Perceptual Doping: A Hypothesis on How Early Audiovisual Speech Stimulation Enhances Subsequent Auditory Speech Processing.

Face-to-face communication is one of the most common means of communication in daily life. We benefit from both auditory and visual speech signals that lead to better language understanding. People prefer face-to-face communication when access to auditory speech cues is limited because of background noise in the surrounding environment or in the case of hearing impairment. We demonstrated that an early, short period of exposure to audiovisual speech stimuli facilitates subsequent auditory processing of speech stimuli for correct identification, but early auditory exposure does not. We called this effect "perceptual doping" as an early audiovisual speech stimulation dopes or recalibrates auditory phonological and lexical maps in the mental lexicon in a way that results in better processing of auditory speech signals for correct identification. This short opinion paper provides an overview of perceptual doping and how it differs from similar auditory perceptual aftereffects following exposure to audiovisual speech materials, its underlying cognitive mechanism, and its potential usefulness in the aural rehabilitation of people with hearing difficulties.

A serious game for speech training in dysarthric speakers with Parkinson's disease: Exploring therapeutic efficacy and patient satisfaction.

BACKGROUND: The increasing need for speech therapy due to our ageing population raises the demand on therapeutical resources. To meet this demand, innovative delivery of speech training is required. eHealth applications may provide a solution, as intensified and prolonged training is only possible and affordable in patients' home environment. AIMS: This study explores the effects on speech intelligibility of game-based speech training that provides automatic feedback on loudness, pitch and pronunciation. Additionally, we investigate how satisfied patients are with the game-based speech training and how they experience the automatic feedback. Furthermore, patients' preferences for game-based speech training compared with face-to-face training are explored. METHODS AND PROCEDURES: Eight adult dysarthric speakers with Parkinson's disease (PD) completed a 4-week game-based speech training in their home environment. For each speaker, 24 speech utterances were audio recorded 4 weeks before (T1), immediately before (T2) and immediately after (T3) the training. All speech samples were rated on speech intelligibility by 10 untrained listeners, by comparing them with the corresponding utterances realized by a healthy speaker. Changes over time were analysed using a linear mixed-effects analysis. Patient satisfaction with the game and the automatic feedback was assessed using a questionnaire. The preferences of patients were collected using a paired comparisons procedure in which the patients were asked whether they would prefer game-based or face-to-face speech training in four hypothetical scenarios with different hypothesized levels of speech improvement. OUTCOMES AND RESULTS: While there was no significant difference in speech intelligibility ratings between T1 and T2, we did find one between T2 and T3. At T3, speech intelligibility was rated higher than at T2, indicating positive effects of the game-based speech training. Patients generally seemed satisfied with the game as average ratings were above 7 on a 10-point rating scale. Generally, patients agreed with the automatic feedback and could use it to positively change the way they spoke. Patients prefer the training that provides the highest hypothetical improvement, and thus do not prefer face-to-face above game-based therapy. CONCLUSIONS AND IMPLICATIONS: The results of this study suggest that dysarthric speakers due to PD see game-based speech therapy as a valid alternative for face-to-face therapy and that it leads to an average improvement in speech intelligibility. For an optimal effect and user satisfaction it should preferably not be used in isolation but in combination with face-to-face training. In this manner, the strengths of both therapeutic deliveries can be harnessed. WHAT THIS PAPER ADDS: What is already known on this subject Dysarthric speech in patients with PD is known to benefit from intensified and long-term speech therapy. The increasing need for speech therapy due to our ageing population raises the demand on therapeutical resources making highly frequent and long-term therapy difficult. eHealth provides the opportunity to intensify and prolong speech training in patients' home environment. A drill-and-practice method was employed and investigated in a web-based speech application, indicating positive effects on speech intelligibility. However, participants indicated a lack of variation in exercises making the training less enjoyable. Other research showed that serious games can increase enjoyment during training. What this paper adds to existing knowledge The results of this study show that it is possible to develop a serious game that can be successfully used for speech training by patients with dysarthria due to PD. Comparing speech intelligibility ratings before and after training, we observed significant improvements in speech intelligibility ratings. Patients generally agree with the automatic feedback and can use it to positively change the way they speak. Average ratings were above 7 on a 10-point scale, indicating that patients are satisfied with the game. Patients prefer the type of training (game based or face to face) that provides the highest hypothetical improvement. What are the potential or actual clinical implications of this work? The results of this study suggest that game-based speech training can improve speech intelligibility in patients. This indicates that it can be considered a suitable approach in the treatment of patients with dysarthria due to PD. Patients do not prefer game-based training above face-to-face training in all scenarios. For that reason, for every patient one should carefully consider how to optimally combine game-based and face-to-face training.

Comparison of the efficacy of acupuncture-related Therapies for post-stroke motor aphasia: A Bayesian network meta-analysis.

