RESUMEN
The study describes the development of the AAC-Arm questionnaire and its initial psychometric and logometric testing for reliability and validity. Psychometric and logometric principles were used to develop an assessment questionnaire capable of evaluating the communication state domains important to patients with neurological disorders. The hypothesized domains were to include (1) auditory function, (2) speech function (3) cognitive functions (4) sensorimotor function, and (5) activities of daily living (ADL). An initial pool of 78 questions was pilot-tested for clarity in 10 patients; following factor analysis, the number of questions was reduced to 39-items. Then the questionnaire was subjected to reliability and validity testing. Factor analysis supported the 5 hypothesized domains. Test-retest reliability using Spearman's correlation demonstrated substantial agreement, ranging from 0.72 for the ADL domain to 0.92 for the auditory function domain. In testing for internal consistency, Cronbach's alphas ranged from 0.86 for-the ADL domain to 0.96 for the cognitive function domain. Correlation between domains gave evidence of construct validity. In comparing similar domains in the AAC questionnaire, a moderate correlation (range 0.33-0.83) for the ADL and sensorimotor function scales were found. The correlation was more positive between the other domains. Testing of reliability for the phraseological, syntactic and semantic competence indices showed good positive correlation between initial and retest scores. The questions in the AAC questionnaire have undergone rigorous psychometric and logometric testing, and the tool is an appropriate instrument for the assessment of neurological patients with communication deficit. The psycholinguistic assessment provides with the main weight of data for successful communication therapy.
Asunto(s)
Actividades Cotidianas , Comunicación , Armenia , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
PURPOSE: Assess the effectiveness of augmentative and alternative communication (AAC) interventions in patients with CP and to reveal determinant variables of main intervention outcomes: receptive and expressive language. RESEARCH STRATEGIES: The search was performed in following databases: MEDLINE (Ovid); PubMed (NLM); Embase (Ovid); Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Database of Abstracts of Reviews of Effects; Cochrane Central Register of Controlled Trials; Health Technology Assessment database and PEDro. SELECTION CRITERIA: Full-text and peer-reviewed studies in English studying the effectiveness of AAC in patients with cerebral palsy were included. Studies with patients (<18 years) diagnosed with CP were included. DATA ANALYSIS: A narrative analysis was conducted to evaluate the efficacy of AAC methods. A random-effects model meta-analysis was used to assess determinants of AAC intervention outcomes. RESULTS: The online database and manual reference search revealed 445 records. Nine studies investigating a total of 294 subjects with CP met predefined eligibility criteria: 4 studies with single subject, multiple baseline research designs, 3 longitudinal cohort studies, 1 case control study and 1 case series. Results revealed moderate-quality evidence that AAC interventions improve the receptive and expressive communication skills in patients with CP. The random-effects model meta-analysis revealed the power of identified determinant variables affecting the AAC intervention outcomes. CONCLUSION: Diversity of CP patients requires proper analysis of determinant variables to ensure the efficacy of AAC assessment and intervention. More studies of high methodological and practical quality assessing the efficacy of AAC interventions are needed to clarify the evidence.
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Parálisis Cerebral , Humanos , Estudios de Casos y Controles , Parálisis Cerebral/complicaciones , Comunicación , Estudios LongitudinalesRESUMEN
ABSTRACT Purpose Assess the effectiveness of augmentative and alternative communication (AAC) interventions in patients with CP and to reveal determinant variables of main intervention outcomes: receptive and expressive language. Research strategies The search was performed in following databases: MEDLINE (Ovid); PubMed (NLM); Embase (Ovid); Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Database of Abstracts of Reviews of Effects; Cochrane Central Register of Controlled Trials; Health Technology Assessment database and PEDro. Selection criteria Full-text and peer-reviewed studies in English studying the effectiveness of AAC in patients with cerebral palsy were included. Studies with patients (<18 years) diagnosed with CP were included. Data analysis A narrative analysis was conducted to evaluate the efficacy of AAC methods. A random-effects model meta-analysis was used to assess determinants of AAC intervention outcomes. Results The online database and manual reference search revealed 445 records. Nine studies investigating a total of 294 subjects with CP met predefined eligibility criteria: 4 studies with single subject, multiple baseline research designs, 3 longitudinal cohort studies, 1 case control study and 1 case series. Results revealed moderate-quality evidence that AAC interventions improve the receptive and expressive communication skills in patients with CP. The random-effects model meta-analysis revealed the power of identified determinant variables affecting the AAC intervention outcomes. Conclusion Diversity of CP patients requires proper analysis of determinant variables to ensure the efficacy of AAC assessment and intervention. More studies of high methodological and practical quality assessing the efficacy of AAC interventions are needed to clarify the evidence.