Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Discourse Communication in Individuals with and without Traumatic Brain Injury

Traumatic brain injury (TBI) is a global health epidemic that has detrimental consequences for individuals who sustain the brain injury, their families, and society. As a result of TBI, many individuals experience significant cognitive-communicative impairments, including difficulties with structuring and eliciting discourse. The purpose of this study was to gain a better understanding of these language difficulties and their possible clinical implications by comparing discourse communication samples from adults with TBI to those from adults without TBI. Audio recordings of 18 adults, consisting of narratives on different genres of discourse communication (e.g., conversational, procedural, personal narrative, and fictional narrative), were used for the purposes of this project. The discourse samples of 4 individuals with TBI were compared with the discourse samples of 14 individuals without TBI on the basis of several discourse communication measures including: (1) story length, (2) frequency of discourse errors, (3) elements, (4) story organization, (5) information content, and (6) information relevance. Overall, the differences observed between the TBI and non-TBI individuals on the discourse communication tasks reflect the typical communication impairments experienced by those living with TBI. Compared to the discourse samples of participants without TBI, the individuals with TBI produced more linguistic dysfluencies and discourse errors which indicated impairments related to pragmatic skill, information transfer and relevance, linking the events in a story, and effectively structuring discourse communication. The participants without TBI showed strengths in the quality and completeness of their spoken narratives. Ultimately, the differences observed among participants from each group provide important insight into what types of speech-language therapy might be appropriate and effective for these individuals

The INTERSPEECH 2013 computational paralinguistics challenge: social signals, conflict, emotion, autism

The INTERSPEECH 2013 Computational Paralinguistics Challenge provides for the first time a unified test-bed for Social Signals such as laughter in speech. It further introduces conflict in group discussions as new tasks and picks up on autism and its manifestations in speech. Finally, emotion is revisited as task, albeit with a broader ranger of overall twelve emotional states. In this paper, we describe these four Sub-Challenges, Challenge conditions, baselines, and a new feature set by the openSMILE toolkit, provided to the participants. \em Bj\"orn Schuller$^1$, Stefan Steidl$^2$, Anton Batliner$^1$, Alessandro Vinciarelli$^{3,4}$, Klaus Scherer$^5$}\\ {\em Fabien Ringeval$^6$, Mohamed Chetouani$^7$, Felix Weninger$^1$, Florian Eyben$^1$, Erik Marchi$^1$, }\\ {\em Hugues Salamin$^3$, Anna Polychroniou$^3$, Fabio Valente$^4$, Samuel Kim$^4$

Relationships between cognitive status, speech impairment and communicative participation in Parkinson’s disease

Aim: To assess the relationships between cognitive status, speech impairment and communicative participation in Parkinson’s disease. Introduction: Speech and communication difficulties, as well as cognitive impairment, are prevalent in Parkinson’s. The contributions of cognitive impairment and acoustic speech characteristics remain equivocal. Relationships between Impairment and Participation levels of the International Classification of Functioning, Disability and Health (ICF) have not been thoroughly investigated. Methods: 45 people with Parkinson’s and 29 familiar controls performed read, mood and conversational speech tasks as part of a multimethod investigation. Data analysis formed three main parts. Depression, cognition and communication were assessed using questionnaires. Phonetic analysis was used to produce an acoustic characterisation of speech. Listener assessment was used to assess conveyance of emotion and intelligibility. Qualitative Content Analysis was used to provide a participant’s insight into speech and communicative difficulties associated with Parkinson’s disease. Results: Cognitive status was significantly associated with certain read speech acoustic characteristics, emotional conveyance and communicative participation. No association was found with intelligibility or conversational speech acoustic characteristics. The only acoustic speech characteristics that predicted intelligibility were intensity and pause in the read speech condition. The contribution of intelligibility to communicative participation was modest. People with Parkinson’s disease reported a range of psychosocial, cognitive and physical factors affecting their speech and communication. Conclusions: I provide evidence for a role for cognitive status in emotional conveyance and communicative participation, but not necessarily general speech production, in Parkinson’s disease. I demonstrate that there may not be a strong relationship between ICF Impairment level speech measures and functional measures of communication. I also highlight the distinction between measures of communication at the ICF Activity and Participation levels. This study demonstrates that reduced participation in everyday communication in Parkinson’s disease appears to result from a complex interplay of physical, cognitive and psychosocial factors. Further research is required to apply these findings to contribute to future advances in speech and language therapy for Parkinson’s disease

Pragmatic Language and Social Skills Functioning in Children Diagnosed with Asperger\u27s Disorder

