Frenchay dysarthria examination
The Frenchay dysarthria examination is a standardized diagnostic tool for the classification of forms of dysarthria . In addition to the Munich intelligibility profile (MVP), this examination offers a standardized alternative for determining dysarthric speech disorders . It should be noted that the standard values of the Frenchay dysarthria examination were only collected for the English-speaking area. The Aachen materials for the diagnosis of neurogenic speech disorders (AMDNA) represent an objective examination method for neurogenic speech disorders standardized for the German-speaking region .
history
The Frenchay dysarthria examination was developed by Pamela M. Enderby at the Frenchay Hospital (near Bristol, England) over a period of seven years and tested by speech therapists working in Hamburg over a longer period and translated into German. The first German-language edition dates back to 1991. A newly revised edition was published in 2004.
scope of application
With the examination one can divide dysarthria into different forms. It provides therapeutic approaches by showing damaged and intact functions. Even minor changes in the speaking behavior of dysarthric patients can be registered. The structure of the investigation is easy to use, so that the risk of changing procedures or reducing execution times is minimized. Due to its compactness and brevity, the Frenchay dysarthria examination is also suitable for patients with low endurance.
Test quality criteria
The examination has been tested as a diagnostic tool by more than 200 speech therapists in over 600 patients in England with regard to reliability and validity .
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Reliability
The measurement accuracy of the examination in a comparison of different examiners was first recorded in healthy patients. Eight speech therapists then independently assessed 113 dysarthric test subjects. A product-moment correlation of the evaluations of the various examiners gave a coefficient of 0.79-0.92. The investigation can thus be described as sufficiently reliable. -
Validity
A study with 85 dysarthric patients examined whether and how certain speech characteristics can be ascribed to underlying neurological disorders. This examination enabled the assignment to various medical diagnoses. A discriminant analysis carried out afterwards showed that the correct diagnosis could be predicted in 90% of the cases examined. -
Clinical validity
To check the clinical validity, the test results were compared with descriptive reports. 89.3% of the 112 cases analyzed were found to be applicable.
Classification of dysarthric disorders
The Frenchay dysarthria examination allows a classification into five main syndromes:
- Upper motor neuron lesions ... spastic dysarthria
- Mixed upper and lower motor neuron lesions ... mixed dysarthria
- Extrapyramidal Disorders ... hypokinetic dysarthria
- Cerebellar dysfunction ... atactic dysarthria
- Lower motor neuron lesions ... flaccid dysarthria
These subtypes represent a mixture of aetiological and symptomatic classification.
For these five forms there are statistical mean values and standard deviations for the individual examination areas, which are illustrated in a diagram in the manual.
execution
General
The investigation consists of 10 areas. The performance of the test persons is recorded on a 9-point scale and graphically illustrated in a bar chart. It is recommended to keep the order of the areas. The sequence of the subtests is prescribed. For all areas, the patient's second attempt serves as the basis for evaluation.
Required material
Manual instructions, a form, a spatula, a stopwatch, a glass of water, a biscuit, word cards and sentence cards as well as a recording device are required for implementation. The manual contains precise instructions and enables gradual differences in performance to be recorded using the scaling. The subtests shown in the table (areas 1–8) have a heterogeneous structure and, in addition to assessing non-verbal motor skills, also include questions to the patient, visual observations while speaking or at rest, auditory judgments and measurements with a stopwatch. The additional observations (areas 9-10) are added to the form.
Areas of investigation and their subtests
| Areas | Subtests | Areas | Subtests | ||
|---|---|---|---|---|---|
| 1 | Reflexes | Coughing, swallowing, salivation | 6th | voice | Tone holding time, pitch differentiation, voice strength, voice when speaking |
| 2 | respiration | Breathing at rest, breathing while speaking | 7th | tongue | Tongue at rest, sticking out the tongue, lifting the tongue, lateral movements of the tongue, alternating movements of the tongue, tongue while speaking |
| 3 | Lip movement | Lips at rest, spreading the lips, closing lips, alternating movements, lip movements while speaking | 8th | Comprehensibility | Words, sentences, spontaneous speech |
| 4th | jaw | Jaw at rest, jaw movement while speaking | 9 | Influencing factors | Hearing, eyesight, teeth, language, mental state, posture |
| 5 | Soft palate | Soft palate movements when eating, soft palate function, soft palate movement when speaking | 10 | Other factors | Speed, kinaesthetic perception |
Advantages and disadvantages
The advantages are the tested test quality criteria , the profile presentation of the results and the information on additional observations that complement the overall picture of the person.
The mixture of aetiological and symptomatic classification is disadvantageous. In the clinical area, a classification according to the type of movement disorder (symptomatic) is useful and common. Another disadvantage is the different weighting of the functional groups, since respiration and phonation are paid less attention than prosody , oral motor skills or reflex functions .
The majority of the tasks review non-linguistic disorder areas. Nevertheless, the Frenchay dysarthria examination is the only procedure that is mentioned as an example of standardized dysarthria diagnosis in Germany's therapeutic products guidelines .
See also
literature
- PM Enderby: Frenchay Dysarthria Examination . Gustav Fischer Verlag, Stuttgart / Jena / New York 1991, ISBN 3-437-11392-5
- A Schubert: Dysarthria, diagnostics - therapy - advice . Schulz-Kirchner Verlag, Idstein 2004, ISBN 3-8248-0446-8
- W. Ziegler, M. Vogel: Diagnosis of dysarthric disorders . In: L. Springer, D. Schrey-Dern (Ed.): Dysarthrie, Basics - Diagnostics - Therapy . Georg Thieme Verlag, Stuttgart / New York 1998, ISBN 3-13-112441-5
Individual evidence
- ^ PM Enderby: Frenchay Dysarthria Examination . Gustav Fischer Verlag, Stuttgart / Jena / New York 1991, ISBN 3-437-11392-5
- ^ A Schubert: Dysarthria, diagnostics - therapy - advice . Schulz-Kirchner Verlag, Idstein 2004, ISBN 3-8248-0446-8
- ↑ cf. Schubert, 2004, p. 31ff.
- ↑ cf. Ziegler, 1998, p. 29f.
