The Articulation Handicap Scale with 12 items (AHS-12): a short form of the Articulation Handicap Index (AHI).

OBJECTIVE: The objective is to produce a short instrument for measuring the subjectively experienced articulation handicap, i.e. the extent to which physical, functional, and emotional handicaps caused by a physical deficit are subjectively experienced. METHODS: The items for the short instrument were selected from the 30 items of the Articulation Handicap Index (AHI) by removing items on the basis of item-total correlations using data from 113 cancer survivors. Reliability and validity of the sum score of the corresponding item selection were used for determining the optimal item selection. This optimal item selection was compared with the AHI in an RCT with patients undergoing phoniatric routine diagnostics. RESULTS: With only 12 items left, the measurement instrument was still as reliable and valid as the AHI. With less than 12 items, reliability and validity decreased. In the RCT between the AHI (n = 41) and the 12-item selection (n = 40), reliability and validity of both instruments were the same, but processing times differed (AHI; 3.84 min; 12-item selection: 2.02 min). CONCLUSION: The 12-item selection, further referred to as the Articulation Handicap Scale with 12 items (AHS-12), provides nearly as much information as the original AHI.

Articulation handicap index: an instrument for quantifying psychosocial consequences of impaired articulation.

Structural, neurological and muscular diseases can lead to impairments of articulation. These impairments can severely impact social life. To judge health status comprehensively, this impact must be adequately quantified. For this purpose, the articulation handicap index (AHI) has been developed. Psychometric analyses referring to this index are presented here. The AHI was completed by 113 patients who had undergone treatment of tumours of the head or neck. The patients also gave a general self-assessment of their impairments due to articulation problems. Furthermore, tumour size, tumour location and kind of therapy were recorded. Missing data were analysed and replaced by multiple imputation. Internal structure was investigated using principal component analysis (PCA); reliability using Cronbach's alpha. Validity was investigated by analysing the relationship between AHI and general self-assessment of impairments. Moreover, the relationships with tumour size, tumour location and kind of therapy were analysed. Only 0.12 % of the answers to the AHI were missing. The Scree test performed with the PCA results suggested one-dimensionality with the first component explaining 49.6 % of the item variance. Cronbach's alpha was 0.96. Kendall's tau between the AHI sum score and the general self-assessment was 0.69. The intervals of AHI sum scores for the self-assessment categories were determined with 0-13 for no, 14-44 for mild, 46-76 for moderate, and 77-120 for severe impairment. The AHI sum score did not systematically relate to tumour size, tumour location or kind of therapy. The results are evidence for high acceptance, reliability and validity.