Background: Motor aphasia, which can affect the communication ability of patients and even triggers severe psychological disorders, is one of the most common sequelae after stroke. Acupuncture (a typical complementary alternative therapy) is frequently combined with speech training (ST) to treat post-stroke motor aphasia (PSMA) and presents significant efficacy. However, the most effective acupuncture intervention is still unknown. This study aims to analyze the efficacy of several acupuncture approaches combined with ST for PSMA to identify the best intervention for clinical decision-making by using network meta-analysis (NMA). Methods: Eight major databases were searched from the time of their establishment to March 2022. Clinical efficacy rate (CER) was used as the primary outcome indicator. R software (version 4.13.0) and STATA software (version 16.0) were used to analyze the data. Results: A total of 29 randomized controlled trials (RCTs) and six treatment regimens were included in this study. In the pair-wise meta-analysis, we found that the efficacy of scalp-tongue acupuncture (STA) combined with ST [OR = 8.30; 95% Credible interval (CrI): 3.87, 17.33], tongue acupuncture (TA) combined with ST (OR = 3.95; 95% CrI: 2.27, 6.89), scalp-body acupuncture (SBA) combined with ST (OR = 3.75; 95% CrI: 2.26, 6.22), scalp acupuncture (SA) combined with ST (OR = 2.95; 95% CrI: 1.74, 5.0), and body acupuncture (BA) combined with ST (OR = 2.30; 95% CrI: 1.26, 4.19) were significantly superior to that of ST. In addition, the efficacy of STA + ST was significantly superior to that of SA +ST (OR = 2. 82; 95% CrI: 1.24, 6.38) and BA + ST (OR = 3.61; 95% CrI: 1.40, 9.29). According to the surface under the cumulative ranking curve (SUCRA), STA + ST (SUCRA = 97.9%) may be the best treatment regimen to improve the clinical outcome in patients with PSMA. Conclusion: The NMA showed that STA combined with ST may be the best treatment to improve CER, compared with other combination treatments. However, since the overall quality and number of studies are limited, further RCTs with a large sample and multicenter are needed for further validation. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=316081, identifier CRD42022316081.

Phonetic versus spatial processes during motor-oriented imitations of visuo-labial and visuo-lingual speech: A functional near-infrared spectroscopy study.

While a large amount of research has studied the facilitation of visual speech on auditory speech recognition, few have investigated the processing of visual speech gestures in motor-oriented tasks that focus on the spatial and motor features of the articulator actions instead of the phonetic features of auditory and visual speech. The current study examined the engagement of spatial and phonetic processing of visual speech in a motor-oriented speech imitation task. Functional near-infrared spectroscopy (fNIRS) was used to measure the haemodynamic activities related to spatial processing and audiovisual integration in the superior parietal lobe (SPL) and the posterior superior/middle temporal gyrus (pSTG/pMTG) respectively. In addition, visuo-labial and visuo-lingual speech were compared with examine the influence of visual familiarity and audiovisual association on the processes in question. fNIRS revealed significant activations in the SPL but found no supra-additive audiovisual activations in the pSTG/pMTG, suggesting that the processing of audiovisual speech stimuli was primarily focused on spatial processes related to action comprehension and preparation, whereas phonetic processes related to audiovisual integration was minimal. Comparisons between visuo-labial and visuo-lingual speech imitations revealed no significant difference in the activation of the SPL or the pSTG/pMTG, suggesting that a higher degree of visual familiarity and audiovisual association did not significantly influence how visuo-labial speech was processed compared with visuo-lingual speech. The current study offered insights on the pattern of visual-speech processing under a motor-oriented task objective and provided further evidence for the modulation of multimodal speech integration by voluntary selective attention and task objective.

[Etiopathogenetic treatment of professional singers with vocal nodules]. / Étiopatogeneticheskoe lechenie uzelkov golosovykh skladok u professional'nykh vokalistov.

The article deals with optimization of treatment policy for professional singers. The survey sample is 67 singers with vocal nodules of the age from 24 to 42 and the length of time worked from 3 to 28 years. The following methods are used: questionnaire survey (professional anamnesis, voice evaluation according to Visual Analog Scale (VAS), Spielberg-Hanin test), microlaryngoscopy, video endolaringostroboscopy, voice acoustic analysis (MDVP Kay Pentax system). The algorithm and evaluation criteria of vocal nodules treatment efficiency for the singers taking into account the specific character of their professional activity are proposed.

The effect of speech training experiences on speechreading skills of Chinese children with hearing impairment.

