Aachener Sprachanalyse (ASPA): Evaluation bei Patienten mit chronischer Aphasie

Abstract

ZusammenfassungHintergrund: Ziel der vorliegenden Studie war, die Aachener Sprachanalyse (ASPA) als ein neues und viele Parameter umfassendes Spontansprachanalysesystem anhand der Testgütekrite-rien Objektivität, Reliabilität und Validität zu evaluieren. Methode: Die Spontansprache von 16 chronischen Aphasikern wurden zu drei Zeitpunkten (zweimal vor und einmal nach zweiwöchi-ger Intensivtherapie) mit ASPA evaluiert. Zudem wurden Transkripte von gesunden Kontrollen mit ASPA ausgewertet. Die Inter-und Intraraterreliabilität wurde für die Transkripterstellung und für die Phraseneinteilung berechnet. Zur Untersuchung der Reliabilität wurden die zwei Messungen vor Therapiebeginn verglichen. Die Validität wurde anhand der Differenzierungsfähig-keit zwischen Aphasikern und Kontrollen sowie der Sensitivität zur Erfassung von Therapieeffekten evaluiert. Ergebnisse: Die Evaluation der Testgütekriterien von ASPA ergab Inter-und Intraraterreliabilitätswerte von über 93 %. Bei den Patienten zeigten sich hohe Korrelationen zwischen den zwei Prä-Messungen. Die Satzbau-und Wortwahlparameter differenzierten signifikant zwischen Aphasikern und Gesunden. In drei der Satzbauparameter zeigten sich signifikante Verbesserungen nach Therapieende. Schlussfolgerungen: Die Ergebnisse der Evaluation von ASPA sprechen für eine gute Objektivität und Reliabilität des Verfahrens. Im Rahmen der Evaluation von Therapieeffekten zeichnen sich die Satzbauparameter durch besondere Sensitivität aus. SchlüsselwörterAphasie´Spontansprache´Aachener Sprachanalyse´Testgüte-kriterien Abstract Background: The proof of the effectiveness of aphasia therapy gains more and more in importance in light of the present financial situation of the public health system and the increasing demand for evidence based medicine. In this context it is expected that improvements are evaluated not only by means of standardised tests or questionnaires but also in communicational situations similar to those in everyday life. The aim of this study was the evaluation of the Aachen Language Analysis (Aachener Sprachanalyse, ASPA). This new analysis system covers many parameters and was evaluated with regard to its objectivity, reliability and validity. Methods: The interraterreliability and the intraraterreliability for the transcript and the division into phrases were evaluated. A comparison of the two pre-therapy measurements was conducted in order to test the reliability of the results. The validity of ASPA was tested by evaluating its ability to differentiate between patients with aphasia and a healthy control group and the sensitivity when evaluating therapy effects. Results: Interraterreliability and intraraterreliability of ASPA were >93 %. High correlations between the two pre-tests were obtained in the patient group. The syntax parameters and wordretrieval parameters differed significantly between patients with aphasia and the healthy controls, whereas no differences were

Intensive language training in the rehabilitation of chronic aphasia: Efficient training by laypersons

“…However, no significant differences were present between groups. These findings replicate previous studies that report substantial improvement in language functions and measures of connected speech after CIAT in patients with different aphasia syndromes and levels of aphasia severity (Barthel et al, 2006;Maher et al, 2006;Meinzer et al, 2005;Pulvermueller et al, 2001). These results also agree with previous evidence of effective treatment provided by trained laypersons (David et al, 1982;Lesser et al, 1986;Marshall et al, 1989;Meikle et al, 1979;Shewan & Kertesz, 1984;Wertz et al, 1986;Worrall & Yiu, 2000).…”

“….91 for all subtests in chronic aphasia patients; Huber et al, 1983). Moreover, Barthel et al (2006) demonstrated stability of language impairment across two repeated baseline assessments in chronic patients with aphasia. Significant improvement was substantiated after a subsequent 2-week intensive treatment interval.…”

First Decade of Research on Constrained-Induced Treatment Approaches for Aphasia Rehabilitation

“…In another study, Barthel et al 25 assessed the impact of intensive speech and language therapy (CI-based and MOAT) on connected speech measures. Speech samples were obtained from 12 patients (spontaneous speech scales of the AAT; standard picture descriptions) across two baseline trials prior to treatment and immediately after treatment.…”

Intensive language therapy in chronic aphasia: Which aspects contribute most?

“…We did not assess baseline stability of language functions across repeated sessions: However, patients were in the late chronic stage of aphasia (average onset: 51.6 months; range: 12-156 months) and one would not expect substantial improvement of language function without training (Robey, 1998). Moreover, only recently we assessed the stability of connected speech measures in 16 patients with chronic aphasia across a 2-day baseline interval (Barthel, Djundja, Meinzer, Rockstroh, & Eulitz, 2006), which yielded comparable results, while substantial improvement after 2 additional weeks of intensive training was observed. Therefore, we are confident that the improvement found in our sample can be attributed to the training provided.…”