2000 — 2002 |
Green, Jordan R |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Development of Early Orofacial Motility and Control @ University of Wisconsin Madison
DESCRIPTION (adapted from applicant's abstract): The goal of this project is to identify the characteristics of the immature oromotor control system that shape early speech production. Fundamental similarities in vocal development within and across cultures suggest that young children have a propensity for certain articulatory movements and configurations (Kent, 1992; Locke, 1983; Oller, Eilers, Urbano, and Cobo-Lewis, 1997). These universal tendencies probably reflect the properties of the immature oromotor control system that, in part, delimit early phonetic abilities. The few existing studies of early articulatory control have revealed the coordinative organization for speech to emerge much earlier than previously suggested (Moore and Ruark, 1996; Ruark and Moore, 1997). Accordingly, an improved understanding of speech development requires more direct information about the organization of spontaneous and task-related orofacial movements produced in early infancy. Early lip and jaw movements and associated muscle activity will be studied in five different groups at differing stages of early development (age range: birth to 12 months) using a 3D computerized movement capture system. Movement data will be collected from the upper lip, lower lip, and jaw using three reflective markers placed midline on the vermilion border of the upper and lower lip, and just superior to the mental protuberance of the mandible. Muscle activity will be recorded using miniature surface electrodes from five targeted muscles sites: right temporalis, right masseter, anterior belly of digastric, right quadrant of the orbicularis oris superior, and right quadrant of the orbicularis oris inferior. Lip and jaw data will be subjected to analyses that will characterize early oromotor coordination and control at multiple levels (e.g., spatio-temporal stability, inter- articulator coupling, and frequency of movement). These analyses will also include the novel use of 3D movement space mapping to describe the diversity and richness of early lip and jaw movements exhibited at each age across and within distinct oromotor behaviors (e.g., spontaneous vs. chewing vs. sucking vs. vocalization). It is hypothesized that even newborn subjects will exhibit some stereotypic lip and jaw movement patterns for certain tasks and that changes in spontaneous movements will parallel changes in task-related movement patterns. The developmental sequence observed in this study will provide empirically based guidelines for advancing underlying movement competencies in children with speech motor delays and will lead to a descriptive framework in which speech motor delays can be detected at an earlier stage of development.
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0.913 |
2004 — 2009 |
Green, Jordan R |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Early Speech Motor Development @ University of Nebraska Lincoln
DESCRIPTION (provided by applicant): The primary objective of this application is to identify essential oromotor skills that children obtain during early speech development and factors that contribute to individual variation in the course of speech development. The specific aims are (1) to identify the movement characteristics of prespeech orofacial behaviors, (2) to identify developmental changes in articulatory performance that underlie early phonetic ability, (3) to identify speaker factors that influence the rate of early speech motor development, and (4) to identify the articulatory characteristics of infant-directed speech. Thirty children will be studied longitudinally every 3 months from 3 to 33 months of age. At each age, measures of oromotor performance, phonetic ability, craniofacial growth, receptive and expressive language development, and general-motor development will be gathered. An optical motion-capture system will be used to quantify developmental changes in craniofacial size and orofacial kinematics for a wide range of speech and non-speech behaviors. Orofacial kinematic data will also be collected from each child's caregiver during infant-directed and adult-directed speech to examine the potential relationship between parental articulation style and early articulatory performance. Latent growth modeling will be used to characterize individual patterns of development in speech and oromotor performance and to quantify the strength of association between the rates of growth in oromotor performance, phonetic ability, and skills in other developmental domains. This study will provide essential information regarding the developmental course of early articulatory development and the influence of physiologic, anatomic, and linguistic processes on early speech development. These normative descriptions will serve as reference data for gauging the degree of impairment in children with speech motor disorders, and will provide developmentally appropriate guidelines for speech-treatment focused on improving underlying movement competencies.
