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

doi:10.1590/2317-1782/20192018230

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

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

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] SD: standard deviation