College of Health Sciences, University of Kentucky, Lexington.
Shirley Ryan AbilityLab, Chicago, IL.
J Speech Lang Hear Res. 2019 Sep 20;62(9):3367-3380. doi: 10.1044/2019_JSLHR-L-18-0466. Epub 2019 Aug 9.
Purpose Politeness markers (PMs) are words that enhance cooperativity in dialogue and are an essential component of professional/work communication. Persons with moderate/severe traumatic brain injury (TBI) underuse PMs in connected speech and have employment stability issues. The voicemail elicitation task (VET) is a standardized computerized language sampling procedure measuring PM rate in role-play tasks. Our purpose is to provide preliminary data establishing the potential of a screening assessment tool for professional/work communication. Method We measured VET performance using spoken PMs per minute (PMpM). We present data from 63 persons. Forty-three participants with TBI (22-65 years old, ≥ 1-year postinjury) worked in midlevel jobs before their injury and attempted work return after injury at the same job level. Twenty participants with TBI did not maintain work > 1 year (unstably employed), and 23 did maintain work for ≥ 1 year (stably employed). Twenty controls without history of neurological impairment working at the same job level also completed the VET protocol. We analyzed the data using between-group comparison with 1-way analysis of variance and post hoc analysis. We used receiver operating characteristic curve analysis to calculate sensitivity and specificity, as well as an optimal cutoff value for a screening measure. Results Group differences, (2, 60) = 19.59, = .0001, η = .376, were identified between unstably employed persons with TBI performing with lower PMpM scores than the stably employed TBI group and the control group. Receiver operating characteristic curve analysis indicated a cutoff score of 11.55 PMpM. There was acceptable specificity (0.700, 95% CI [0.499, 0.901]) and sensitivity (0.696, 95% CI [0.508, 0.883]) for a screening tool indicating further assessment of social communication. Conclusion The VET holds promise as a clinical screening tool to identify persons at risk for social communication-related job instability after TBI and the need for a more comprehensive social communication assessment.
目的 礼貌用语（PMs）是增强对话合作的词，是专业/工作交流的重要组成部分。患有中度/重度创伤性脑损伤（TBI）的人在连贯的话语中使用 PMs 不足，并且存在就业稳定性问题。语音邮件诱发任务（VET）是一种标准化的计算机语言抽样程序，用于测量角色扮演任务中的 PM 率。我们的目的是提供初步数据，以确定一种用于专业/工作交流的筛查评估工具的潜力。
方法 我们使用每分钟的语音 PM 数（PMpM）来衡量 VET 的表现。我们提供了 63 名参与者的数据。43 名患有 TBI（22-65 岁，受伤后≥1 年）的参与者在受伤前从事中层工作，并在受伤后尝试回到相同的工作岗位。20 名患有 TBI 的参与者的工作无法维持 1 年以上（就业不稳定），而 23 名患有 TBI 的参与者的工作可以维持 1 年以上（就业稳定）。20 名没有神经损伤史、从事相同工作水平的对照组参与者也完成了 VET 方案。我们使用单因素方差分析和事后分析进行组间比较分析。我们使用受试者工作特征曲线分析来计算敏感性和特异性，以及用于筛查测量的最佳截断值。
结果 组间差异，（2,60）= 19.59，p <.0001，η =.376，在就业不稳定的 TBI 患者中，PMpM 评分低于就业稳定的 TBI 组和对照组。受试者工作特征曲线分析表明，截断值为 11.55 PMpM。对于一种筛查工具，其特异性为 0.700（95%CI[0.499,0.901]），敏感性为 0.696（95%CI[0.508,0.883]），表明该工具具有进一步评估社交沟通的潜力。
结论 VET 有望成为一种临床筛查工具，用于识别 TBI 后社交沟通相关工作不稳定风险较高的患者，并需要进行更全面的社交沟通评估。