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0.906 |
2009 — 2013 |
Green, Jordan R Yunusova, Yana (co-PI) [⬀] |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Bulbar Motor Deterioration in Als @ Mgh Institute of Health Professions
DESCRIPTION (provided by applicant): The goal of this application is to improve the understanding of bulbar (head) deterioration in Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease), which is a fatal neurologic disease caused by degeneration of the motor neurons in the motor cortex, brainstem, and spinal cord. Despite the devastating consequences of bulbar deterioration, including impaired speech and swallowing, on the survival and quality of life of individuals with ALS, only a few studies have been conducted on ALS bulbar symptoms compared to research on ALS spinal involvement. This application responds to this gap in clinical and scientific knowledge by studying bulbar decline longitudinally and comprehensively using established and innovative methods for recording, measuring, and analyzing speech behaviors. One hundred persons with ALS will be studied every three months for a period of two years. The course of deterioration in each participant's speech will be tracked longitudinally using multiple measures of bulbar performance, with each measure broadly classified as either a representing speech performance at the global (i.e., speech system) level or subsystem level. The speech subsystem measures will represent the functional integrity of multiple bulbar regions known to support speech production, including the respiratory, phonatory, resonatory, and articulatory subsystems. Patterns of decline at each speech system and subsystem level will be used to address four specific aims: (1) determine if the rate of speech subsystem performance in the early stage of the disease accurately predicts the long-term rate of decline, (2) determine if speech subsystem measures accurately predict the onset of speech decline and the subsequent loss of oral communication, (3) identify sensitive quantitative indicators of the onset and rate of bulbar deterioration, and (4) identify several putative subtypes of bulbar ALS. In the short term, the identification of sensitive measures of bulbar involvement will improve early detection and prognostic accuracy and address the critical need for objective outcome measures in future experimental drug trials. The findings will also provide much needed information regarding the implications of speech subsystem deterioration on speech intelligibility. In the long term, the more refined endophenotype (i.e., hereditary characteristic) of bulbar involvement obtained from this research may strengthen future efforts at identifying the genetic loci of ALS and improving diagnostic and treatment specificity of the disease.
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1 |
2014 — 2018 |
Green, Jordan R |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Speech Movement Classification For Assessing and Treating Als @ Mgh Institute of Health Professions
DESCRIPTION (provided by applicant): The purpose of this project is advance the assessment and treatment of speech motor impairments due to ALS using novel computer-based approaches. Recently developed speech movement tracking technology will be used to record movements of tongue, lips, and jaw in 50 persons with ALS and 50 healthy control participants. The speech movement data will be analyzed using custom machine learning algorithms to address three important translational needs in person with ALS: improved early detection of speech motor involvement, improved progress monitoring of speech motor decline, and improved options for maintaining oral communication. The established interdisciplinary team with expertise in data mining, speech- language pathology, clinical neurology, and spatial statistics are well positioned to conduct this research. If successful, the specific aims have the potential to transform clinical practice for speech-language pathologists, neurologists, and other related health care professionals. The propose research will enhance human health by making an impact on individuals with speech motor impairment due to ALS and potentially to a broad range of other speech motor due to stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease, cerebral palsy, traumatic brain injury, and orofacial or laryngeal cancer.
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1 |
2017 — 2021 |
Green, Jordan R |
K24Activity Code Description: To provide support for the clinicians to allow them protected time to devote to patient-oriented research and to act as mentors for beginning clinical investigators. |
Prolonging Functional Speech in Persons With Amyotrophic Lateral Sclerosis: a Real-Time Virtual Vocal Tract @ Mgh Institute of Health Professions
People with ALS eventually and inevitably experience serious speech impairment due to progressive deterioration of brain cells that control movements of the tongue, lips and jaw. Despite the devastating consequences of this speech impairment on quality of life and survival, few options are available to assist impaired oral communication, and many existing speech-generating technologies are slow to operate and cost prohibitive. This project seeks to improve quality of life for persons with impaired speech due to ALS by testing the effectiveness of a low-cost, speech-generating device (a virtual vocal tract) that could significantly prolong the ability of these patients to communicate orally. If successful, these techniques could be extended for use by patients' with a broad range of speech motor impairments. The virtual vocal track uses machine learning algorithms to predict what a person is attempting to say, in real-time, based solely on lip movements. Users of the device are able to trigger the playback of a number of predetermined phrases by simply attempting to articulate what they want to say. Our previous work has shown the feasibility of this approach using cost-prohibitive laboratory systems such as electromagnetic articulography. Recent advances in 3D depth mapping camera technology allow these techniques to be tested for the first time using technologies, which are low-cost, portable and already being integrated into consumer devices such as laptops and cellphones. To this end, the system under development will be tested in 60 patients with ALS, representing a range of speech impairment from normal to severe speech intelligibility (15 normal, 15 mild, 15 moderate, 15 severe). During testing, participants will be cued to articulate the phrases in a random order as fast as is comfortable for them. The entire session will be recorded and the following variables will be measured offline: recognition accuracy, recognition latency, task time, % completion, and communication rate (words per minute). Users will rate the usability and acceptability of the virtual vocal tract immediately following device testing, using the System Usability Scale. Results of this testing will be used to address the following specific aims: (1) Determine the accuracy and latency of real-time phrase synthesis based on dysarthric speech using the virtual vocal tract, (2) Determine the usability and acceptability of real-time phrases produced using the virtual vocal tract, and (3) Identify the articulatory and speech factors that degrade recognition accuracy.
