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Comprehensibility : a potential measure for improvement in communication Visser, Tiffany

Abstract

The present study examined the relationship between changes in comprehensibility and changes in intelligibility over time, for an individual with dysarthria. Intelligibility has been the primary focus in the assessment and treatment of dysarthria. This study builds on the work of Yorkston, Strand, and Kennedy (1996) to establish comprehensibility as an alternative or additional focus for dysarthria. It does so within the context of the International Classification of Functioning, Disability and Health (ICF) proposed by the World Health Organization (WHO). The WHO is dedicated to ensuring that individuals meet the highest level of biological, psychological, and physiological health. Comprehensibility has the potential to promote increased health and quality of life by focusing on the communication within a dyad rather than focusing only on the speech signal as intelligibility does. This study was based on secondary analysis of audio- and videotaped assessment data. The data were collected at two points in time during the externship of a clinical student, G, with a client E, who had mixed spastic hypokinetic dysarthria. The goal of the present study was to establish the clinical utility of comprehensibility in terms of its application in structured assessment, in addition to the reflection of changes in conversation and in judgments of unfamiliar individuals. Two focus groups were recruited for perceptual judgments of conversations. Results revealed that in structured assessment, changes in comprehensibility occurred in the absence of changes in speech characteristics. Changes in comprehensibility were also reflected in conversation in the form of more efficient breakdown resolution strategies of both members of the dyad and in differences in topic control. Both groups of participants rated the second conversation to be more successful, and slightly more proficient, than the first. Ratings on other elements of the conversation, such as comfort, interest, and effort, however, varied between the two groups. Interpretation of these differences, clinical implications, and potential for future research is discussed.

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