Indicators of Communication Limitation in Dysarthria and Their Relation to Auditory-Perceptual Speech Symptoms: Construct Validity of the KommPaS Web App

Abstract

Purpose: Despite extensive research into communication-related parameters in dysarthria, such as intelligibility, naturalness, and perceived listener effort, the existing evidence has not been translated into a clinically applicable, comprehensive, and valid diagnostic tool so far. This study addresses Communication-Related Parameters in Speech Disorders (KommPaS), a new web-based diagnostic instrument for measuring indices of communication limitation in individuals with dysarthria through online crowdsourcing. More specifically, it answers questions about the construct validity of KommPaS. In the first part, the interrelationship of the KommPaS variables intelligibility, naturalness, perceived listener effort, and speech rate were explored in order to draw a comprehensive picture of a patient's limitations and avoid the collection of redundant information. Second, the influences of motor speech symptoms on the KommPaS variables were studied in order to delineate the structural relationships between two complementary diagnostic perspectives. Method: One hundred persons with dysarthria of different etiologies and varying degrees of severity were examined with KommPaS to obtain layperson-based data on communication-level parameters, and with the Bogenhausen Dysarthria Scale (BoDyS) to obtain expert-based, function-level data on dysarthria symptoms. The internal structure of the KommPaS variables and their dependence on the BoDyS variables were analyzed using structural equation modeling. Results: Despite a high multicollinearity, all KommPaS variables were shown to provide complementary diagnostic information and their mutual interconnections were delineated in a path graph model. Regarding the influence of the BoDyS scales on the KommPaS variables, separate linear regression models revealed plausible predictor sets. A complete path model of KommPaS and BoDyS variables was developed to map the complex interplay between variables at the functional and the communication levels of dysarthria assessment. Conclusion: In validating a new clinical tool for the diagnostics of communication limitations in dysarthria, this study is the first to draw a comprehensive picture of how auditory-perceptual characteristics of dysarthria interact at the levels of expert-based functional and layperson-based communicative assessments.