American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

Agency for Healthcare Research and Quality
Criteria for Determining Disability in Speech-Language Disorders

Biddle, A. K., Watson, L. R., et al. (2002).
AHRQ Publication No. 02-E010. Rockville, MD: Agency for Healthcare Research and Quality.

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a systematic review of English-language research on 18 instruments in which investigators evaluated the instruments’ reliability, validity, or predictive ability. Research could take the form of published articles or manuals.

Question(s) Addressed:

  1. What instruments have demonstrated reliability, validity, and normative data?
  2. Do these instruments have predictive value for an individual’s communicative impairment, performance, or both?

Population: Children and adults

Intervention/Assessment:

18 instruments chosen by a panel of ten national experts:

  • Assessment of Intelligibility in Dysarthric Speech
  • Boston Diagnostic Aphasia Examination
  • Clinical Evaluation of Language Fundamentals
  • Clinical Evaluation of Language Fundamentals – Spanish Edition
  • Clinical Evaluation of Language Fundamentals – Preschool
  • Dysarthria Examination Battery
  • Goldman-Friscoe Test of Articulation
  • GRBAS Scale
  • Multi-Dimensional Voice Profile
  • Porch Index of Communicative Ability
  • Preschool Language Scale – 3
  • Preschool Language Scale – 3 Spanish Edition
  • Stuttering Severity Instrument for Children and Adults
  • Test of Language Development – Primary
  • Test of Language Development – Intermediate
  • Test of Pragmatic Language
  • Voice Handicap Index
  • Western Aphasia Battery

Number of Studies Included: 92 articles or manuals

Years Included: 1966 – October 2000

Findings:

Conclusions:

  • Assessment/Diagnosis
    • Assessment Instruments
      • Stroke
        • Boston Diagnostic Aphasia Examination (BDAE) - The Boston Diagnostic Aphasia Examination, 2nd Edition (BDAE-2) did not meet reliability or validity criterion. Normative data for two instruments were derived from individuals treated at single institutions and there was insufficient information to determine if they are representative of typical individuals with aphasia.
        • Porch Index of Communicative Ability (PICA) and Western Aphasia Battery (WAB) - The Porch Index of Communicative Ability (PICA) and the original version of the Western Aphasia Battery (WAB) met relaxed standards of evidence for reliability and validity. One small study, however, suggested that the WAB may not consistently classify patients with aphasia.
      • Childhood Speech and Language & Speech Sound Disorders
        • Language Instruments
          • The Clinical Evaluation of Language Fundamentals, 3rd Edition, Spanish Edition (CELF-3Sp), the Test of Language Development, Primary, 3rd Edition, (TOLD-P:3), and the Test of Language Development, Intermediate, 3rd Edition (TOLD-I:3) met reliability, validity, and availability of normative data standards.
          • The Preschool Language Scale, 3rd Edition (PLS-3) met the relaxed reliability criterion for use with children of all ages except between 0 and 8 months.
          • The Clinical Evaluation of Language Fundamentals, 3rd Edition (CELF-3) met the relaxed criterion based on total score, but not based on composite scores.
        • Speech Instruments - "Neither the Goldman-Fristoe test of Articulation, 2nd Edition (GFTA-2) nor the SSI-3 met our relaxed criteria for reliability and validity. The GFTA-2 met our relaxed criterion for internal consistency reliability. Developers of both instruments employed nonstandard statistical methods to test other forms of reliability. GFTA-2 provided normative data derived from nationally representative populations; the SSI-3 also provided normative data but gave no information on its representativeness” (p. 10 of 12).
      • Voice Disorders
        • “Both the Voice Handicap Instrument (VHI) and the Kay Elemetrics Multi-Dimensional Voice Program (MDVP) met our criteria for reliability, validity, and availability of normative data” (p. 10 of 12).
      • Dysarthria & Fluency Disorders
        • None of the instruments for assessment of adult speech disorders met the established evidence standards for both reliability and validity, however the Stuttering Severity Instrument for Children and Adults, 3rd Edition (SSI-3), met the validity criterion. No instrument met normative data standards.
        • The SSI-3 and the Assessment of Intelligibility in Dysarthric Adults (AIDS) obtained normative data from individuals treated at single institutions and there was insufficient information to determine if these patients were representative of adults with speech disorders.

Keywords: Language Disorders, Speech Disorders

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Added to Compendium: December 2011

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