Abstract
OBJECTIVE
To develop and validate the FIRST ever speech-specific perceptual speech evaluation tool, the London Speech Evaluation scale (LSE-scale) for head and neck cancer (HNC) patients.
METHOD
Following a literature review and discussion in a multidisciplinary setting, five speech parameters (intelligibility, articulation, speech rate, nasality and asthenia) and overall grade were identified. Speech samples of 117 subjects (65 consecutive follow-up oral and oropharyngeal cancer patients and 52 healthy volunteers) were recorded using a standard protocol consisting of reciting specific words and a standard text passage. All samples were independently judged and rated by three experienced raters and re-rated 12 weeks apart to establish intra-rater reliability. Internal consistency, intra-rater reliability and inter-rater reliability of different parameters of this scale and overall grade were determined using Cronbach's alpha and Spearman's rank correlation coefficients. Construct validity was tested using Spearman's rank correlation coefficient and Mann-Whitney U-test.
RESULTS
The Cronbach's alpha coefficients for internal consistency ranged between 0.87-0.90 for connected speech and 0.79-0.84 for single words. The Spearman's correlation coefficients for intra-rater reliability of these parameters for connected speech and words varied between 0.38-0.87 and 0.50-0.71, respectively, while those for inter-rater reliability were between 0.55-0.99 and 0.40-0.57, respectively. For construct validity, the Spearman's correlation coefficient ranged between 0.41- 0.55.
CONCLUSION
LSE scale is a reliability and valid tool for speech evaluation in HNC patients. We believe that it will be a helpful adjunct in rehabilitation of HNC patients. This scale may also have some extended usage in the rehabilitation of neurological patients suffering from speech problems.