Borrie’s team has received another five-year NIH grant to analyze behaviors and patterns of conversations and interactions between Parkinson’s patients and caregivers or strangers to identify what facilitates and what obstructs communication.
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