Reliability and validity of speech & pause measures during passage reading in ALS

Abstract

Objective: The use of speech measures is becoming a common practice in the assessment of bulbar disease progression in amyotrophic lateral sclerosis (ALS). This study aimed to establish psychometric properties (e.g. reliability, validity, sensitivity, specificity) of speech and pause timing measures during a standardized passage. Methods: A large number of passage recordings (ALS N = 775; Neurotypical controls N = 323) was analyzed using a semi-automatic method (Speech and Pause Analysis, SPA). Results: The results revealed acceptable reliability of the speech and pause measures across repeated recording by the control participants. Strong construct validity was established via significant group differences between patients and controls and correlation statistics with clinical measures of overall ALS and bulbar disease severity. Speaking rate, pause events, and mean pause duration were able to detect ALS participants at the presymptomatic stage of bulbar disease with a good discrimination ability (AUC 0.81). Conclusions: Based on the current psychometric evaluation, performing passage recording and speech and pause timing analysis was deemed useful for detecting early and progressive changes associated with bulbar ALS.

Keywords:

• Bulbar ALS
• speaking rate
• pauses
• reliability
• validity
• passage reading

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

The funding for this work was provided by National Institutes of Health (NIH-NIDCD) grants R01DC009890, R01DC013547 and R01DC017291 as well as the Canadian Institutes for Health Research (CIHR), ALS Canada and Brain Canada for the Canadian ALS Neuroimaging Consortium (CALSNIC). Clinical data management and quality control was facilitated in part by the Canadian Neuromuscular Disease Registry.