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The study aimed at evaluating the diadochokinetic (DDK) skills of Greek-speaking preschool children with phonological disorder (PD) by means of a structured evaluation protocol and at proposing cut-off points for children at risk of speech impairment. The participants were 36 children with PD and 60 typically developing (TD) peers. The groups were matched on age and gender. The PD group performed significantly slower than the TD group in all speech DDK tasks but not in the oral-motor tasks. The ROC analysis showed a statistically significant positive discrimination for all speech tasks. The internal consistency of the protocol was excellent (Cronbach's [alpha] = 0.844), while complex stimuli showed a better discriminatory ability. The obtained results agree with Dodd's classification for speech sound disorders (SSDs). Different types of speech stimuli must be included in the evaluation of DDK performance as a clinical predictor for preschoolers with SSDs who face difficulties in speech maturation.

Background: Diadochokinetic rates tasks are frequently used for the assessment of diadochokinesia (DKK) in young and elderly adults. However, there is scarce research on healthy elderly adults over 65 years old, and little is known about the effect of different types of stimuli (non-words/real words) in this specific population. Furthermore, the current research supports significant language variations, highlighting the need for language-specific norms. Aims: To investigate the effect of age, gender and type of stimuli (non-words versus real words) in DDK rates in healthy elderly adults of over 65 years of age, and to provide normative data for the Greek language. Methods & Procedures: The participants were 791 healthy monolingual Greek-speaking adults (531 adults, aged 20-39 years; 157 participants aged 65-74 years; and 103 participants aged over 75 years). All participants were monolingual speakers of Greek and had normal hearing acuity, which allowed them to understand and follow instructions. Participants with a medical condition, which would affect DDK rates' performance, were excluded from the study. The time-by-count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non-words (/'gaba/, /'taka/, /'kata/, /'baga/); (2) four disyllabic real words (/'kapa/, /'tapa/, /ka'la/, /'paka/); and (3) two trisyllabic non-words (/'pataka/, /'badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected DDK rates significantly, with older adults achieving slower DDK rates for all speech stimuli (non-words/real words). Gender did not have an effect on the performance of DDK rates. The type of speech stimuli affected DDK rates significantly for all age groups. Analytically, trisyllabic non-word stimuli were articulated more slowly than disyllabic non-word stimuli, and real words were produced faster than non-words. A linear regression analysis revealed that only the repetition of non-words predicted 68.4% of the performance on the repetition of trisyllabic non-words. Conclusions & Implications: The above results complement prior research, which supports that real word stimuli yield faster performance than non-word stimuli. Clinicians should keep in mind that age, language and type of stimuli (non-words/real words) affect significantly the performance of DDK rates, as well as the fact that different types of stimuli tap distinct underlying levels of speech. The current research highlights the need for language-specific norms for different populations.

This study examined the performance of Greek monolingual typically developing (TD) children on diadochokinetic (DDK) rates in real words and non-words and attempted to establish normative data for Greek. The effects of age, type of stimuli and gender were investigated. A total of 380 children aged 4.0–15.0 years as well as a control group of 313 adults participated in the study. Age significantly affected DDK performance, yet normative data differ from other studies. DDK rates for bisyllabic stimuli were faster than DDK rates for trisyllabic stimuli and real words were articulated faster than non-words. Adolescents aged 13.0–15.0 years were slower than adults both in real word and in non-word /ˈpataka/ repetition. Additionally, overall boys were significantly faster than girls. These findings show the need to: (a) implement real word stimuli in DDK tasks in order to better depict an individual’s oral-motor abilities and (b) establish language-specific normative data for TD children.

Background: Diadochokinetic (DDK) rate tasks are extensively used in the evaluation of speech disorders; however, it is unclear how the different types of speech stimuli affect DDK rate performance. Aims: To investigate the effect of age, gender and type of stimuli (non‐words versus real words) on the DDK rates in individuals across the lifespan and to provide normative data for Greek. Also to examine the discrimination ability of the speech DDK stimuli administered (non‐words and real words) based on a dual DDK assessment protocol using a polytomous item response theory (IRT) model. Methods & Procedure: The participants were 1747 monolingual Greek speakers (376 children, aged 4–17 years; and 1371 adults, aged 18–90+ years). All participants had normal hearing acuity which allowed them to understand and follow instructions. Participants with a medical condition or a language disorder which would affect DDK rate performance were excluded from the study. The time‐by‐count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non‐words (/'gaba/, /'taka/, /'kata/, /'baga/), (2) four disyllabic real words (/'kapa/, /'tapa/, /ka'la/, /'paka/) and (3) two trisyllabic non‐words (/'pataka/, /'badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected significantly DDK rates with performance increasing gradually until approximately the age of 40 and then gradually decreasing. Gender had no effect. Overall, there was a significant advantage of disyllabic real word stimuli over disyllabic non‐word stimuli and of trisyllabic non‐word stimuli over disyllabic non‐word stimuli on DDK rates performance. IRT analysis suggested that the data fit the polytomous model reasonably well and all DDK stimuli (real words and non‐words) showed a strong relationship (loadings > 0.50) with the latent trait. Conclusions & Implications: The current study complements prior research which supports that age and type of stimuli significantly affect DDK rates performance. It is the first study, that testifies to the benefit of real‐word stimuli over non‐word stimuli on DDK rates across the lifespan in a large representative sample. The implementation of IRT analysis provides empirical evidence about the discrimination ability of the DDK stimuli administered and confirms the reliability of this dual DDK assessment protocol. These findings are valuable for clinicians who work with motor speech disorders. WHAT THIS PAPER ADDS: What is already known on this subject: Age, type of stimuli (real words versus non‐words) and language significantly affect DDK rates performance. Current research strongly suggests the administration of language‐specific norms since language‐dependent features seem to have a noteworthy effect on the DDK rates, but scarce evidence exists about the discriminatory ability of the DDK speech stimuli commonly administered. What this study adds to the existing knowledge: Conflicting findings have been reported about the effect of different types of DDK speech stimuli (real words and non‐words) but no study to date has evaluated their discriminatory abilities. The current study is the first to implement a polytomous IRT model to examine this issue. This is also the first study to attempt an investigation of the effect of types of stimuli (real words versus non‐words) on a large representative sample across the lifespan (4–90+ years) and to provide normative data for Greek. What are the practical and clinical implications of this work?: The present study offers concrete evidence about the advantage of real‐word stimuli over non‐word stimuli in Greek, as well as normative data for the Greek‐speaking populations. Moreover, the IRT analysis testifies to the discriminatory ability of real‐word and non‐word stimuli affirming the reliability of the present dual DDK assessment protocol as a psychometrically sound measure of DDK ability. The above has significant value for clinicians who work with individuals with motor speech disorders as the protocol can help them with the diagnosis and differential diagnosis of motor speech disorders. [ABSTRACT FROM AUTHOR]

