A Perceptual Learning Approach for Dysarthria Remediation: An Updated Review

Abstract

Purpose Early studies of perceptual learning of dysarthric speech, those summarized in Borrie, McAuliffe, and Liss (2012), yielded preliminary evidence that listeners could learn to better understand the speech of a person with dysarthria, revealing a potentially promising avenue for future intelligibility interventions. Since then, a programmatic body of research grounded in models of perceptual processing has unfolded. The current review provides an updated account of the state of the evidence in this area and offers direction for moving this work toward clinical implementation. Method The studies that have investigated perceptual learning of dysarthric speech ( N = 24) are summarized and synthesized first according to the proposed learning source and then by highlighting the parameters that appear to mediate learning, culminating with additional learning outcomes. Results The recent literature has established strong empirical evidence of intelligibility improvements following familiarization with dysarthric speech and a theoretical account of the mechanisms that facilitate improved processing of the neurologically degraded acoustic signal. Conclusions There are no existing intelligibility interventions for individuals with dysarthria who cannot behaviorally modify their speech. However, there is now robust support for the development of an approach that shifts the weight of behavioral change from speaker to listener, exploiting perceptual learning to ease the intelligibility burden of dysarthria. To move this work from bench to bedside, recommendations for translational studies that establish best practices and candidacy for listener-targeted dysarthria remediation, perceptual training, are provided.

Rapid but specific perceptual learning partially explains individual differences in the recognition of challenging speech

“…Instead, training-based studies or interventions should consider the specificity of learning in their design and expected outcomes. Recent work on dysarthric speech suggests that this could be feasible 71 . Learning of dysarthric speech is constrained by the characteristics of individual patients 72 , and even experienced clinicians still benefit from talker-specific training 39 .…”

“…Learning of dysarthric speech is constrained by the characteristics of individual patients 72 , and even experienced clinicians still benefit from talker-specific training 39 . Therefore, it is proposed that communication partners train to improve the intelligibility of specific patients (e.g., a family member), accounting for learning specificity 71 .…”

Abstracts of the 8th International Conference on Speech Motor Control Groningen, August 2022

“…Theoretical models posit that experience affords the listener an opportunity to acquire distributional knowledge of the degraded speech signal (Kleinschmidt & Jaeger, 2015). A large body of literature has experimentally examined perceptual learning of dysarthric speech in adult populations: neurotypical adult listeners familiarized with the speech of adults with dysarthria show significant improvements in intelligibility performance relative to those familiarized with neurotypical speech (see Borrie & Lansford, 2021, for a review). Collectively, the results support a novel approach for adult speech remediation: listenertargeted remediation to improve intelligibility of speakers with dysarthria.…”

Same or Different? Perceptual Learning for Connected Speech Induced by Brief and Longer Experiences

“…Instead, training-based studies or interventions should consider the speci city of learning in their design and expected outcomes. A recent review of perceptual learning of dysarthric speech [65] suggests that this is feasible. Since learning of dysarthric speech is constrained by the dysarthria characteristics of individual patients [66] and even experienced clinicians still bene t from talker-speci c training [67] it is proposed that communication partners train to improve the intelligibility of speci c patients (e.g., a family member), accounting for learning speci city.…”