Speechreading contributes significantly to effective communication, and persons with hearing impairment (HI) may need to rely more on speechreading. However, whether they may benefit from training/practice to improve their speechreading performance remains unclear. In this study, we examine the effect of speech training on speechreading performance of children with HI in China, and how such effect, if any, may be influenced by age. Fifty-nine HI children with speech training experiences, and fifty-eight HI children without speech training experiences completed tasks measuring their ability to speechread Chinese at the linguistic levels of words, phrases, and sentences. The children ranged from 7 to 14 years old, and were divided into four age groups by two-year age intervals. Both accuracy rate and response time data were collected. Results revealed three findings: (1) HI children with speech training experiences speechread more accurately but more slowly than those without speech training experiences; (2) while speechreading performance generally improved with age, age didn't alter the relative performance between the two groups; and (3) speechreading performance was best for phrases, and worst for sentences. These findings suggest that HI children benefit from speech training to improve their speechreading performance, and their speechreading performance is influenced by age, linguistic level, and the specific measure used.

["Xingnao Kaiyin acupuncture" combined with speech training for post-stroke aphasia].

OBJECTIVE: To verify the clinical efficacy of "Xingnao Kaiyin acupuncture" combined with speech training for post-stroke aphasia. METHODS: A total of 68 patients with post-stroke aphasia were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the control group were treated with basic therapy and speech rehabilitation exercises (mainly Schuell's aphasia stimulation therapy). Based on the treatment of the control group, the patients in the observation group were treated with "Xingnao kaiyin acupuncture" at Shuigou (GV 26), Neiguan (PC 6), Sanyinjiao (SP 6), Lianquan (CV 23), Baihui (GV 20), Fengfu (GV 16), Yamen (GV 15), Hegu (LI 4) and Taichong (LR 3), once a day, six times a week; four-week treatment was taken as one session, and totally 2 sessions were given. The speech function scores, including comprehension, naming, retelling, writing and reading, were observed before and after treatment in both groups, and the efficacy of the two groups was evaluated. RESULTS: The total effective rate was 91.2% (31/34) in the observation group, which was superior to 67.6% (23/34) in the control group (P<0.05). Compared before treatment, each index of speech function scores in the two groups were increased significantly after treatment (all P<0.05); compared with the control group, each index of speech function scores in the observation group were increased significantly after treatment (all P<0.05). CONCLUSION: Based on the basic treatment and speech training, "Xingnao kaiyin acupuncture" could improve the early rehabilitation effect of post-stroke aphasia.

ISi-Speech: A Digital Training System for Acquired Dysarthria.

Speech impairment like dysarthria poses a major risk to participation in society due to reduced speech intelligibility. This paper focuses on the ongoing development of the technology-based pilot training system, ISi-Speech, for treatment of dysarthria incorporating automatic speech recognition, a psychological model of motivation and evidence-based exercises.

Further Evidence of the Positive Influence of Repetitive Transcranial Magnetic Stimulation on Speech and Language in Patients with Aphasia after Stroke: Results from a Double-Blind Intervention with Sham Condition.

BACKGROUND: After a stroke, up to 20% of patients suffer from aphasia. The preferred treatment for stroke-related aphasia (SRA) is regular speech and language training (SLT). In the present study, we investigated to what extent adjuvant repetitive transcranial magnetic stimulation (rTMS) might enhance recovery. While there is growing evidence of the positive effect of adjuvant rTMS on aphasia, no study has yet been based on an Iranian sample. METHOD: A total of 12 patients (mean age: 55 years; right-handed; 7 women) underwent treatment for SRA 1 month after stroke. The standard treatment consisted of regular 45-min SLT sessions 5 times a week for 2 consecutive weeks. Additionally, patients were randomly assigned either to adjuvant rTMS (5 times a week for 30 min) or to a sham condition (5 times a week for 30 min). At baseline and after 2 weeks of intervention, the degree of aphasia was assessed with the Farsi version of the Western Aphasia Battery. rTMS was applied to the inferior posterior frontal gyrus of the right hemisphere. RESULTS: Speech and language improved over time, but more so in the rTMS than in the sham condition. Large effect sizes were observed for content, fluency, and the aphasia quotient; medium effect sizes were observed for command comprehension and repetition, while effect sizes were small for auditory comprehension and naming. CONCLUSIONS: Among patients with SRA, compared to a sham condition, adjuvant rTMS improved speech and language skills. The present results add to the accumulating evidence that rTMS as a neuromodulation technique has the capacity to enhance the effect of conventional SLT.

Computer-Assisted Speech Training for Cochlear Implant Patients: Feasibility, Outcomes, and Future Directions.

Learning electrically stimulated speech patterns can be a new and difficult experience for cochlear implant patients. Cochlear implantation alone may not fully meet the needs of many patients, and additional auditory rehabilitation may be necessary to maximize the benefits of the implant device. A recently developed computer-assisted speech-training program provides cochlear implant patients with the means to conduct auditory rehabilitation at home. The training software targets important acoustic contrasts between speech stimuli and provides auditory and visual feedback as well as progressive training, thereby maintaining patients' interest in the auditory training exercises. Recent scientific studies have demonstrated the effectiveness of such specialized auditory training programs in improving cochlear implant patients' speech recognition performance. Provided with an inexpensive and accessible auditory training program, cochlear implant patients may find the motivation and momentum to get the most from the implant device.