The study aimed at evaluating the diadochokinetic (DDK) skills of Greek-speaking preschool children with phonological disorder (PD) by means of a structured evaluation protocol and at proposing cut-off points for children at risk of speech impairment. The participants were 36 children with PD and 60 typically developing (TD) peers. The groups were matched on age and gender. The PD group performed significantly slower than the TD group in all speech DDK tasks but not in the oral-motor tasks. The ROC analysis showed a statistically significant positive discrimination for all speech tasks. The internal consistency of the protocol was excellent (Cronbach's α =.844), while complex stimuli showed a better discriminatory ability. The obtained results agree with Dodd's classification for speech sound disorders (SSDs). Different types of speech stimuli must be included in the evaluation of DDK performance as a clinical predictor for preschoolers with SSDs who face difficulties in speech maturation. [ABSTRACT FROM AUTHOR]

The present study aims to be the first to validate the Tuokko version of the Clock Drawing Test (CDT) and estimate its cutoff score after its translation into the Greek language and administration in the Greek population. One hundred and thirty-two individuals participated in this study [60 with Good Cognitive Health (GCH), 24 with Parkinson's Disease (PD), 24 with Parkinson's Disease Dementia (PDD) and 24 with Alzheimer's Disease (AD)]. The CDT was administered to all participants. Additionally, the cognitive and mental status of the sample were estimated through the use of the Mini Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Arizona Battery for Communication Disorders of Dementia (ABCD), Instrumental Activities of Daily Living (IADL), the Neuropsychiatric Inventory (H-NPI) and the Geriatric Depression Scale −15 (GDS-15). Statistically significant differences were found between all groups on the CDT, with AD patients having lower scores than all subgroups in the study. The CDT showed a high internal consistency (Cronbach's alpha = 0.832). The ROC analysis provided a cutoff point equal to 4.00 (AUC: 0.821, p < 0.001) between the Cognitively Unimpaired Group (CUG: GCH and PD group) and the Cognitively Impaired Group (CIG: PPD and AD patients), 5.00 (AUC: 0.845, p < 0.001) between the GCH group and the PDD group, and 4.00 (AUC: 0.780, p < 0.001) between the GCH group and the AD group. Finally, the cutoff point between the PD group and the PDD group was 4.00 (AUC: 0.896, p < 0.005), and 3.00 (AUC: 0.899, p < 0.001) between the PD group and the AD group. Significant positive Pearson's correlations were observed between CDT and MMSE (r = 0.808, p < 0.001), CDT and AMTS (r = 0.688, p < 0.001), CDT and ABCD (r = 0.770, p < 0.001), CDT and the ABCD Visuospatial Construction subdomain (r = 0.880, p < 0.001); while a negative correlation was found between CDT and IADL (r = −0.627, p < 0.001) between the CUG and the CIG groups. Given the results obtained, the CDT appears to be a clinically valid screening instrument for the assessment of visuospatial abilities, with high reliability in Greek populations with cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Screening people's cognitive skills have been proven essential for reference to full assessment. These methods include short scales, such as the Abbreviated Mental Test Score (AMTS). The AMTS is a valid 10-item questionnaire that has been translated into many languages, but not in Greek yet. The aim of this study is the validation of the Greek version of the AMTS with an additional estimation of its cutoff scores., Methods: About 132 individuals [60 controls and 72 patients (24 with Parkinson's disease (PD), 24 with Parkinson's disease dementia (PDD), and 24 with Alzheimer's disease (AD)] participated in this study. All participants besides the AMTS completed the Mini Mental State Examination (MMSE), the Tuokko's Clock Drawing Test (CDT), the Instrumental Activities of Daily Living (IADL), the Arizona Battery for Communication Disorders of Dementia (ABCD), the Hellenic versions of the Neuropsychiatric Inventory (NPI), and the Geriatric Depression Scale (GDS-15)., Results: Statistically significant differences were found between all subgroups for the AMTS. The AMTS showed high internal consistency (Cronbach alpha = 0.819 and coefficient omega ω  = 0.814). A threshold equal to 6.50 (AUC: 0.908, p   =   0.000) between groups with and without cognitive impairment was calculated. The AMTS was significantly correlated with the CDT, IADL, and MMSE., Conclusion: The proposed version of the AMTS can distinguish between groups with and without cognitive impairment. Additionally, the AMTS is found to be clinically valid having high reliability and classification accuracy. Conclusively, it is a valuable instrument for screening different types of cognitively impaired patients.

Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht.