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How Do Clinicians Judge Fluency in Aphasia?
Jean K Gordon1, Sharice Clough2
1Department of Communication Sciences and Disorders, The University of Iowa, Iowa City.
Assessing aphasia fluency is challenging. Perceptual rating scales show promise but require more reliable clinical tools to identify specific speech production deficits.
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Area of Science:
- Speech-language pathology
- Neurolinguistics
- Clinical assessment
Background:
- Aphasia fluency is influenced by lexical retrieval, grammar, and speech production.
- Developing reliable clinical tools to measure fluency in aphasia is difficult.
Purpose of the Study:
- To examine the reliability and validity of perceptual ratings for aphasia fluency.
- To understand clinicians' perspectives on current fluency assessment methods.
Main Methods:
- An online survey of 112 speech-language pathologists assessing 181 individuals with aphasia (PwA).
- Ratings were collected on eight perceptual scales, alongside questions on clinical practices.
Main Results:
- Interrater reliability for scales ranged from fair to good, with speech rate, pausing, and phrase length being most reliable.
- Clinician ratings correlated with objective measures of speech rate and utterance length.
- Ratings aligned with expected patterns for different aphasia subtypes.
Conclusions:
- Perceptual rating scales are valid for assessing speech-language production in aphasia.
- A need exists for more reliable and clinically feasible tools to assess fluency.
- Future work aims to develop tools that identify specific deficits to guide treatment.