Measuring verbal and non‐verbal communication in aphasia: reliability, validity, and sensitivity to change of the Scenario Test

Abstract

Background: This study explores the psychometric qualities of the Scenario Test, a new test to assess daily‐life communication in severe aphasia. The test is innovative in that it: (1) examines the effectiveness of verbal and non‐verbal communication; and (2) assesses patients' communication in an interactive setting, with a supportive communication partner. Aims: To determine the reliability, validity, and sensitivity to change of the Scenario Test and discuss its clinical value. Methods & Procedures: The Scenario Test was administered to 122 persons with aphasia after stroke and to 25 non‐aphasic controls. Analyses were performed for the entire group of persons with aphasia, as well as for a subgroup of persons unable to communicate verbally (n = 43). Reliability (internal consistency, test–retest reliability, inter‐judge, and intra‐judge reliability) and validity (internal validity, convergent validity, known‐groups validity) and sensitivity to change were examined using standard psychometric methods. Outcomes & Results: The Scenario Test showed high levels of reliability. Internal consistency (Cronbach's α = 0.96; item‐rest correlations = 0.58–0.82) and test–retest reliability (ICC = 0.98) were high. Agreement between judges in total scores was good, as indicated by the high inter‐ and intra‐judge reliability (ICC = 0.86–1.00). Agreement in scores on the individual items was also good (square‐weighted κ values 0.61–0.92). The test demonstrated good levels of validity. A principal component analysis for categorical data identified two dimensions, interpreted as general communication and communicative creativity. Correlations with three other instruments measuring communication in aphasia, that is, Spontaneous Speech interview from the Aachen Aphasia Test (AAT), Amsterdam–Nijmegen Everyday Language Test (ANELT), and Communicative Effectiveness Index (CETI), were moderate to strong (0.50–0.85) suggesting good convergent validity. Group differences were observed between persons with aphasia and non‐aphasic controls, as well as between persons with aphasia unable to use speech to convey information and those able to communicate verbally; this indicates good known‐groups validity. The test was sensitive to changes in performance, measured over a period of 6 months. Conclusions & Implications: The data support the reliability and validity of the Scenario Test as an instrument for examining daily‐life communication in aphasia. The test focuses on multimodal communication; its psychometric qualities enable future studies on the effect of Alternative and Augmentative Communication (AAC) training in aphasia.

Cultural adaptation and psychometric testing of The Scenario Test UK for people with aphasia

“…The Scenario Test is a Dutch functional communication assessment (van der Meulen et al 2010). It measures how PWA convey a message (verbally and/or non-verbally) in daily-life situations; examines communication in an interactive setting; and is designed for use with individuals with severe aphasia.…”

“…The measure also had good convergent validity, as demonstrated by moderate-to-strong (0.50-0.85) correlations with three other measures of communication in aphasia, and good known-groups validity, as established by group differences between PWA and controls, and between people unable to use speech and those communicating verbally. The test was also sensitive to changes in performance over 6 months (van der Meulen et al 2010).…”

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Background: This study explores the psychometric properties of The Scenario Test UK, a culturally adapted version of the Dutch original (The Scenario Test) developed by van der Meulen et al in 2010, which evaluates functional, daily-life communication in aphasia. The Scenario Test assesses communication in an interactive context with a supportive communication partner.

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Aphasia rehabilitation and the role of computer technology: Can we keep up with modern times?

“…The majority of participants (patients, their partners, and their SLTs), including even people who were unable to use the system in a creative way, rated TS as good, very good, or excellent. Another unexpected result was that patients improved in their overall communication as measured by the Scenario Test (van der Meulen, van de Sandt-Koenderman, Duivenvoorden, & Ribbers, 2010). These gains were interpreted as a generalization effect, as the participants did not use TS during this test.…”

FCET2EC (From controlled experimental trial to = 2 everyday communication): How effective is intensive integrative therapy for stroke-induced chronic aphasia under routine clinical conditions? A study protocol for a randomized controlled trial

“…(i) Specially devised screening measures for language-systematic and communicative-pragmatic communication ability; (ii) the German version of the Stroke and Aphasia Quality of Life Scale-39/SAQOL-39 [29]; (iii) German Version of the Communicative Effectiveness Index/CETI [30]; (iv) B-scale (intelligibility) of the ANELT scenarios [28]; (v) ratings of the syntactic complexity of the ANELT scenarios using the AAT scoring system for spontaneous speech [27]; (vi) ratings of non-verbal communication skills on the ANELT scenarios (based on the Scenario test [31]).…”