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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Two types of intervention will be provided via online to 32 dyads of people with Parkinson's disease: (1) speech therapy (PD patients) and (2) family education/training (PD families). 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.
Florida State University
Tallahassee, Florida, United States
RECRUITINGSpeech Intelligibility Score on a Visual Analogue Scale
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.
Time frame: Immediately after and 6 months after treatment
Vowel Space Area (kHz)
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.
Time frame: Immediately after and 6 months after treatment
Speaking Rate (syl/s)
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.
Time frame: Immediately after and 6 months after treatment
Dysarthria Impact Profile (DIP)
DIP is an assessment tool designed to measure the psychosocial impact of dysarthria on affected individuals. It consists of several sections with statements rated on a five-point scale, ranging from "strongly agree" to "strongly disagree." DIP incorporates positively and negatively worded statements with differing scoring schemes. This will be obtained from people with Parkinson's disease. Higher scores indicate greater impact of dysarthria.
Time frame: Immediately after and 6 months after treatment
Everyday Communication Measure
Family members will also be asked to rate five different aspects of the PD participant's everyday communication abilities using Everyday Communication Measures on a scale of 1 (poor) to 7 (very good). Example questions include, "how easy is it to understand the speaker?" and "how often does the speaker initiate conversation with you?". This will be obtained from family members of PD participants. Lower scores indicate greater difficulties of everyday communication.
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Time frame: Immediately after and 6 months after treatment
Quality of Family Life Scale
The Family Quality of Life Scale (FQOL) is a 25-item instrument used to measure several aspects of families' perceived satisfaction in terms of quality of family life (e.g., family interaction, emotional well-being, physical/material well-being, and disability-related support). It uses a 1(very dissatisfied)-5 (very satisfied) Likert scale. Higher scores indicated a better quality of family life.
Time frame: Immediately after and 6 months after treatment
Perceived Stress Scale
The Perceived Stress Scale (PSP) will be used for measuring psychological stress. Among the three versions of the PSS, the Korean version of PSS-10 will be used. It uses a 0 (never)-4 (very often) Likert scale. Higher scores indicate more stress.
Time frame: Immediately after and 6 months after treatment