In current practice, motor speech disorders are assessed using tools such as the Assessment of Motor Speech for Dysarthria (AMSD), speech intelligibility measures, and the Frenchay Dysarthria Assessment (FDA-2). However, when translating results into clinical documentation, critical information is frequently lost: which layer of the speech production process is impaired. This paper defines this problem as the process–product documentation gap and proposes the PHASE Model (Phenomenal Hierarchical Assessment of Speech and Expression; T-P-M-A-S-D-R-O) to address it — by decomposing the execution level of previous frameworks into anatomically and functionally distinct layers, and by introducing Context-Dependent Attribution of Observational Result, a mechanism that dynamically aligns the final observed output O with the appropriate ICF level depending on clinical context and disease stage. The model requires no modification to existing assessment protocols. Three illustrative cases demonstrate applicability across cleft palate, Parkinson's disease, and post-stroke dysarthria.
Naoki Yoneda (Tue,) studied this question.