Speech training for neurological patients using a serious game

Abstract: The majority of patients with neurological impairment like Parkinson's Disease (PD) or stroke are affected by dysarthria. Dysarthria is a motor speech impairment which negatively affects speech dimensions such as articulation and loudness. This leads to reduced intelligibility, often hindering daily life communication. Intensive and prolonged speech training can increase patients’ speech intelligibility. Unfortunately, interventions by speech therapists are generally provided only for a short period of time, while continuing practice is needed to maintain or improve intelligibility. eHealth applications might provide a solution. In our research, we explored whether it is possible to develop a game that is suitable for providing speech training in elderly patients with dysarthria due to PD or stroke. In the game, we developed, called Treasure Hunters, two players interact verbally to find the way to the treasure, while receiving automatic feedback on voice loudness and pitch. Participants played with our game in several sessions and generally appreciated it, hinting at our game's potential for speech training in elderly patients. In a within‐subjects experiment with five dysarthric patients, our game was compared to a non‐game computer‐based speech training system: e‐learning‐based Speech Therapy (EST). We focussed on three variables: speech intelligibility, user satisfaction and user preference. Substantial variability between participants was observed, in the outcomes of these three variables and their relations. We conclude that ”one size that fits all” does not apply to computer‐based speech training, but a personalised approach is needed. [ABSTRACT FROM AUTHOR]

[1]  H. Scheffé An Analysis of Variance for Paired Comparisons , 1952 .

[2]  S. Countryman,et al.  Intensive voice treatment (LSVT®) for patients with Parkinson's disease: a 2 year follow up , 2001 .

[3]  M. Bodt,et al.  Intelligibility as a linear combination of dimensions in dysarthric speech. , 2002 .

[4]  M. Horstink,et al.  Improvement of voicing in patients with Parkinson’s disease by speech therapy , 2003, Neurology.

[5]  Jennifer L. Spielman,et al.  Effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson disease: acoustic and perceptual findings. , 2007, Journal of speech, language, and hearing research : JSLHR.

[6]  M. Hawley,et al.  Addressing the needs of speakers with longstanding dysarthria: computerized and traditional therapy compared. , 2007, International journal of language & communication disorders.

[7]  R. Schmidt,et al.  Principles of motor learning in treatment of motor speech disorders. , 2008, American journal of speech-language pathology.

[8]  Jan Theeuwes,et al.  OpenSesame: An open-source, graphical experiment builder for the social sciences , 2011, Behavior Research Methods.

[9]  Ronald Meyer,et al.  A digital game to support voice treatment for parkinson's disease , 2013, CHI Extended Abstracts.

[10]  A. Geurts,et al.  Preparing an E-learning-based Speech Therapy (EST) efficacy study: Identifying suitable outcome measures to detect within-subject changes of speech intelligibility in dysarthric speakers , 2014, Clinical linguistics & phonetics.

[11]  Ute Ritterfeld,et al.  Developing a Technology-Based Speech Intervention for Acquired Dysarthria - A Psychological Approach , 2016, ICCHP.

[12]  L. Beijer,et al.  Intuitive visualizations of pitch and loudness in speech , 2015, Psychonomic Bulletin & Review.

[13]  Emre Yilmaz,et al.  On the Development of an ASR-based Multimedia Game for Speech Therapy: Preliminary Results , 2016, MMHealth@ACM Multimedia.

[14]  Guang Deng,et al.  Systematic review of virtual speech therapists for speech disorders , 2016, Comput. Speech Lang..

[15]  Zakkoyya H. Lewis,et al.  What's the Point?: A Review of Reward Systems Implemented in Gamification Interventions. , 2016, Games for health journal.

[16]  Domen Novak,et al.  Comparison of two difficulty adaptation strategies for competitive arm rehabilitation exercises , 2017, 2017 International Conference on Rehabilitation Robotics (ICORR).

[17]  B. Lange,et al.  Virtual reality for stroke rehabilitation. , 2015, The Cochrane database of systematic reviews.

[18]  Tuomas Kari Promoting Physical Activity and Fitness with Exergames: Updated Systematic Review of Systematic Reviews , 2017 .