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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.
Journal of Speech, Language, and Hearing Research : JSLHR
|March 10, 2022
Summary
Assessing aphasia fluency is challenging. Perceptual rating scales show promise but require more reliable clinical tools to identify specific speech production deficits.
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.
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