Validity and Reliability of the Turkish Version of the Dynamic Evaluation of Motor Speech Skill (DEMSS-TR) Test for Children With Speech Sound Disorders

IF 2.1 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

International Journal of Language & Communication Disorders Pub Date : 2025-06-30 DOI:10.1111/1460-6984.70067

Aşena Karamete, Bülent Toğram

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引用次数: 0

Abstract

Background

Childhood apraxia of speech (CAS) is a complex motor speech disorder that requires careful differential diagnosis, particularly in languages where validated diagnostic tools are lacking. The Dynamic Evaluation of Motor Speech Skill (DEMSS) is a widely used tool for identifying CAS, but a Turkish version had not yet been developed.

Aims

This study aimed to adapt DEMSS into Turkish (DEMSS-TR) and evaluate its psychometric properties for use with Turkish-speaking children with speech sound disorders (SSD).

Methods

Eighty-two monolingual Turkish-speaking children aged 3;0 to 6;11 with SSDs participated. Participants were assessed for speech-motor skills, oral-motor function, articulation, and language development. Following translation and pilot testing, DEMSS-TR was evaluated for internal consistency, test–retest reliability and intra- and inter-rater reliability. Validity was assessed through expert-based content validation, cluster analysis and receiver operating characteristic (ROC) analysis.

Results

DEMSS-TR demonstrated strong reliability and validity. Cronbach's alpha exceeded 0.90 for all subtests and the total score. Test–retest coefficients ranged from 0.823 to 0.991, with inter- and intra-rater reliability consistently above 0.90. Content validity was supported by expert ratings, with all items exceeding a content validity ratio of 0.80. Cluster analysis revealed three distinct participant groupings consistent with CAS, mild CAS and non-CAS diagnoses. ROC analysis showed high sensitivity and specificity across subtests and total score, confirming the tool's diagnostic accuracy.

Conclusions

DEMSS-TR is a reliable and valid assessment for identifying CAS in Turkish-speaking children with SSDs. Its dynamic, structured format allows clinicians to observe motor speech behaviours under cued and spontaneous conditions, supporting accurate diagnosis and treatment planning. This adaptation addresses a significant gap in Turkish clinical practice and contributes to the international literature on cross-linguistic assessment of motor speech disorders.

WHAT THIS PAPER ADDS

What is already known on the subject

It is performed with the Dynamic Evaluation of Motor Speech Skills (DEMSS) (Strand et al. 2013; Strand and McCauley 2019), which performs the dynamic evaluation of childhood apraxia of speech (CAS), one of the subtypes of speech sound disorders. Although the original language of the test is English, there are validity and reliability studies in Swedish and Brazilian Portuguese.

What this paper adds to existing knowledge

This study represents the first international research on CAS in Turkish, presenting reliability and validity data for the first Turkish CAS assessment tool. Uniquely, the study adhered strictly to the original English DEMSS during its adaptation. Unlike other language studies, this research employed Cluster Analysis, a less common validation method in speech and language impairment scales, providing a valuable guide for future test development or adaptation. Additionally, it highlights the importance of dynamic evaluation in the field of motor speech disorders, demonstrating its practical application.

What are the potential or actual clinical implications of this work?

This study holds significant clinical implications, particularly in improving the accuracy and standardisation of motor speech assessments for Turkish-speaking children. By validating this tool, clinicians can more precisely diagnose and tailor treatment plans for individuals with motor speech disorders, especially CAS, ensuring that interventions are both culturally and linguistically appropriate. This advancement not only enhances the consistency of assessments across different clinical settings but also contributes to more effective and individualised speech therapy, ultimately leading to better patient outcomes.

查看原文本刊更多论文

言语障碍儿童运动言语技能动态评价（DEMSS-TR）土耳其语版的效度和信度

儿童语言失用症是一种复杂的运动语言障碍，需要仔细的鉴别诊断，特别是在缺乏有效诊断工具的语言中。运动言语技能动态评估（DEMSS）是一种广泛使用的识别CAS的工具，但土耳其语版本尚未开发。目的本研究旨在将DEMSS翻译成土耳其语（DEMSS- tr），并评估其在土耳其语语音障碍儿童（SSD）中的心理测量特性。方法对82名3岁~ 6岁的突厥语单语儿童进行调查。研究人员对参与者进行了语言运动技能、口腔运动功能、发音和语言发展的评估。在翻译和试点测试之后，对DEMSS-TR进行了内部一致性、测试重测信度以及内部和内部信度评估。通过专家内容验证、聚类分析和受试者工作特征（ROC）分析来评估效度。结果DEMSS-TR具有较强的信效度。所有子检验和总分的Cronbach's alpha均超过0.90。重测系数为0.823 ~ 0.991，评分间和评分内信度均大于0.90。内容效度由专家评分支持，所有条目的内容效度比均超过0.80。聚类分析显示三种不同的参与者分组符合CAS，轻度CAS和非CAS诊断。ROC分析显示，该工具在亚测试和总分中具有较高的敏感性和特异性，证实了该工具的诊断准确性。结论DEMSS-TR是识别突厥语SSDs患儿CAS的可靠、有效的评估方法。它的动态、结构化格式允许临床医生在提示和自发条件下观察运动语言行为，支持准确的诊断和治疗计划。这种适应解决了土耳其临床实践中的重大差距，并有助于运动语言障碍跨语言评估的国际文献。本文补充了关于该主题的已知内容它是通过运动言语技能动态评估（DEMSS）进行的(Strand et al. 2013；Strand and McCauley 2019)，该研究对儿童言语失用症（CAS）进行了动态评估，CAS是言语障碍的一种亚型。虽然测试的原始语言是英语，但瑞典语和巴西葡萄牙语也有效度和信度研究。本研究代表了第一个关于土耳其CAS的国际研究，为第一个土耳其CAS评估工具提供了信度和效度数据。独特的是，本研究在改编过程中严格遵循了英语原版DEMSS。与其他语言研究不同，本研究采用了聚类分析，这是一种在言语和语言障碍量表中不太常用的验证方法，为未来的测试开发或适应提供了有价值的指导。此外，强调动态评估在运动言语障碍领域的重要性，展示其实际应用。这项工作的潜在或实际临床意义是什么？这项研究具有重要的临床意义，特别是在提高土耳其语儿童运动言语评估的准确性和标准化方面。通过验证这一工具，临床医生可以更准确地诊断和定制运动语言障碍患者的治疗计划，特别是CAS，确保干预措施在文化和语言上都是合适的。这一进步不仅提高了不同临床环境评估的一致性，而且有助于更有效和个性化的言语治疗，最终导致更好的患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Language & Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

3.30

自引率

12.50%

发文量

116

审稿时长

6-12 weeks

期刊介绍： The International Journal of Language & Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The Journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.