Validation of Content and Reliability of the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson's Disease (PADAF)

Presotto, Monia; Rieder, Carlos Roberto de Mello; Olchik, Maira Rozenfeld

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Original Article • CoDAS 31 (5) • 2019 • https://doi.org/10.1590/2317-1782/20192018230 copy

Validation of Content and Reliability of the Protocol for the Evaluation of Acquired Speech Disorders in Individuals with Parkinson's Disease (PADAF)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To develop a protocol for the evaluation of acquired speech disorders in individuals with Parkinson's disease (PADAF) and to validate its content and determine its inter-judge reliability.

Methods

The study was carried out in three stages: in the first one, the protocol was prepared and its content validated through the analysis of seven specialists; in the second, the instrument was applied to 25 individuals with idiopathic Parkinson's disease (PD); in the third and last stage, the inter-judge reliability was determined.

Results

The final version of PADAF consisted of 32 items that evaluated breathing, phonation, resonance, articulation, and prosody. It was shown to be valid, with a content validity index (CVI) much higher than that established in the literature, and with perfect agreement in the determination of inter-judge reliability.

Conclusion

PADAF for PD individuals was developed and its content was validated, showing perfect instrument reliability.

Keywords
Dysarthria; Speech; Parkinson's disease; Evaluation; Validation; Reliability

Variable	Mean(SD)
Age (years)	63.5 (±13.6)
Schooling (years)	8.3 (±5.3)
Disease duration (years)	8.4 (±5.4)

Items on the evaluation instrument	Examiners in agreement n=7	CVI-I
1. Respiration – rate	7	1
2. Respiration – inspiration and expiration	7	1
3. Respiration – phonotactics and articulatory coordination	7	1
4. Phonation – pasty voice	7	1
5. Phonation – hoarse voice	7	1
6. Phonation – breathy voice	7	1
7. Phonation – harsh voice	7	1
8. Phonation – trembling voice	7	1
9. Phonation – wet voice	7	1
10. Phonation – asthenic voice	7	1
11. Phonation – loudness	5	*0.71
12. Phonation – pitch (+/-)	6	0.86
13. Phonation – vocal quality variation	6	0.86
14. Resonance – velar movement	7	1
15. Resonance – nasal emission	6	0.86
16. Resonance – Gutzman test	6	0.86
17. Articulation - lip movements (/i/, /u/, and /pa/)	6	0.86
18. Articulation – tongue (ka/ta)	6	0.86
19. Articulation – jaw opening	5	*0.71
20. Articulation – diadochokinesia	7	0.86
21. Articulation – isolated vowels and words	6	0.86
22. Articulation – plosives	6	0.86
23. Articulation – nasal	6	0.86
24. Articulation – fricatives	6	0.86
25. Articulation – liquid	6	0.86
26. Articulation – vibrants	6	0.86
27. Articulation – consonant meeting	6	0.86
28. Articulation – spontaneous speech	7	1
29. Articulation – speed (+/-)	7	1
30. Prosody – affirmative phrase	7	1
31. Prosody – interrogative phrase	7	1
32. Prosody – exclamative phrase	6	0.86
	CVI -T	0.93

Items on the evaluation instrument	Examiners in agreement n=7	CVI-I
1. Respiration – rate	7	1
2. Respiration – inspiration and expiration	7	1
3. Respiration – phonotactics and articulatory coordination	7	1
4. Phonation – pasty voice	7	1
5. Phonation – hoarse voice	7	1
6. Phonation – breathy voice	7	1
7. Phonation – harsh voice	7	1
8. Phonation – trembling voice	7	1
9. Phonation – wet voice	7	1
10. Phonation – asthenic voice	7	1
11. Phonation – loudness	7	1
12. Phonation – pitch (+/-)	6	0.86
13. Phonation – vocal quality variation	6	0.86
14. Resonance – velar movement	7	1
15. Resonance – nasal emission	6	0.86
16. Resonance – Gutzman test	6	0.86
17. Articulation - lip movements (/i/, /u/, and /pa/)	6	0.86
18. Articulation – tongue (ka/ta)	6	0.86
19. Articulation – jaw opening	5	0.86
20. Articulation – diadochokinesia	7	0.86
21. Articulation – isolated vowels and words	6	0.86
22. Articulation – plosives	6	0.86
23. Articulation – nasal	6	0.86
24. Articulation – fricatives	6	0.86
25. Articulation – liquid	6	0.86
26. Articulation – vibrants	6	0.86
27. Articulation – consonant meeting	6	0.86
28. Articulation – spontaneous speech	7	1
29. Articulation – speed (+/-)	7	1
30. Prosody – affirmative phrase	7	1
31. Prosody – interrogative phrase	7	1
32. Prosody – exclamative phrase	6	0.86
	CVI -T	0.91

Final opinion - Checklist
Requirements of the evaluation instrument	Examiners in agreement n=7	CVI-I
1. Utility	7	1
2. Practicality	7	1
3. Objectivity	6	0.86
4. Clinical-scientific aspect	6	0.86
5. Precision	6	0.86
6. Clarity	6	0.86
7. Instructional sequence of items	7	1
8. Vocabulary	7	1
9. Scope	6	0.86
10. Organization	7	1
	CVI -T	0.93

	Kappa value (k)
Respiration
	0.82
Phonation
	1.00
Resonance
	1.00
Articulation
	0.93
Prosody
	0.88
Total
	1.00

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[1] Conflict of interests: nothing to declare.