Lehner Katharina, Ziegler Wolfram
Clinical Neuropsychology Research Group, Institute for Phonetics and Speech Processing, Ludwig-Maximilians-University Munich, Germany.
J Speech Lang Hear Res. 2022 Jan 12;65(1):22-42. doi: 10.1044/2021_JSLHR-21-00215. Epub 2021 Dec 10.
Despite extensive research into communication-related parameters in dysarthria, such as intelligibility, naturalness, and perceived listener effort, the existing evidence has not been translated into a clinically applicable, comprehensive, and valid diagnostic tool so far. This study addresses Communication-Related Parameters in Speech Disorders (KommPaS), a new web-based diagnostic instrument for measuring indices of communication limitation in individuals with dysarthria through online crowdsourcing. More specifically, it answers questions about the construct validity of KommPaS. In the first part, the interrelationship of the KommPaS variables were explored in order to draw a comprehensive picture of a patient's limitations and avoid the collection of redundant information. Second, the influences of motor speech symptoms on the KommPaS variables were studied in order to delineate the structural relationships between two complementary diagnostic perspectives.
One hundred persons with dysarthria of different etiologies and varying degrees of severity were examined with KommPaS to obtain layperson-based data on communication-level parameters, and with the Bogenhausen Dysarthria Scale (BoDyS) to obtain expert-based, function-level data on dysarthria symptoms. The internal structure of the KommPaS variables and their dependence on the BoDyS variables were analyzed using structural equation modeling.
Despite a high multicollinearity, all KommPaS variables were shown to provide complementary diagnostic information and their mutual interconnections were delineated in a path graph model. Regarding the influence of the BoDyS scales on the KommPaS variables, separate linear regression models revealed plausible predictor sets. A complete path model of KommPaS and BoDyS variables was developed to map the complex interplay between variables at the functional and the communication levels of dysarthria assessment.
In validating a new clinical tool for the diagnostics of communication limitations in dysarthria, this study is the first to draw a comprehensive picture of how auditory-perceptual characteristics of dysarthria interact at the levels of expert-based functional and layperson-based communicative assessments.
尽管对构音障碍中与沟通相关的参数进行了广泛研究，如可懂度、自然度和听众感知的努力程度，但目前现有的证据尚未转化为一种临床适用、全面且有效的诊断工具。本研究探讨了言语障碍中与沟通相关的参数（KommPaS），这是一种基于网络的新型诊断工具，通过在线众包来测量构音障碍患者的沟通受限指标。更具体地说，它回答了关于KommPaS结构效度的问题。在第一部分中，探索了KommPaS变量之间的相互关系，以便全面了解患者的局限性并避免收集冗余信息。其次，研究了运动性言语症状对KommPaS变量的影响，以描绘两种互补诊断视角之间的结构关系。
使用KommPaS对100名不同病因和不同严重程度的构音障碍患者进行检查，以获取基于外行人的沟通水平参数数据，并使用博根豪森构音障碍量表（BoDyS）获取基于专家的构音障碍症状功能水平数据。使用结构方程模型分析KommPaS变量的内部结构及其对BoDyS变量的依赖性。
尽管存在高度多重共线性，但所有KommPaS变量均显示可提供互补的诊断信息，并且它们的相互联系在路径图模型中得以描绘。关于BoDyS量表对KommPaS变量的影响，单独的线性回归模型揭示了合理的预测变量集。开发了KommPaS和BoDyS变量的完整路径模型，以描绘构音障碍评估功能水平和沟通水平变量之间的复杂相互作用。
在验证一种用于诊断构音障碍沟通受限的新临床工具时，本研究首次全面描绘了构音障碍的听觉感知特征在基于专家的功能评估和基于外行人的沟通评估水平上是如何相互作用的。
