Toward a Quantitative Basis for Assessment and Diagnosis of Apraxia of Speech PurposeWe explored the reliability and validity of 2 quantitative approaches to document presence and severity of speech properties associated with apraxia of speech (AOS).MethodA motor speech evaluation was administered to 39 individuals with aphasia. Audio-recordings of the evaluation were presented to 3 experienced clinicians to determine AOS diagnosis and to ... Supplement: Apraxia of Speech: Concepts and Controversies
Supplement: Apraxia of Speech: Concepts and Controversies  |   October 01, 2012
Toward a Quantitative Basis for Assessment and Diagnosis of Apraxia of Speech
 
Author Affiliations & Notes
  • Katarina L. Haley
    The University of North Carolina at Chapel Hill
  • Adam Jacks
    The University of North Carolina at Chapel Hill
  • Michael de Riesthal
    Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee
  • Rima Abou-Khalil
    Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee
  • Heidi L. Roth
    The University of North Carolina at Chapel Hill
  • Correspondence to Katarina L. Haley: Katarina_Haley@med.unc.edu
  • Editor: Anne Smith
    Editor: Anne Smith×
  • Associate Editor: Wolfram Ziegler
    Associate Editor: Wolfram Ziegler×
Article Information
Speech, Voice & Prosodic Disorders / Apraxia of Speech & Childhood Apraxia of Speech / Speech, Voice & Prosody / Speech
Supplement: Apraxia of Speech: Concepts and Controversies   |   October 01, 2012
Toward a Quantitative Basis for Assessment and Diagnosis of Apraxia of Speech
Journal of Speech, Language, and Hearing Research, October 2012, Vol. 55, S1502-S1517. doi:10.1044/1092-4388(2012/11-0318)
History: Received April 10, 2012 , Accepted June 19, 2012
 
Journal of Speech, Language, and Hearing Research, October 2012, Vol. 55, S1502-S1517. doi:10.1044/1092-4388(2012/11-0318)
History: Received April 10, 2012; Accepted June 19, 2012
Web of Science® Times Cited: 21

PurposeWe explored the reliability and validity of 2 quantitative approaches to document presence and severity of speech properties associated with apraxia of speech (AOS).

MethodA motor speech evaluation was administered to 39 individuals with aphasia. Audio-recordings of the evaluation were presented to 3 experienced clinicians to determine AOS diagnosis and to rate severity of 11 speech dimensions. Additionally, research assistants coded 11 operationalized metrics of articulation, fluency, and prosody in the same speech samples and in recordings from 20 neurologically healthy participants.

ResultsAgreement among the 3 clinicians was limited for both AOS diagnosis and perceptual scaling, but inter-observer reliability for the operationalized metrics was strong. The relationships between most operationalized metrics and mean severity ratings for corresponding perceptual dimensions were moderately strong and statistically significant. Both perceptual scaling and operationalized quantification approaches were sensitive to the presence or absence of AOS.

ConclusionsPerceptual scaling and operationalized metrics are promising quantification techniques that can help establish diagnostic transparency for AOS. However, because satisfactory reliability cannot be assumed for scaling techniques, effective training and calibration procedures should be implemented. Operationalized metrics show strong potential for enhancing diagnostic objectivity and sensitivity.

Acknowledgments
This article originated from a presentation given at the “Apraxia of Speech: Mechanisms and Symptoms” satellite workshop during the 6th International Conference on Speech Motor Control in Groningen, the Netherlands, June 2011. Portions of this research were presented at the Annual Convention of the American Speech-Language-Hearing Association in Philadelphia, Pennsylvania, November 2010. This work was supported by National Institute on Deafness and Other Communication Disorders Grants R03DC006163 and R43DC009708 and by a grant from the University of North Carolina Research Council. We gratefully acknowledge Anne Marie Bartholomew, Mackenzie Fama, Rachel Goff, Clay Hadden, Megan Jacobson, Olivia Lysakowski, Marissa McGlamery, Kristen Peet, Samantha Schlegelmilch, and Anna Styers for their help with data collection.
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