Validation and Reliability of the Japanese Version of the Speech Handicap Index - IALP 2025 Innovation and Inspiration in Communication Sciences and Disorders

Jitsuro Yano ¹ Dr. Tomonori Yokoyama ² Mr. Daisuke Hara ³ Ms. Maya Nakahira ⁴ Prof. Hirotaka Hara ⁵ Dr. Isami Kumakura ⁶

¹Department of Speech‑Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Japan
²Division of Speech‑Language‑Hearing Therapy, Rehabilitation Center, Kawasaki Medical School General Medical Center, Japan
³Division of Rehabilitation, Nagoya University Hospital, Japan
⁴Department of Rehabilitation, Kochi Medical School Hospital, Japan
⁵Department of Otolaryngology-Head and Neck Surgery, Kawasaki Medical School, Japan
⁶Senri Rehabilitation Hospital, Japan

Purpose: This study aimed to validate the cross-cultural adaptation of the Japanese Speech Handicap Index (SHI-JP) for Japanese patients with speech disorders and assess its reliability.

Theoretical Background: Speech disorders often occur after head and neck cancer treatment or stroke. While perceptual ratings by clinicians are the gold standard, they fail to measure the impact on patients` quality of life. The SHI measures speech`s psychosocial impact in oral/pharyngeal cancer patients, yet no speech-specific questionnaire exists for Japanese speakers.

Research Method: The SHI-JP was given to 55 patients with oral/oropharyngeal cancer or neuromuscular disease and 68 healthy subjects. Content validity, construct validity, internal consistency, and test–retest reliability were evaluated. An unpaired t-test was used to compare scores between patients and healthy subjects to determine discriminatory ability.

Findings: The SHI-JP demonstrated high internal consistency (Cronbach’s α = 0.91) and test–retest reliability: total (T) 0.83, speech (S) 0.79, psychosocial (P) 0.81. Mean scores of SHI-JP for patient: 33.6 (T), 18.3 (S), 14.0 (P); healthy subject: 3.1 (T), 2.0 (S), 1.0 (P). The scores differed significantly between the groups (P < 0.001).

Discussion: The SHI-JP, adapted from the English SHI, is a culturally relevant, valid, and reliable tool to assess speech-related quality of life in Japanese-speaking patients.

Reference: 1) Rinkel, R. N., Verdonck-de Leeuw, I. M., van Reij, E. J., Aaronson, N. K., & Leemans, C. R. (2008). Speech Handicap Index in patients with oral and pharyngeal cancer: better understanding of patients` complaints. Head & neck, 30(7), 868–874. 2) Shiromoto, O., Oridate, N., Ikui Y., Taguchi A., Mizoguchi K., Watanabe Y., Tamura E., Omori K., & Yumoto E. (2014). Reliability and validity of the Japan Society of Logopedics and Phoniatrics version of VHI and VHI-10: a multi-center study. The Japan Society of Logopedics and Phoniatrics, 55(4), 291-298.