Sixteen children with a diagnosis of Asperger\u27s Disorder, as defined by the DSM-IV-TR (2000), were assessed using the following standardized measures: KBIT-2 (Kaufman & Kaufman, 2003), CASL (Carrow-Woolfolk, 1999), and SSRS (Gresham & Elliot, 1990). The purpose of the study was to determine whether the measurement of pragmatic language functioning is reliably associated with social skill performance in children with Asperger\u27s disorder. Results indicated that the group mean composite index score of the CASL was in the average range for children with a standard score of 85 or higher on the KBIT -2. Group average scores for formal language functioning and pragmatic language functioning each fell in the average range as measured by the CASL. However, qualitative analysis strongly suggested that formal language was superior to pragmatic language in the studied sample. Results measuring social skills functioning were mixed. Parent report for children in Grades K -6 indicated below average social skills functioning (M = 77) and above average problem behavior (M= 112). Similarly, parent report for children for Grades 7-12 indicated below average social skills functioning (M = 53) and above average problem behavior (M= 135). Teacher report for children in Grades K -6 indicated average social skills functioning (M = 90). However, teacher report indicated problem behavior frequency in the above average range for children in Grades K -6 (M = 112). Parent/guardian and teacher ratings of social skills functioning were not significantly correlated (r = .05). Pragmatic Language Test scores were not significantly correlated with social skills functioning (r = .26). Cognitive functioning was not significantly correlated with social skills functioning (r = .26)

Measuring outcomes from a peer-led social communication skills intervention for adults following acquired brain injury

Background: Reduced social competence and social integration following acquired brain injury (ABI) is well-documented. There is evidence that group social communication interventions for people with ABI and training for neuro-typical communication partners can be more effective than training the person with ABI alone. This study explores the effectiveness of a peer-led group intervention based on claims that peer models are a more powerful mechanism for learning and behaviour change than interventions led by a clinician. A peer-led training model for social communication has not previously been tested in ABI. Method: Twenty-four participants with severe ABI were recruited from a residential post-acute neurorehabilitation centre. An experimental parallel group design was used to compare a peer-led group intervention to a social activity group (usual care). A pilot study tested the feasibility of the approach followed by a main study. The groups ran for 8 weeks. A peer facilitator was trained in sixteen individual sessions over 4 weeks with a clinician. Behaviour was measured twice at baseline, after intervention and at maintenance. Four primary outcome measures, including the Adapted Measure of Participation in Conversation (MPC), and a newly devised measure of conversational interaction evaluated change in group communication behaviours. Results: Groups did not differ in baseline behaviour. There were significant differences in the treated group on the MPC and the measure of conversational interaction post-intervention. The treated group showed a more balanced interaction post-intervention and at follow-up. However, outcome measures showed differential sensitivity. Conclusion: There is preliminary evidence of advantage for peer-led groups in ABI intervention. The new conversational measure shows promise as a method to detect change in group communication behaviour

Language loss in bilingual speakers with Alzheimer's disease

PhD ThesisThis study investigated the changes in language and cognition in five bilingual speakers with Alzheimer's Disease over a period of twelve months. The pattern and rate of loss in English was compared to that of Afrikaans. The bilingual behaviour of language mixing was also investigated, as was the interaction between deteriorating cognitive skills and language functions. Data was collected at three time points (0 - 6 - 12 months) employing a battery of neuropsychological and language tests, and conversation analysis. It was predicted that where both languages were automatised to a similar extent, a similar pattern, severity and rate of loss would be evident across languages. This hypothesis was supported by results. It was also predicted that in cases where one language was less automatised than the other, the less automatised language (i.e. the language learnt later in life (L2) anchor the less proficient language) would be more severely impaired and would deteriorate at a faster rate than the fully automatised language (Li). Results revealed that while L2 was more impaired than Li for some speakers, for others, languages were similarly impaired/spared. These discrepancies were attributed to the fact that tests were not sensitive to inter-language differences near floor or ceiling. Results did not strongly support the second prediction that L2 would deteriorate at a faster rate. Ambiguous findings could be artefacts of the time window of examination, insensitive assessment tasks, and the heterogeneous nature of the population. With regards to language mixing behaviour, code switching mainly affected L2 interactions even though the extent of switching varied across speakers. The amount of language mixing increased for two participants over the year. With regards to a possible interaction between language and cognition, complex language tasks appeared to be more compromised by deteriorating neuropsychological support than less complex tasks, but the extent of this interaction varied across languages and across speakers. Finally, the overall profile of results suggested that a language learnt later in life will never become fully automatised, even if high levels of L2 proficiency had been attained in adulthood.Overseas Research Students Awar