The Lingraphica Blog

Aphasia Access Report on Program Effectiveness for Persons with Aphasia

Apr 24, 2019 | by Richard Steele, PhD

Lingraphica Co-founder and Chief Scientist, Dr. Richard Steele, summarizes the work of the Education and Research Committee of Aphasia Access, who published a report of responses to a questionnaire that they developed to understand how programs for persons with aphasia (PWA) track effectiveness. 

The goals of the committee were to identify which outcome measures are currently used, and how, in documenting beneficial changes among program participants. Each assessment instrument typically addresses a specific level from a complementary spectrum, i.e., impairment, functional communication, participation, and quality of life.

Using Qualtrics technology, the Committee developed an on-line survey that asked: (i) what measures respondents used for clinical or research assessments, how they described meaningful change in PWA over time, and how they evaluated program outcomes and/or success; (ii) whom they involved in assessment activities; and (iii) whether formal assessment instruments were modified and how, and whether they were supplemented with informal measures.

Altogether, 108 responses were received from the US, Canada, the UK, New Zealand, and Chile. Most (38%) were from clinical inpatient/outpatient/home settings; 10% were from aphasia research centers, 6.4% from intensive aphasia programs, and the remainder represented unspecified research or clinical venues. Across settings and contexts, the Western Aphasia Battery (WAB) was employed most widely to track outcomes, followed by the Boston Naming Test (BNT), the Cognitive Linguistic Quick Test (CLQT), and the Communicative Effectiveness Index (CETI). Modifications to specified administration procedures were reported, including repetition of stimuli, rephrasing of stimuli, addition of written-/verbal-/or pointing-cueing, and inclusion of only selected subsections.

Overall, 14 individual aphasia assessment instruments were named by respondents, from across the spectrum of assessment levels. Aphasia research centers reported using the largest number of these (13/14), with a focus on research purposes; intensive aphasia programs used the fewest (12/14), with a focus on clinical ends. Three of the four most widely used instruments – WAB, BNT, CLQT – assess impairments, while the fourth—CETI—assesses functional communication. The remaining 11 instruments, which include some that report participation-level and quality-of-life-level data, are used neither widely nor frequently. These findings underscore the need to develop more usable tools for studying outcome changes broadly at these higher, complementary levels.

For further reading:  S. Kiran, L. R. Cherney, A. Kagan et al., 2018. Aphasia assesments: a survey of clinical and research settingsAphasiology, 32:sup1, 47–49.