荷兰语版维京言语量表在脑瘫儿童中的信度和效度
Reliability and validity of the Dutch-language version of the Viking Speech Scale in children with cerebral palsy.
作者信息
Spaans Irene E M, Geytenbeek Joke J M, Vaillant Emma, de Kleijn Maaike A M C, Buizer Annemieke I, Pennington Lindsay
机构信息
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Rehabilitation Medicine, Dijklander Ziekenhuis, Hoorn, The Netherlands.
出版信息
Child Care Health Dev. 2023 May;49(3):605-616. doi: 10.1111/cch.13076. Epub 2022 Nov 22.
PURPOSE
The Viking Speech Scale is used to classify speech performance in children with cerebral palsy (CP). A Dutch-language version (VSS-NL) has recently become available. This study aimed to determine the reliability and validity of the VSS-NL and the association with motor type of CP, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS).
METHODS
A total of 90 children with CP, recruited throughout the Netherlands, took part in the study. VSS-NL classifications by speech and language therapists unfamiliar (SLT1) and familiar (SLT2) with the child, parents and physicians were compared. Convergent and discriminant validity were determined with the Intelligibility in Context Scale-Dutch (ICS-NL) and the Computer Based Instrument for Low Motor Language Testing (C-BiLLT). Inter- and intrarater reliability were determined by weighted Kappa (ƙ ). Validity and associations between VSS-NL and GMFCS, MACS and CFCS were determined with Spearman's coefficient. Association between VSS-NL and motor type of CP was determined with Fisher's exact test.
RESULTS
Interrater reliability was excellent between SLT1-SLT2 (ƙ = 0.93, 95% confidence interval [CI] 0.87-0.99), good between SLT1-parent (ƙ = 0.71, 95% CI 0.60-0.83), SLT1-physician (ƙ = 0.70, 95% CI 0.58-0.81), SLT2-parent (ƙ = 0.71, 95% CI 0.57-0.84), SLT2-physician (ƙ = 0.73, 95% CI 0.62-0.85) and parent-physician (ƙ = 0.72, 95% CI 0.60-0.85). Intrarater reliability was excellent for SLTs familiar and unfamiliar to the child (ƙ = 1.00, 95% CI 1.00-1.00), and very good for physicians (ƙ = 0.89, 95% CI 0.75-1.00) and parents (ƙ = 0.72, 95% CI 0.62-1.00). Convergent validity was very strong (r = -0.81, p < 0.001) and discriminant validity moderate (r = -0.56, p < 0.001). Association with motor type of CP was significant (χ = 27.558, p < 0.001) and strong with GMFCS (r = 0.62, p < 0.001), MACS (r = 0.63, p < 0.01) and CFCS (r = 0.69, p < 0.001).
CONCLUSION
The VSS-NL is a reliable and valid system to classify speech performance in children with cerebral palsy. Classifications can be performed by SLTs, parents and physicians.
目的
维京言语量表用于对脑瘫（CP）患儿的言语表现进行分类。荷兰语版本（VSS-NL）最近已可用。本研究旨在确定VSS-NL的信度和效度，以及与CP运动类型、粗大运动功能分类系统（GMFCS）、手动能力分类系统（MACS）和沟通功能分类系统（CFCS）的关联。
方法
在荷兰各地招募了90名CP患儿参与本研究。比较了不熟悉患儿的言语和语言治疗师（SLT1）、熟悉患儿的言语和语言治疗师（SLT2）、家长和医生对VSS-NL的分类。使用荷兰语情境可懂度量表（ICS-NL）和基于计算机的低运动语言测试工具（C-BiLLT）确定收敛效度和区分效度。通过加权Kappa（ƙ）确定评分者间信度和评分者内信度。使用Spearman系数确定VSS-NL与GMFCS、MACS和CFCS之间的效度和关联。使用Fisher精确检验确定VSS-NL与CP运动类型之间的关联。
结果
SLT1与SLT2之间的评分者间信度极佳（ƙ = 0.93，95%置信区间[CI] 0.87 - 0.99），SLT1与家长之间良好（ƙ = 0.71，95% CI 0.60 - 0.83），SLT1与医生之间良好（ƙ = 0.70，95% CI 0.58 - 0.81），SLT2与家长之间良好（ƙ = 0.71，95% CI 0.57 - 0.84），SLT2与医生之间良好（ƙ = 0.73，95% CI 0.62 - 0.85），家长与医生之间良好（ƙ = 0.72，95% CI 0.60 - 0.85）。对于熟悉和不熟悉患儿的言语和语言治疗师，评分者内信度极佳（ƙ = 1.00，95% CI 1.00 - 1.00），对于医生（ƙ = 0.89，95% CI 0.75 - 1.00）和家长（ƙ = 0.72，95% CI 0.62 - 1.00）非常好。收敛效度非常强（r = -0.81，p < 0.001），区分效度中等（r = -0.56，p < 0.001）。与CP运动类型的关联显著（χ = 27.558，p < 0.001），与GMFCS（r = 0.62，p < 0.001）、MACS（r = 0.63，p < 0.01）和CFCS（r = 0.69，p < 0.001）的关联很强。
结论
VSS-NL是一种可靠且有效的系统，可用于对脑瘫患儿的言语表现进行分类。言语和语言治疗师、家长和医生均可进行分类。
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