汉语普通话言语失用症评估诊断工具的编制与验证

doi:10.3969/j.issn.1006-9771.2026.05.005

Abstract

Abstract:

Objective To develop an assessment tool for apraxia of speech (AOS) of Chinese Putonghua speakers and test its reliability and validity.
Methods The Chinese Apraxia of Speech Assessment and Diagnostic Tool (CAADT) was developed based on the Apraxia of Speech Rating Scale 3.5, combined with the linguistic characteristics of Chinese and clinical experience. The tool consistsed of eleven items across three sections: articulation, prosody and alternating motion rates. Six experts evaluated the content validity. From November, 2024 to May, 2025, 51 patients with post-stroke AOS (experimental group) and ten patients with post-stroke aphasia without AOS (control group) were recruited from Anhui Wannan Rehabilitation Hospital (the Fifth People's Hospital of Wuhu), and tested with CAADT. Reliability was assessed using Cronbach's α coefficient, Kendall's coefficient of concordance W and Pearson correlation coefficient. Validity was evaluated using the content validity index (CVI) and Spearman correlation coefficient. Discriminative effect was analyzed using the receiver operating characteristic (ROC) curve.
Results The Cronbach's α coefficients for the articulation and prosody sections and the total scale were all>0.9, while it was 0.454 for the alternating motion rates. Inter-rater reliability was good (W ≥ 0.598, P<0.001). Test-retest reliability showed high positive correlations for the three sections and the total score between the two assessments (r ≥ 0.84, P<0.001). The scale-level CVI was 0.95, and the item-level CVI ≥ 0.83. The Spearman correlation coefficients among the sections ranged from 0.30 to 0.70. ROC analysis revealed an area under the curve of 0.953, with a cut-off value of 11, yielding a sensitivity of 0.92 and a specificity of 0.90.
Conclusion CAADT demonstrates good reliability, validity and discriminative effect, which can be used for clinical assessment and auxiliary diagnosis of Chinese Putonghua speaking patients with post-stroke AOS.

Key words: stroke, apraxia of speech, diagnosis, assessment, Chinese Apraxia of Speech Assessment and Diagnostic Tool, reliability, validity

CLC Number:

R767.92

NI Tianhao, BI Siyu, DAI Yuan, QIAN Hong, WANG Yongli, WAN Qin, HUANG Zhaoming. Development and validation of assessment and diagnostic tools for apraxia of speech of Chinese Putonghua[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(5): 550-560.

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References 24

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版块	条目
语音	歪曲、替代、添加、摸索、句长/复杂性增加时
韵律	单字中、字与字间、语速、语调、重音
轮替	交替、顺序

评分	严重程度	描述
0	无损伤	表现与年龄相符，未观察到异常表现
1	轻度损伤	存在轻度异常表现或异常表现发生频次低
2	中度损伤	存在中等程度异常表现或异常表现发生频次中等
3	重度损伤	存在重度异常表现，或大多数情况下出现异常表现
4	完全损伤	几乎所有情况下均出现异常表现或无法完成任务

版块	评估条目	操作定义
语音	1.1歪曲	复述语料，记录声母/韵母歪曲次数
	1.2替代	复述语料，记录替代类型和音位
	1.3添加/省略	复述语料，记录音位省略或添加的次数和音位
	1.4摸索	观察复述时口面部异常摸索动作，记录次数
	1.5句长/复杂性增加时	复述3、5、7、9、11字句，计算错误率随句长增幅
韵律	2.1字间停顿	朗读、自发语、看图叙事过程中，计算停顿次数和时长
	2.2语速	朗读、自发语、看图叙事过程中，计算言语速率和构音速率
	2.3语调	朗读、自发语、看图叙事过程中，计算基频相关声学参数
	2.4重音	朗读含重读符号句子，计算重音出现率和音节时长
轮替	3.1交替运动	/papapa/, /tatata/,/kakaka/任选其一，4 s内快速重复，记录正确完成个数和构音速率
轮替	3.2顺序运动	4 s内重复发音/pataka/，记录正确完成个数

组别	n	性别(男/女)/n	年龄/岁	卒中类型(出血/梗死/梗死伴出血)/n
对照组	10	6/4	54.20±4.54	6/4/0
试验组	51	44/7	51.31±1.46	32/17/2
χ²/t值			-0.750	0.510
P值		0.070	0.456	0.775

版块	条目数量	α系数
语音	5	0.934
韵律	4	0.922
轮替	2	0.454
总分	11	0.937

Development and validation of assessment and diagnostic tools for apraxia of speech of Chinese Putonghua

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版块	Kendall W	P值
语音	0.833	<0.001
韵律	0.720	<0.001
轮替	0.598	<0.001
总分	0.937	<0.001

版块	r值	P值
语音	0.978	<0.001
韵律	0.841	<0.001
轮替	0.853	<0.001
总分	0.977	<0.001

版块	专家评分						3/4分的个数	I-CVI	评价
版块	A	B	C	D	E	F	3/4分的个数	I-CVI	评价
语音	4	4	4	4	4	4	6	1	优秀
韵律	4	4	4	4	4	4	6	1	优秀
轮替	4	4	3	4	4	4	6	1	优秀
S-CVI	1								优秀

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