Cross-cultural adaptation into Italian and validation of the Frenchay dysarthria assessment - 2

BACKGROUND: Acomprehensive evaluation of dysarthria is required to make an accurate differential diagnosis with other communication disorders and plan effective rehabilitation programs. The Frenchay Dysarthria Assessment-2 (FDA-2) is a valid, reliable and widely used protocol for the assessment of dysarthria. An Italian version of the FDA-2 is currently lacking. AIM: To perform a cross-cultural adaptation of the FDA-2 in Italian and to validate the Italian version of the FDA-2 DESIGN: Validation study SETTING: Inpatient rehabilitation center POPULATION: 69 patients with dysarthria and 112 healthy controls. METHODS: The FDA-2 was translated and cross-culturally adapted to Italian. The validation study was carried out in 4 steps: (1) 42 audio-recorded samples of FDA-2 items from 11 patients with dysarthria were independently assessed by 7 speech and language pathologists for interrater reliability and re-assessed after 6 weeks for intrarater reliability; (2) 11 patients were simultaneously assessed by 3 speech and language therapists for interrater reliability of the whole Italian version of the FDA-2 and re-assessed within 24 hours for test-retest reliability; (3) the Italian version of the FDA-2 was administered to 112 healthy volunteers to gain normative data; (4) 49 patients with different types of dysarthria were assessed using the Italian version of the FDA-2, the Therapy Outcome Measure impairment scale and the Robertson Profile for the validity analysis. RESULTS: Interrater and intrarater reliability ranged from good to excellent (ICC>0.75) except for 3 audio-recorded items. The overall protocol demonstrated excellent (ICC>0.9) inter-rater and test-retest reliability for all the sections and the total score. Normative data were gained for 6 age groups. For the validity analysis, a statistically significant difference was found between dysarthric patients and healthy subjects for all sections and the total score. The FDA-2 significantly correlated to the therapy outcome measure (r=0.75) and the Robertson Profile (r=0.81). CONCLUSIONS: The Italian version of the FDA-2 yield satisfactory reliability and validity, comparable to the psychometric properties of the original version. CLINICALREHABILITATIONIMPACT: Speech and language pathologists can rely on a valid and reliable tool in Italian for the assessment of dysarthria in both clinical and research practice.