# Clear speech in ALS: Effects of feedback from a novel ASR practice paradigm and practice dosage

> **NIH NIH F31** · HARVARD MEDICAL SCHOOL · 2021 · $33,743

## Abstract

PROJECT SUMMARY
Dysarthria is a motor speech impairment characterized by sensorimotor abnormalities that affect the movements
required for speech, frequently resulting in reduced speech intelligibility and naturalness [1], [2]. Dysarthria often
significantly impairs communication, in turn threatening a patient’s participation in daily life activities and quality
of life [2]–[7]. However, relatively few treatments for dysarthria exist, and patient access to treatments is often
limited by financial and geographic barriers [8]–[10]. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative
disease characterized by the progressive loss of upper and lower motor neurons. Nearly all individuals with ALS
will at some point experience speech impairment [11], [12], characterized by flaccid, spastic, or mixed flaccid-
spastic dysarthria. Given the devastating loss of speech in ALS, there is a critical need for evidence-based
treatments to help patients maintain their functional speech. Clear speech, which trains a mode of speech with
deliberate enunciation, is a successful dysarthria treatment that globally affects the speech system and
intelligibility. However, clear speech training uses subjective feedback from a partner, and its effects on
intelligibility in ALS have been understudied. Additionally, although increased practice amount has been
associated with positive motor learning outcomes in people with unimpaired motor function [13], [69], there is a
dearth of research into the effects of single-session practice dosage on impaired limb [57] and motor speech
function [10], [14]. This study investigates a novel method for providing feedback using noise-augmented
automatic speech recognition to automatically and objectively facilitate clear speech treatment in healthy
participants and participants with bulbar ALS. It also examines the effects of single-session practice dosage on
learning a clear mode of speaking. Preliminary results support both nASR and increased practice dosage for
facilitating clear speech.

## Key facts

- **NIH application ID:** 10161598
- **Project number:** 5F31DC019016-02
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Sarah Gutz
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $33,743
- **Award type:** 5
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10161598

## Citation

> US National Institutes of Health, RePORTER application 10161598, Clear speech in ALS: Effects of feedback from a novel ASR practice paradigm and practice dosage (5F31DC019016-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10161598. Licensed CC0.

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