Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson.
Department of Neurology, The University of Arizona, Tucson.
Am J Speech Lang Pathol. 2019 May 27;28(2):550-568. doi: 10.1044/2018_AJSLP-18-0192. Epub 2019 Apr 4.
Purpose Auditory-perceptual assessment, in which trained listeners rate a large number of perceptual features of speech samples, is the gold standard for the differential diagnosis of motor speech disorders. The goal of this study was to investigate the feasibility of applying a similar, formalized auditory-perceptual approach to the assessment of language deficits in connected speech samples from individuals with aphasia. Method Twenty-seven common features of connected speech in aphasia were defined, each of which was rated on a 5-point scale. Three experienced researchers evaluated 24 connected speech samples from the AphasiaBank database, and 12 student clinicians evaluated subsets of 8 speech samples each. We calculated interrater reliability for each group of raters and investigated the validity of the auditory-perceptual approach by comparing feature ratings to related quantitative measures derived from transcripts and clinical measures, and by examining patterns of feature co-occurrence. Results Most features were rated with good-to-excellent interrater reliability by researchers and student clinicians. Most features demonstrated strong concurrent validity with respect to quantitative connected speech measures computed from AphasiaBank transcripts and/or clinical aphasia battery subscores. Factor analysis showed that 4 underlying factors, which we labeled Paraphasia, Logopenia, Agrammatism, and Motor Speech, accounted for 79% of the variance in connected speech profiles. Examination of individual patients' factor scores revealed striking diversity among individuals classified with a given aphasia type. Conclusion Auditory-perceptual rating of connected speech in aphasia shows potential to be a comprehensive, efficient, reliable, and valid approach for characterizing connected speech in aphasia.
目的 听觉感知评估是指经过训练的听力评估者对大量言语样本的感知特征进行评分，是运动性言语障碍鉴别诊断的金标准。本研究的目的是探索将类似的、规范化的听觉感知方法应用于评估失语症患者连续言语样本中的语言缺陷的可行性。
方法 定义了 27 种失语症连续言语的常见特征，每个特征的评分都在 5 分制上。3 名经验丰富的研究人员评估了来自 AphasiaBank 数据库的 24 个连续言语样本，12 名学生临床医生则分别评估了 8 个言语样本的子集。我们计算了每组评估者的组内信度，并通过将听觉感知评估的特征评分与从抄本和临床评估中得出的相关定量测量值进行比较，以及通过检查特征共现模式，来研究听觉感知方法的有效性。
结果 研究人员和学生临床医生对大多数特征的评分具有良好到优秀的组内信度。大多数特征与从 AphasiaBank 抄本和/或临床失语症电池子评分计算得出的定量连续言语测量值具有很强的同时效度。因子分析显示，有 4 个潜在因素（错语、言语减少、语法障碍和运动性言语）可以解释连续言语特征的 79%的方差。对个体患者的因子得分进行检查，发现给定失语症类型的个体之间存在显著的多样性。
结论 对失语症患者的连续言语进行听觉感知评估具有成为一种全面、高效、可靠且有效的方法的潜力，可以用于描述失语症患者的连续言语。
