From Speech Acoustics to Communicative Participation in Dysarthria: Toward a Causal Framework

2021 ◽  
pp. 1-14
Author(s):  
Stephanie A. Borrie ◽  
Camille J. Wynn ◽  
Visar Berisha ◽  
Tyson S. Barrett
Keyword(s):  
Speech Rate ◽  
Objective Measure ◽  
Strong Relationship ◽  
World Health ◽  
International Classification Of Functioning ◽  
Speech Acoustics ◽  
Communicative Participation ◽  
Causal Framework ◽  
Moderate Relationship

Purpose: We proposed and tested a causal instantiation of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, linking acoustics, intelligibility, and communicative participation in the context of dysarthria. Method: Speech samples and communicative participation scores were collected from individuals with dysarthria ( n = 32). Speech was analyzed for two acoustic metrics (i.e., articulatory precision and speech rate), and an objective measure of intelligibility was generated from listener transcripts. Mediation analysis was used to evaluate pathways of effect between acoustics, intelligibility, and communicative participation. Results: We observed a strong relationship between articulatory precision and intelligibility and a moderate relationship between intelligibility and communicative participation. Collectively, data supported a significant relationship between articulatory precision and communicative participation, which was almost entirely mediated through intelligibility. These relationships were not significant when speech rate was specified as the acoustic variable of interest. Conclusion: The statistical corroboration of our causal instantiation of the ICF framework with articulatory acoustics affords important support toward the development of a comprehensive causal framework to understand and, ultimately, address restricted communicative participation in dysarthria.

Sixth Edition: the New Standard

2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach
Keyword(s):  
Review Process ◽  
Peer Review Process ◽  
World Health ◽  
International Classification Of Functioning ◽  
Revision Process ◽  
Sixth Edition ◽  
Impairment Ratings ◽  
Health Organization ◽  
Impairment Severity

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.

The Historical Development of Burden of Treatment Compliance

2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter
Keyword(s):  
Internal Medicine ◽  
Treatment Compliance ◽  
World Health ◽  
International Classification Of Functioning ◽  
Sixth Edition ◽  
Burden Of Treatment ◽  
Specific Goal ◽  
Surrogate Measure ◽  
Health Organization

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

scholarly journals Dysphonia in adults with developmental stuttering: A descriptive study

2017 ◽  
Vol 64 (1) ◽  
Author(s):  
Anél Botha ◽  
Elizbé Ras ◽  
Shabnam Abdoola ◽  
Jeannie Van der Linde
Keyword(s):  
Voice Quality ◽  
Severity Index ◽  
Health Condition ◽  
World Health ◽  
International Classification Of Functioning ◽  
Future Research ◽  
Positive Correlations ◽  
Developmental Stuttering ◽  
Moderate Positive Correlation

Background: Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised.Objectives: This study aimed to describe the vocal characteristics of PWS.Method: Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study.Result: Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41).Conclusion: The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

scholarly journals Ontological modeling of the International Classification of Functioning, Disabilities and Health (ICF): Activities&Participation and Environmental Factors components

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Silvia Cozzi ◽  
Andrea Martinuzzi ◽  
Vincenzo Della Mea
Keyword(s):  
Environmental Factors ◽  
Conceptual Model ◽  
Case Studies ◽  
International Classification ◽  
World Health ◽  
International Classification Of Functioning ◽  
Conceptual Clarity ◽  
Health Related ◽  
Upper Ontology

Abstract Background The International Classification of Functioning, Disability and Health (ICF) is a classification of health and health-related states developed by the World Health Organization (WHO) to provide a standard and unified language to be used as a reference model for the description of health and health-related states. The concept of functioning on which ICF is based is that of a “dynamic interaction between a person’s health condition, environmental factors and personal factors”. This overall model has been translated into a classification covering all the main components of functioning. However, the practical use of ICF has highlighted some formal problems, mainly concerning conceptual clarity and ontological coherence. Methods In the present work, we propose an initial ontological formalization of ICF beyond its current status, focusing specifically on the interaction between activities and participation and environmental factors. The formalization has been based on ontology engineering methods to drive goal and scope definition, knowledge acquisition, selection of an upper ontology for mapping, conceptual model definition and evaluation, and finally representation using the Ontology Web Language (OWL). Results A conceptual model has been defined in a graphical language that included 202 entities, when possible mapped to the SUMO upper ontology. The conceptual model has been validated against 60 case studies from the literature, plus 6 ad-hoc case studies. The model has been then represented using OWL. Conclusions This formalization might provide the basis for a revision of the ICF classification in line with current efforts made by WHO on the International Classification of Diseases and on the International Classification of Health Interventions.