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1 |
2018 — 2021 |
Green, Jordan R Yunusova, Yana |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
The Development and Validation of a Novel Tool For the Assessment of Bulbar Dysfunction in Als @ Sunnybrook Research Institute
PROJECT SUMMARY The ultimate goal of this research is to improve clinical practice standards and expedite the pace of therapeutic trials through the development of a clinical tool for assessing the progression of bulbar dysfunction in amyotrophic lateral sclerosis (ALS). As per patient reports, bulbar dysfunction is the most debilitating consequence of ALS, because it leads to the inability to communicate one?s wishes and to eat normally, and because it increases the risk of serious medical complications such as aspiration pneumonia and choking. The great majority of persons diagnosed with ALS experience the loss of motor function in the muscles responsible for speaking and swallowing. Despite its significant impact on quality of life and widespread in ALS, bulbar dysfunction has not received sufficient research attention to date. Bulbar dysfunction is also typically not assessed in clinical trials, beyond a patient report of symptoms. For these reasons, there is strong agreement among the ALS experts on the need for an objective clinician-administered bulbar dysfunction assessment tool. The overall goal of this project is to design a valid and reliable bulbar motor severity assessment tool - the ALS Index of Bulbar Dysfunction (ALS-IBD). In our preliminary work, we have obtained expert consensus regarding the domains to be included in the tool and then exhaustively sampled the literature identifying a large number of candidate items for assessing bulbar motor dysfunction across the identified domains. Our tool development plan adheres to the current best practices for outcome measure development, which have determined the following specific aims: (1) further refine the candidate items by surveying a cohort of speech- language pathology experts; (2) evaluate inter-rater and test-retest reliability of each item and reduce items based on the pre-set reliability criterion; (3) evaluate construct validity of each reliable item relative to the instrumental measures established in our prior work and the validity of the ALS-IBD as a whole relative to the current symptom-based standards; and finally (4) estimate the ALS-IBD?s responsiveness to change over time and its interpretability in the context of changes that are meaningful to the patients. To achieve these aims, we will recruit 100 people diagnosed with ALS, presenting with a range of bulbar impairment severity. To establish content and face validity of ALS-IBD, we will survey 30 expert speech- language pathologists regarding the content, feasibility, clarity of wording, and response options of the candidate items. To estimate inter-rater and intra-rater reliability, we will administer the ALS-IBD multiple times in a subset of participants. To establish construct validity, the individual item scores will be correlated with the highly sensitive instrumental measures to identify items that are most valid with respect to the constructs that they represent. The instrumental measures will be extracted from the kinematic analyses of oromotor and speech movements; acoustic analyses of syllables and connected speech tasks; aerodynamic measures of voice and cough; and the videofluoroscopic analysis of swallowing. The optimized item set created as a result of the item reliability and validity evaluations will comprise the ALS-IBD. The final version of the tool will be subjected to recalculation of its reliability and the assessment of its construct validity relative to the symptom- based measures (e.g. ALS-Functional Rating Scale ? Revised). The ALS-IBD will also be assessed for its responsiveness and interpretability using the change in scores between the baseline session and a second session recorded in six months. This effort will yield a brief, scientifically valid, inexpensive, easy-to-use, clinician-administered assessment tool that can be used to track bulbar disease progression in ALS clinics and as an outcome measure in clinical trials.
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0.93 |
2018 — 2019 |
Green, Jordan R |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Assessing and Restoring Lip Motor Function Following Facial Transplantation @ Mgh Institute of Health Professions
PROJECT SUMMARY Facial transplantation is a relatively new and promising surgical option for people who have suffered severe facial injury and disfigurement. The precipitating events resulting in facial transplantation vary but include chemical burn, electrical burn, animal attack, gunshot, neurofibromatosis, and damage due to oncological treatment and radiotherapy. To date, over 30 facial transplantations have been performed worldwide, seven of them at Brigham and Women's Hospital in Boston. Although facial mobility appears to be slowly improving in these patients, speech deficits persist due to persistent lip muscle weakness. Now that technologic and immunologic feasibility of this surgery have been established, the next steps for improving clinical science and management is to (1) determine baseline rates of facial motor recovery in a cohort of patients, (2) test the efficacy of exercise for improving facial motor and speech outcomes, and (3) improve the accuracy of outcome measures used in clinical assessments, in research on mechanisms of recovery, and in clinical trials of surgical and behavioral interventions. The proposed series of studies addresses each of these needs by leveraging state-of-the-art 3D facial movement tracking technology to quantify recovery post-facial transplantation and to provide real-time feedback of lip movement treatment targets. Our established interdisciplinary team, with expertise in speech-language pathology, motor speech, clinical neurology, and facial transplantation, is well positioned to conduct this research. The findings will (1) advance understanding of functional recovery following face transplantation, (2) identify the most useful outcome measures for use in routine clinical assessments of facial motor function for future clinical trials, and (3) provide preclinical data on the safety, compliance, and efficacy of a home-based lip exercise program. The findings are also likely to be relevant for improving the assessment and treatment of a broad range of other facial motor impairments, both congenital and acquired.
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1 |