Theodoros Deborah, Hill Anne, Russell Trevor, Ward Elizabeth, Wootton Richard
Division of Speech Pathology, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Telemed J E Health. 2008 Aug;14(6):552-9. doi: 10.1089/tmj.2007.0091.
Aphasia, a language disturbance, frequently occurs following acquired brain impairment in adults. Because management of aphasia is often long-term, provision of ongoing and equitable access to treatment creates a significant challenge to speech-language pathologists (SLPs). This study aimed to determine the validity and reliability of assessing aphasia using standardized language assessments via an Internet-based videoconferencing system using a bandwidth of 128 kbits/sec. Thirty-two participants with aphasia due to stroke or traumatic brain injury were assessed simultaneously in either a face-to-face or online-led environment by two SLPs. Short forms of the Boston Diagnostic Aphasia Examination (BDAE-3) and the Boston Naming Test (BNT, 2nd edition) were administered. An eight-item participant satisfaction questionnaire was completed by 15 participants assigned to the online-led assessment. Results failed to identify any significant differences between the 24 subtest scores of the BDAE-3 and the BNT scores obtained in the online and face-to-face test environments (p > 0.01). Weighted kappa statistics indicated moderate to very good agreement (0.59-1.00) between the two assessors for the 24 subtests and eight rating scales of the BDAE-3, the BNT, and for aphasia diagnosis. Good to very good inter- and intra-rater reliability for the online assessment was found across the majority of assessment tasks. Participants reported high overall satisfaction, comfort level, and audio and visual quality in the online environment. This study supports the validity and reliability of delivering standardized assessments of aphasia online and provides a basis for ongoing development of telerehabilitation as an alternate mode of service delivery to persons with aphasia.
失语症是一种语言障碍，在成人后天性脑损伤后经常出现。由于失语症的治疗通常是长期的，为患者持续提供公平的治疗机会对言语语言病理学家（SLP）构成了重大挑战。本研究旨在确定通过基于互联网的视频会议系统，使用128 kbits/秒的带宽，采用标准化语言评估来评估失语症的有效性和可靠性。32名因中风或创伤性脑损伤导致失语症的参与者，由两名SLP在面对面或在线主导的环境中同时进行评估。使用了波士顿诊断失语症检查（BDAE - 3）的简短形式和波士顿命名测试（BNT，第二版）。15名被分配到在线主导评估的参与者完成了一份包含8个项目的参与者满意度问卷。结果显示，在BDAE - 3的24个分测试分数与在线和面对面测试环境中获得的BNT分数之间，未发现任何显著差异（p > 0.01）。加权kappa统计表明，两位评估者在BDAE - 3、BNT的24个分测试和8个评分量表以及失语症诊断方面的一致性为中等至非常好（0.59 - 1.00）。在大多数评估任务中，在线评估的评分者间和评分者内信度良好至非常好。参与者报告在在线环境中总体满意度高、舒适度高以及音频和视频质量良好。本研究支持在线进行失语症标准化评估的有效性和可靠性，并为远程康复作为失语症患者替代服务提供模式的持续发展提供了依据。
