The influence of auditory, visual and audiovisual modalities in the interpretation of cough reflex

Type of content
Theses / Dissertations
Publisher's DOI/URI
Thesis discipline
Speech and Language Therapy
Degree name
Master of Speech and Language Therapy
Publisher
University of Canterbury. Communication Disorders
Journal Title
Journal ISSN
Volume Title
Language
Date
2012
Authors
How, Hui Teng
Abstract

Cough reflex testing (CRT) is used to assess the sensory and motor components of a reflexive cough. When used as an adjunct to the clinical swallowing evaluation, it has the potential to identify individuals who are more likely to aspirate silently in the event of aspiration. It is unknown how reliable clinicians are at interpreting cough responses and the factors that influence this reliability. Therefore, this study ascertained the reliability of Speech Language Therapists in interpreting cough responses in CRT and determined how sensory perception and training influence reliability. Additionally, the study determined a relative measure of CRT interpretation validity through a comparison with ‘expert’ consensus ratings. A total of 111 clinicians completed an online survey consisting of ratings of 30 audio-, visual- and audiovisual clips over three sessions, and a final questionnaire. Reliability was substantial (κ=.76) in rating for presence of cough but only fair (κ=.25) in rating for strength of cough. Clinicians used a variety of auditory and visual cues to assist in decision making. Training did not result in higher reliability. Ratings of individual clinicians were significantly associated with consensus ratings for presence of cough (p < 0.001) and strength of cough (p < 0.05). In summary, clinicians could reliably and accurately judge presence of cough response, but were poorer at rating the strength of cough.

Description
Citation
Keywords
Cough reflex testing, reliability, relative validity, perception
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Rights
Copyright Hui Teng How