Rosenbek, John C.

Thirty patients with apraxia of speech, 10 patients with aphasia and no apraxia of speech, and 30 normal subjects were tested by three oral sensory-perceptual measurements: oral form identification, two-point discrimination, and mandibular kinesthesia. The apraxia-of-speech group was significantly inferior to the aphasic and normal groups on all three oral sensory-perceptual tests. The normal and aphasic groups did not differ significantly from each other. Apraxia of speech and oral sensory-perceptual deficit were related in that the more severe the apraxia of speech, the more profound the oral sensory-perceptual deficit. Not all patients with apraxia of speech demonstrated impaired oral sensation and perception; however, higher cortical sensory dysfunction frequently accompanied apraxia of speech.

Purpose Darley, Aronson, and Brown (1969a, 1969b) detailed methods and results of auditory-perceptual assessment for speakers with dysarthrias of varying etiology. They reported adequate listener reliability for use of the rating system as a tool for differential diagnosis, but several more recent studies have raised concerns about listener reliability using this approach. Method In the present study, the authors examined intrarater and interrater agreement for perceptual ratings of 47 speakers with various dysarthria types by 2 listener groups (inexperienced and experienced). The entire set of perceptual features proposed by Darley et al. was rated based on a 40-s conversational speech sample. Results No differences in levels of agreement were found between the listener groups. Agreement was within 1 scale value or better for 67% of the pairwise comparisons. Levels of agreement were lower when the average rating fell in the mid-range of the scale compared with samples that had an average rating near either of the scale endpoints; agreement was above chance level. No significant differences in agreement were found between the perceptual features. Discussion The levels of listener agreement that were found indicate that auditory-perceptual ratings show promise during clinical assessment for identifying salient features of dysarthria for speakers with various etiologies.