SBIR-STTR Award

The inability to engage in spoken communication is among the most debilitating of all human conditions. In the field of communication disorders, a speech-language pathologist's (SLP's) perceptual evaluation of the quality of speech production is the gold standard for assessment and for documenting treatment progress. However, decades of research has confirmed that auditory-perceptual judgments of speech are inherently biased, which compromises reliability. The reason is that the human perceptual system is adaptive, with perceptual bias accrued by working with an individual across multiple treatment sessions, or by working with patient populations across a career. Thus, to reliably document treatment outcomes subjectively, it is necessary to involve multiple, unfamiliar listeners. This is untenable in most clinical settings, which means that subjective impressions are made by the treating clinicians. The reliance on subjective evaluation directly undermines the quality of clinical practice and a clinician's ability to demonstrate the efficacy of an intervention. Aural Analytics has developed new objective acoustic speech metrics that track with disease progression in neurological disorders. Our technology is based on a strong scientific premise and has been adopted early by pharmaceutical companies and neurologists in clinical research. We have collected and analyzed tens of thousands of speech samples using our technology, and the results are demonstrating that our measures are robust, reliable, and more sensitive to longitudinal changes in speech than are other existing outcome measures. With this proposal we aim to translate this technology to SLP clinical practice by developing an app- based automated solution that provides objective speech-based outcomes and to solve the clinical crises created by reliance on subjective ratings. Our SBIR Phase I project will have two specific aims. In SA1 we will develop a stand-alone application that SLPs can use to objectively evaluate the effects of behavioral intervention. This will require translating the existing algorithms to Python, developing an Application Programming Interface, and designing a mobile application that speech-language pathologists can use in clinical practice. In SA2, in collaboration with Barrow Neurological Institute, we will validate the usability of the application in a clinical setting through beta testing with SLPs. The deliverable of this proposal will be a fully- functional mobile application with real time metrics, that will be ready for a clinical evaluation in a follow-on Phase II proposal.

Public Health Relevance Statement:
Narrative In the field of communication disorders, a speech-language pathologist's perceptual evaluation of the quality of speech production is the gold standard for assessment and for documenting treatment progress. We propose to augment subjective evaluation of speech in this field with a set of objective outcome measures that have been shown to successfully track clinically-relevant changes in speech production. Our approach is based on extensive published research and has already been adopted by pharmaceutical companies and neurologists in clinical research.

Project Terms:
Algorithms; Arizona; Behavior Therapy; behavioral intervention; behavior intervention; Conditioning Therapy; Behavioral Treatment; Behavioral Therapy; Behavioral Modification; Behavioral Conditioning Therapy; Behavior Treatment; Behavior Modification; Behavior Conditioning Therapy; Clinical Study; Clinical Research; Clinical Trials; Communication; Communicative Disorders; Communication Disorders; Communication impairment; Dysarthosis; Dysarthria; Gold; Modern Man; Human; Institutes; Interview; Judgment; Language; Manuals; Methodology; National Institutes of Health; NIH; United States National Institutes of Health; neurological disease; Neurological Disorders; Neurologic Disorders; Nervous System Diseases; nervous system disorder; Patients; Phonation; Production; Publishing; Recommendation; Research; Running; Software; Computer software; Speech; Speech Acoustics; Speech Therapy; Technology; Testing; Time; Translating; Measures; Treatment outcome; Outcome Measure; base; career; improved; Clinical; Phase; Neurologic; Neurological; Pythons; Evaluation; Individual; Neurologist; Disease Progression; Collaborations; Pathologist; programs; Adopted; Auditory; Clinic; System; impression; Human Resources; personnel; Manpower; Modeling; Sampling; Intervention; interventional strategy; Intervention Strategies; Pharmacological Substance; Pharmaceuticals; Pharmaceutical Agent; Pharmacologic Substance; Address; Data; research clinical testing; clinical test; Clinical Testing; Clinical Evaluation; Scheme; Small Business Innovation Research Grant; Small Business Innovation Research; SBIR; efficacy research; design; designing; Treatment Efficacy; therapy efficacy; therapeutically effective; therapeutic efficacy; intervention efficacy; Outcome; Population; clinically relevant; clinical relevance; speech processing; usability; patient population; clinical practice; Secure; mobile application; mobile app; cloud based; behavioral outcome; behavior outcome; application programming interface; software as a service; smartphone Application; iPhone Application; iPhone App; iOS application; iOS app; Smartphone App; Smart Phone Application; Smart Phone App; Cellular Phone Application; Cellular Phone App; Cell phone App; Cell Phone Application; Android Application; Android App