scholarly journals The Move & PLAY Study: An Example of Comprehensive Rehabilitation Outcomes Research

2010 ◽  
Vol 90 (11) ◽  
pp. 1660-1672 ◽  
Author(s):  
Doreen J. Bartlett ◽  
Lisa A. Chiarello ◽  
Sarah Westcott McCoy ◽  
Robert J. Palisano ◽  
Peter L. Rosenbaum ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Data Collection ◽  
Outcomes Research ◽  
Service Providers ◽  
World Health ◽  
International Classification Of Functioning ◽  
Rehabilitation Outcomes ◽  
Children With Cerebral Palsy ◽  
Comprehensive Rehabilitation

This perspective article provides an example of a study planned using guidelines for comprehensive rehabilitation outcomes research, an approach that is believed to give service providers meaningful evidence to support practice. This line of investigation has been guided by the World Health Organization's International Classification of Functioning, Disability and Health. The short title of a study under way is Move & PLAY (Movement and Participation in Life Activities of Young Children). The article briefly describes the conceptual model, provides guidelines on how indicators and measures are selected, alludes to the details of selected measures, and describes processes of preparing for data collection, including obtaining ethics approval, preparing data collection booklets, training assessors and interviewers, and sampling. The aim of this investigation is to gain a better understanding of the multiple child, family, and service factors associated with changes in mobility, self-care, and play of preschool children with cerebral palsy as a result of using this research method. Comprehensive rehabilitation outcomes research holds promise in providing evidence that supports the complexities of planning rehabilitation services with clients with chronic conditions, such as children with cerebral palsy.

Functional Assessment of Persons with Motor Limitations

2014 ◽  
pp. 43-74
Author(s):  
Kaliopi Lappas
Keyword(s):  
Functional Assessment ◽  
World Health ◽  
International Classification Of Functioning ◽  
Common Language ◽  
Reference Guide ◽  
The World ◽  
Examination Methods ◽  
Health Organization ◽  
And Function

In this chapter a referral is made to the most known examination methods and tools for evaluating persons with motor limitations. Since there are many methods and tools, standardized or not, describing each of them by the area of evaluation and forming a quick reference guide seem to be helpful. Furthermore referrals are made to some special evaluation forms regarding special conditions, like stoke, which appear to have multiple problems influencing function. Finally, in the last section of this chapter a referral is made to the International Classification of Functioning, Disability and Health scale (ICF), which has been developed the past few years by the World Health Organization (WHO), in an effort to have and apply a universal way of assessing people with disabilities. This scale aims to give to all the health professional and researchers a “common language” when “measuring” disability and function.

Functional Assessment of Persons With Motor Limitations

2019 ◽  
pp. 896-933
Author(s):  
Kaliopi Lappas
Keyword(s):  
Functional Assessment ◽  
World Health ◽  
International Classification Of Functioning ◽  
Common Language ◽  
Reference Guide ◽  
The World ◽  
Examination Methods ◽  
Health Organization ◽  
And Function

In this chapter a referral is made to the most known examination methods and tools for evaluating persons with motor limitations. Since there are many methods and tools, standardized or not, describing each of them by the area of evaluation and forming a quick reference guide seem to be helpful. Furthermore referrals are made to some special evaluation forms regarding special conditions, like stoke, which appear to have multiple problems influencing function. Finally, in the last section of this chapter a referral is made to the International Classification of Functioning, Disability and Health scale (ICF), which has been developed the past few years by the World Health Organization (WHO), in an effort to have and apply a universal way of assessing people with disabilities. This scale aims to give to all the health professional and researchers a “common language” when “measuring” disability and function.

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