title: Auditory discrimination as a condition for E-learning based Speech Therapy: a proposal for an auditory discrimination test (ADT) for adult dysarthric speakers.
abstract: BACKGROUND
  Web based speech training for dysarthric speakers, such as E-learning based Speech Therapy (EST), puts considerable demands on auditory discrimination abilities.
  
  
  OBJECTIVE
  To discuss the development and the evaluation of an auditory discrimination test (ADT) for the assessment of auditory speech discrimination skills in Dutch adult dysarthric speakers as a prelude to EST.
  
  
  METHODS
  Five ADT subtests were developed, each addressing a vital speech dimension in speech therapy: articulation (segmental elements), intensity, overall pitch, speech rate and intonation. A healthy control group of 36 participants performed a 'same-different task' in each subtest. ADT items yielding scores of at least 80% but below 100% correctly responding healthy controls were considered sensitive to diminished auditory discrimination. Subsequently, the ADT was carried out by 14 neurological patients with dysarthric speech and 14 matched healthy controls. Score percentages, sensitivity indices and reaction times (ms) on only sensitive items were compared.
  
  
  RESULTS
  The majority of the ADT items met the 'minimal 80% to below 100% criterion' in the healthy control group. The neurological participants performed lower on all outcome measures across all subtests than the healthy controls, although not all of these differences achieved statistical significance.
  
  
  CONCLUSIONS
  The results of the healthy control group show that the majority of the ADT items meet our criterion for sensitivity to diminished auditory discrimination. The poorer performance of dysarthric patients across all subtests supports the sensitivity of the ADT. However, further research involving larger and more homogeneous groups of neurological patients is required.
  
  
  OBJECTIVE
  Readers will be encouraged to (1) identify potential factors that may hinder web based speech training and (2) estimate the value of assessing auditory discrimination skills as a vital condition for (web based) speech training in dysarthric patients.
authors: Sint Maartenskliniek, Section Research Development & Education, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands. L.Beijer@maartenskliniek.nl
authors: L J
authors: LJ
authors: Beijer
authors: A C M
authors: AC
authors: Rietveld
authors: A J L
authors: AJ
authors: van Stiphout
mesh_terms: D000161:Acoustic Stimulation; D000368:Aged; D001307:Auditory Perception; D003194:Computer-Assisted Instruction / Q000379:methods; D004192:Discrimination, Psychological; D004401:Dysarthria / Q000523:psychology / Q000628:therapy*; D005260:Female; D006320:Hearing Tests / Q000379:methods; D006801:Humans; D008144:Loudness Perception; D008297:Male; D008875:Middle Aged; D010897:Pitch Discrimination; D011930:Reaction Time; D013061:Speech Acoustics; D013067:Speech Perception; D013070:Speech Therapy / Q000379:methods*