The inability to engage in spoken communication is among the most debilitating of all human conditions. In the field of communication disorders, a speech-language pathologist's (SLP's) perceptual evaluation of the quality of speech production is the gold standard for assessment and for documenting treatment progress. However, decades of research have confirmed that auditory-perceptual judgments of speech are inherently biased, which compromises reliability. The reason is that the human perceptual system is adaptive, with perceptual bias accrued by working with an individual across multiple treatment sessions, or by working with patient populations across a career. Thus, to reliably document treatment outcomes subjectively, it is necessary to involve multiple, unfamiliar listeners. This is untenable in most clinical settings, which means that subjective impressions are made by the treating clinicians. The reliance on subjective evaluation directly undermines the quality of clinical practice and a clinician's ability to demonstrate the efficacy of an intervention. Aural Analytics has developed new objective acoustic speech metrics that reliably measure speech in populations with neurological disorders. Its technology is based on a strong scientific premise and has been adopted early by pharmaceutical companies and neurologists in clinical research. Aural Analytics has collected and analyzed tens of thousands of speech samples using its technology, and the results are demonstrating that its measures are robust, reliable, and more sensitive to longitudinal changes in speech than are other existing outcome measures. We successfully completed a Phase I SBIR project with the aim of translating our technology to SLP clinical practice. This Phase II proposal naturally builds on our previous work by connecting the automated app-based outcome measures completed in Phase I to three complementary clinical benchmarks. Specifically, SA1 will validate the Aural Analytics speech measures against the American Speech-Language-Hearing Association's (ASHA) Functional Communication Measures (FCM) for motor speech; the Sentence Intelligibility Test; and expert ratings of speech characteristics. In addition, age and gender-based norms for all objective measures will be obtained from collection of data from 600 new healthy participants. In SA2, Aural Analytics will conduct a usability study with practicing speech-language pathologists to assess real world utility and refine the user experience. The deliverable of this proposal will be a fully-functional mobile application, validated by practicing SLPs in a clinical setting, with real time speech outcome metrics validated with respect to existing community-accepted measures. This will result in objective outcomes that fit into the workflow of the professional standard, thereby expediting our path to commercialization.

Public Health Relevance Statement:
Project Narrative In the field of communication disorders, a speech-language pathologist's perceptual evaluation of the quality of speech production is the gold standard for assessment and for documenting treatment progress. We propose to augment the subjective evaluation of speech with a set of objective app-based outcome measures that have been shown to track clinically-relevant changes in speech production and to connect those measures to existing professional standards of communication measures for speech. We will then test the ability of this technology to fit into the workflow of the professional standard via a user study, thereby expediting our path to commercialization.

Project Terms:
improved; Clinical; Phase; Evaluation; insight; Individual; Neurologist; participant recruitment; Patient Recruitments; Pathologist; Adopted; Auditory; System; Best Practice Analysis; Benchmarking; interest; experience; impression; Performance; Familiarity; HIPAA; Kennedy Kassebaum Act; PL 104-191; PL104-191; Public Law 104-191; United States Health Insurance Portability and Accountability Act; Health Insurance Portability and Accountability Act; Participant; Position; Positioning Attribute; Sampling; Intervention Strategies; interventional strategy; Intervention; Pharmaceutical Agent; Pharmaceuticals; Pharmacological Substance; Pharmacologic Substance; Data; Motor; Small Business Innovation Research Grant; SBIR; Small Business Innovation Research; Update; Characteristics; Development; developmental; Treatment Efficacy; intervention efficacy; therapeutic efficacy; therapy efficacy; Outcome; Population; prospective; Impairment; clinically relevant; clinical relevance; usability; commercialization; patient population; clinical practice; mobile application; mobile app; mobile device application; professional atmosphere; job environment; work atmosphere; work environment; workplace climate; workplace environment; crowdsourcing; crowd source; crowd-sourcing; crowdsource; recruit; Infrastructure; clinical outcome measures; Acoustics; Acoustic; Age; ages; Clinical Research; Clinical Study; Communication; Communication impairment; Communication Disorders; Communicative Disorders; Communities; Data Collection; Dysarthria; Dysarthosis; Feedback; Patient Care; Patient Care Delivery; Gold; Health; Human; Modern Man; Interview; Judgment; Language; Learning; Nervous System Diseases; Neurologic Disorders; Neurological Disorders; neurological disease; nervous system disorder; Patients; Population Distributions; Production; Regression Analyses; Regression Diagnostics; Statistical Regression; Regression Analysis; Research; Research Resources; Resources; Software; Computer software; Speech; Speech Acoustics; Speech Manifestations; Speech Disorders; Speech Intelligibilities; Speech Intelligibility; Speech Therapy; statistics; Survey Instrument; Surveys; Technology; Testing; thoughts; Thinking; Time; Translating; Work; American Speech-Language-Hearing Association; Gender; Measures; Treatment outcome; Outcome Measure; Secondary to; base; career; Loudness