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Apraxia of Speech Rating Scale: Reliability, validity, and utility (Duffy et al., 2023)

online resource
posted on 2023-01-11, 23:11 authored by Joseph R. Duffy, Peter R. Martin, Heather M. Clark, Rene L. Utianski, Edythe A. Strand, Jennifer L. Whitwell, Keith A. Josephs

Purpose: The purpose of this study was to examine the interrater reliability and validity of the Apraxia of Speech Rating Scale (ASRS-3.5) as an index of the presence and severity of apraxia of speech (AOS) and the prominence of several of its important features.

Method: Interrater reliability was assessed for 27 participants. Validity was examined in a cohort of 308 participants (120 with and 188 without progressive AOS) through item analysis; item-Total score correlations; correlations among ASRS Total score and component subscores and independent clinical ratings of AOS, dysarthria and aphasia severity, intelligibility, and articulatory errors, as well as years postonset and age; and regression models assessing item and Total score prediction of AOS presence.

Results: Interrater reliability was good or excellent for most items and excellent for the Total score. Item and Total score analyses revealed good separation of participants with versus without AOS. Inter-item and item-Total score correlations were generally moderately high as were correlations between the ASRS Total score and independent ratings of AOS severity, intelligibility, and articulatory errors. The Total score was not meaningfully correlated with ratings of aphasia and dysarthria severity, years postonset, or age. Total scores below 7 and above 10 revealed excellent diagnostic sensitivity and specificity for AOS. The presence of eight or more abnormal features was also highly predictive of AOS presence.

Conclusions: The ASRS-3.5 is a reliable and valid scale for identifying the presence and severity of AOS and its predominant features. It has excellent sensitivity to AOS presence and excellent specificity relative to aphasia and dysarthria in patients with neurodegenerative disease.

Supplemental Material S1. Subgroup item data. 

Supplemental Material S2. Item exemplars & some guidance for ratings.

Duffy, J. R., Martin, P. R., Clark, H. M., Utianski, R. L., Strand, E. A., Whitwell, J. L., & Josephs, K. A. (2023). The Apraxia of Speech Rating Scale: Reliability, validity, and utility. American Journal of Speech-Language Pathology, 32(2), 469–491.


This study was funded by the National Institutes of Health, National Institute on Deafness and Other Communication Disorders Grants R01 DC014942 (PI: Keith A. Josephs) and R01 DC012519 (PI: Jennifer L. Whitwell), and National Institute of Neurological Disorders and Stroke Grant R01 NS089757 (PI: Jennifer L. Whitwell).