Midwestern University, Glendale, AZ.
Brigham Young University, Provo, UT.
J Speech Lang Hear Res. 2024 Oct 24;67(10S):4038-4052. doi: 10.1044/2024_JSLHR-23-00007. Epub 2024 Mar 26.
Neurogenic speech and language disorders-such as acquired apraxia of speech (AOS) and aphasia with phonemic paraphasia (APP)-are often misdiagnosed due to similarities in clinical presentation. Word syllable duration (WSD)-a measure of average syllable length in multisyllabic words-serves as a proxy for speech rate, which is an important and arguably more objective clinical characteristic of AOS and APP. This study reports stability of WSD over time for speakers with AOS (and aphasia).
Twenty-nine participants with AOS and aphasia (11 women and 18 men, = 53.5 years, = 13.3) repeated 30 multisyllabic words (of three-, four-, and five-syllable lengths) on three occasions across 4 weeks. WSDs were calculated for each word and then averaged across each list (i.e., word length), as well as across combined lists (i.e., all 30 words) to yield four WSDs for each participant at each time point. Stability over time was calculated using Friedman's test for the group and using Spearman's rho for the individual level. Effects of time and word length were examined using robust mixed-effects linear regression.
Friedman's tests and correlations indicated no significant difference in WSDs across sampling occasions for each word length separately or combined. WSD correlated positively with AOS severity and negatively with intelligibility but was not correlated with aphasia severity. Regression analyses confirmed WSD to be stable over time, while WSD calculated from only five tokens (i.e., WSD-5) was less stable over time.
Results indicate that WSD can be a stable measure over time, at the individual and group level, providing support for its use in diagnosis and/or as an outcome measure, both clinically and for research. In general, WSD outperformed WSD-5, suggesting that it may be better to calculate WSD from more than five tokens. Stability of WSD in other populations and suitability for differential diagnosis need to be determined. Currently, differentiating disorders by speaking rate, alone, is not recommended.
神经源性言语和语言障碍，如获得性言语失用症（AOS）和伴有音位错语的失语症（APP），由于临床表现相似，常被误诊。词音节时长（WSD）——多音节词中平均音节长度的衡量标准——可作为言语率的替代指标，而言语率是 AOS 和 APP 的一个重要且更具客观性的临床特征。本研究报告了 AOS（和失语症）患者 WSD 的时间稳定性。
29 名 AOS 伴失语症患者（11 名女性，18 名男性，年龄=53.5 岁，标准差=13.3 岁）在 4 周内分 3 次重复 30 个多音节词（三音节、四音节和五音节词）。为每个词计算 WSD，然后平均每个词（即词长），以及合并的词（即所有 30 个词），以获得每个参与者在每个时间点的 4 个 WSD。采用 Friedman 检验对组内进行时间稳定性分析，采用 Spearman 相关系数对个体水平进行分析。采用稳健混合效应线性回归分析时间和词长的影响。
Friedman 检验和相关分析表明，对于每个词长分别或合并，WSD 在不同采样时间点之间无显著差异。WSD 与 AOS 严重程度呈正相关，与可理解性呈负相关，但与失语症严重程度无相关性。回归分析证实 WSD 随时间稳定，而仅用 5 个词计算的 WSD（即 WSD-5）随时间不够稳定。
结果表明，WSD 在个体和组水平上均可作为时间稳定的测量指标，为其在临床和研究中用于诊断和/或作为结果测量指标提供了支持。一般来说，WSD 优于 WSD-5，这表明从 5 个以上的词计算 WSD 可能更好。需要确定其他人群中 WSD 的稳定性和对鉴别诊断的适用性。目前，仅通过言语率来区分障碍还不被推荐。
