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Development of a Worldwide Screening Test for Communicative Disorders Poststroke for International Comparisons

Kentaro Araki1, 2*, Yoshiyuki Hirano2, Kozono Machiko3 and Eiji Shimizu2
  • 1 Mitsuwadai General Hospital, Japan
  • 2 Chiba University, Japan
  • 3 Kumamoto Health Science University, Japan

Introduction. The early-stage medical examination in speech-language rehabilitation should be comprehensive enough to observe diverse neuropsychological symptoms. As many as 30%‒68% of aphasia patients and 58%‒63% of dysarthria patients have cognitive deficits after a stroke. To address this issue, we developed the Screening Test for Aphasia and Dysarthria (STAD) as a simple and brief screening measure suitable for obtaining an overview of a patient's communicative abilities poststroke (Araki et al. 2009). This test has already been standardized in Japan (Araki & Kozono 2018). In this research, we describe a multicenter prospective validity study designed to investigate the psychometric properties of STAD so that it can be used worldwide. Method. STAD has three sections: (1) a Verbal section to detect aphasia, (2) an Articulation section to detect dysarthria, and (3) a Non-Verbal section to detect nonverbal cognitive impairment. The test takes approximately 10 min to administer. We validated STAD through a prospective study of 591 consecutive stroke patients from 20 medical centers: 314 patients were administered STAD. Results. Of the 314 patients who were administered STAD, the number of patients with/without aphasia were 94 (30%)/220 (70%), with/without dysarthria were 154 (49%)/160 (51%), and with/without cognitive dysfunctions were 178 (57%)/136 (63%), respectively, with duplication. When we compared the dissociation of the three disorders to the three sections of STAD based on the Z–scores shown in Figure, we found that the patients with aphasia performed poorly in the Verbal section; those with dysarthria showed a poor performance in the Articulation section, and the patients with cognitive dysfunction performed poorly in the Non-Verbal section (convergent validity), whereas the patients' performance in the other two sections was relatively good (discriminant validity). The convergent/discriminant validity confirmed the appropriateness of the constructional concept of STAD. The Pearson correlation coefficient for Modified Rankin Scale (mRS) with STAD is shown in Table 1 and the score on the Non-Verbal section has the highest correlation with the outcome of home or not home after patient hospitalization of the three sections of STAD, suggesting that cognitive deficits negatively influence a patient's outcome. The performance in the Non-Verbal section is useful for the prediction of a patient’s ADL outcome (predictive validity). Comparing cross tabulation of the lesion site to the STAD scores, we observed that the left hemisphere lesion reduced the STAD verbal section, right hemisphere lesion reduced the STAD Non-Verbal section, bilateral hemisphere lesion reduced all three sections, cerebellum/brainstem lesion reduced the Articulation section. This shows the known group validity of STAD. Conclusion. We have indicated the appropriate validity of STAD, the use of which will enhance the efficacy of speech-language rehabilitation poststroke. In light of the scale's simplicity, it would be easy to adopt this Japanese-language scale to other languages. We expect that future studies of different languages may allow for international comparisons, providing a unique contribution to the field of speech pathology.

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References

Araki K., Uno S., Fujitani J., Fushimi T. (2009). A screening test for aphasia and dysarthria for patients with acute stroke. Nihon Gengo Chōkakushi Kyōkai (Japanese Journal of Speech, Language, and Hearing Research), 6, 3-11 (in Japanese). Araki K., Kozono M. (2018). Screening Test for Aphasia and Dysarthria. Tokyo: Interuna Publishers Inc. ISBN-13: 978-4900637542 (in Japanese).

Keywords: Aphasia, Dysarthria, Cognition, Screening test, validity

Conference: Academy of Aphasia 57th Annual Meeting, Macau, Macao, SAR China, 27 Oct - 29 Oct, 2019.

Presentation Type: Platform presentation

Topic: Not eligible for student award

Citation: Araki K, Hirano Y, Machiko K and Shimizu E (2019). Development of a Worldwide Screening Test for Communicative Disorders Poststroke for International Comparisons. Front. Hum. Neurosci. Conference Abstract: Academy of Aphasia 57th Annual Meeting. doi: 10.3389/conf.fnhum.2019.01.00010

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Received: 29 Apr 2019; Published Online: 09 Oct 2019.

* Correspondence: Dr. Kentaro Araki, Mitsuwadai General Hospital, Chiba, Japan, kentaro-a-lucky@mist.ocn.ne.jp