Listener Training for Improved Intelligibility of People With Parkinson's Disease

NCT ID: NCT06815263

Last Updated: 2025-04-04

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 360 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-26
• Study Completion Date: 2029-05-31

Brief Summary

Listener training offers a promising avenue for improving communication for people with dysarthria due to Parkinson's disease by offsetting the intelligibility burden from the patient onto their primary communication partners. Here, we employ a repeated-measures, randomized controlled trial to establish the efficacy of listener training for patients with PD and their primary communication partners. This translational work will establish a new realm of clinical practice in which the intelligibility impairments in PD are addressed by training partners to better understand dysarthric speech, thus elevating communication outcomes and participation in daily life.

Detailed Description

People with dysarthria due to Parkinson's disease (PD) frequently present with reduced intelligibility, which can have significant consequences, including reduced participation in situations involving communicating with others and resulting in social isolation.1-5 Few effective treatments exist to ease the intelligibility burden of dysarthria in PD, and most require significant cognitive and physical effort on the part of the speaker to achieve and maintain gains.6,7 Once people with PD have progressed beyond the early stages of the disease, and their cognitive and physical impairments limit their ability to use traditional speech therapy techniques, they are not realistic treatment candidates for current interventions; and no other interventions are available to support their communication. This is a serious and consequential gap in clinical care for people with PD. The current proposal addresses this critical gap by shifting the weight of behavioral change from the speaker to the listener, specifically key communication partners such as family. Indeed, for older adults, most of their time spent with others is spent with family members.8 Further, key partners of patients with PD wish to have a more significant and active role in communication rehabilitation.9,10 A listener-targeted remediation approach for intelligibility impairments in people with dysarthria and PD is firmly grounded in theoretical models of perceptual learning11-13 and rigorously supported by our decade-long research program targeting perceptual learning of dysarthric speech.14-30 To date, this line of investigation has chiefly targeted the theory of listener adaptation to the degraded signal; however, robust intelligibility improvements of up to 20 percent across studies have been observed.15 With a rigorous account of how and what listeners adapt to, we are ideally positioned to move this work from bench to bedside, establishing listener (i.e., perceptual) training as a clinical intervention to improve intelligibility in people with PD. Here, we establish the efficacy of listener training for patients with PD and their primary communication partners using a repeated-measures, randomized controlled trial (SA1). Immediate acquisition and retention of intelligibility improvements will be examined as a function of speaker severity. We then evaluate three theoretically and empirically-motivated communication benefits of listener training that extend beyond intelligibility, including listening effort, comprehension, and communicative participation (SA2). Finally, we engage stakeholder input to inform clinical implementation of listener training using qualitative semi-structured interviews (SA3) with patients with PD and their partners. This will provide insights into the effectiveness and feasibility of the intervention approach, ensuring that their needs and preferences are considered and that they feel empowered and motivated for a listener training approach. Thus, in three independent aims, this proposal will address a current void in our clinical toolbox, establishing a new realm of clinical practice in which communication challenges in PD are managed by training partners to better understand the degraded speech.

Conditions

Dysarthria, Hypokinetic

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Experimental Condition

Listener receives speech of patient with dysarthria

Group Type: EXPERIMENTAL

Listener Training

Intervention Type: BEHAVIORAL

Partner participants are presented with individual audio phrases that make up passage reading speech stimuli and orthographic transcriptions of what the patient is saying. Partners are asked to listen carefully to the audio files and use the written subtitles to help them understand what is being said.

Control condition

Listener receives speech of speaker with no speech disorder

Group Type: SHAM_COMPARATOR

Listener Training

Intervention Type: BEHAVIORAL

Partner participants are presented with individual audio phrases that make up passage reading speech stimuli and orthographic transcriptions of what the patient is saying. Partners are asked to listen carefully to the audio files and use the written subtitles to help them understand what is being said.

Interventions

Listener Training

Partner participants are presented with individual audio phrases that make up passage reading speech stimuli and orthographic transcriptions of what the patient is saying. Partners are asked to listen carefully to the audio files and use the written subtitles to help them understand what is being said.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Primary language is English
• 18 years or older
• medical diagnosis of Parkinson's disease (patient participants)
• speech diagnosis of hyperkinetic dysarthria, exhibiting hallmark characteristics (patient participants)

Exclusion Criteria

• Severe cognitive impairment
• Less than 18 years of age
• Primary language other than English

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role: collaborator

Florida State University

OTHER

Sponsor Role: collaborator

Utah State University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Stephanie Borrie, PhD

Role: PRINCIPAL_INVESTIGATOR

Utah State University

Kaitlin Lansford, PhD

Role: PRINCIPAL_INVESTIGATOR

Florida State University

Sarah Yoho Leopold, PhD

Role: STUDY_DIRECTOR

Utah State University

Locations

Florida State University

Tallahassee, Florida, United States

Site Status: RECRUITING

Utah State University

Logan, Utah, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Sarah Yoho Leopold, PhD

Role: CONTACT

sarah.leopold@usu.edu

614-570-8258

Stephanie Borrie, PhD

Role: CONTACT

stephanie.borrie@usu.edu

435-797-1388

Facility Contacts

Kaitlin Lansford, PhD

Role: primary

klansford@fsu.edu

850-644-8443

Kaitlin Lansford, PhD

Role: backup

Stephanie Borrie, PhD

Role: primary

stephanie.borrie@usu.edu

435-797-1388

Stephanie Borrie, PhD

Role: backup

Sarah Leopold, PhD

Role: backup

Other Identifiers

1R01DC020930

Identifier Type: NIH

Identifier Source: secondary_id

View Link

14004

Identifier Type: -

Identifier Source: org_study_id