DEVELOPMENT AND STANDARDIZATION OF URDU APHASIA ASSESSMENT TOOL (UAAT) FOR CLINICAL USE

Main Article Content

Faiza Badar
Sajida Naz
Ghulam Saqulain
Muhammad Kashif Khan

Keywords

Aphasia, Assessment, Speech-language pathologists, Tools, Standardization.

Abstract

Objectives: To develop and validate the Aphasia Assessment Tool in Urdu and determine its clinical accuracy. 


Methodology: A mixed-methods exploratory study was conducted at Shifa International Hospital from September 2020 to September 2021. The developed tool underwent face validity through peer review. Following changes based on professional feedback, the test was further refined by language experts at the National University of Modern Languages and the Academy of Letters. The pilot study test was then administered to 467 individuals across four provinces in Pakistan, meeting the inclusion criteria. Inter-rater reliability was calculated by having the test scored independently by two therapists. Additionally, UAAT was administered to 70 patients with left middle cerebral artery and 21 patients with right middle cerebral artery infarcts. The sample was also evaluated using the translated version of the Mississippi Aphasia Screening Tool, and scores were compared. A re-administration of the UAAT test after one week on the sample population concluded the study.


Results: The Urdu Aphasia Assessment Test revealed a Cronbach’s α=0.89 with significant correlation (p<0.001, r=0.91 with Mississippi Aphasia Screening Tool. The cut-off score quartiles computed at 27.98±25.21 with a mean of 7.50.  There was a high inter-item correlations.


The factor structure of the scale was assessed with the clinical sample, an exploratory factor analysis was conducted on the 38 items. A principal component analysis was conducted for the one-factor model structure, elucidating 94.00% of the variance. All 38 items exhibited high factor loading on the two-factor structure model, suggesting the retention of all items in the final version of the scale. The one-factor model estimation revealed satisfactory item loadings. Goodness-of-fit model indices..  


Conclusion: In conclusion, the Urdu Aphasia Assessment Tool demonstrates reliability and validity for clinically assessing individuals with aphasia in the Urdu language


 

Abstract 77 | PDF Downloads 69

References

1. Farooq A, Venketasubramanian N, Wasay M. Stroke care in Pakistan. Cerebrovasc Dis Extra. 2021;11(3):118–121. doi:10.1159/000519554.
2. Rehman SS. Challenges in Rehabilitation Research in Pakistan. Journal Riphah College of Rehabilitation Sciences. 2023 Mar 11;11(01):1-3. Doi. 10.53389/JRCRS.2023110101
3. Berg K, Isaksen J, Wallace SJ, Cruice M, Simmons-Mackie N, Worrall L. Establishing consensus on a definition of aphasia: an e-Delphi study of international aphasia researchers. Aphasiology. 2022 Apr 3;36(4):385-400.
4. Stefaniak JD, Geranmayeh F, Lambon Ralph MA. The multidimensional nature of aphasia recovery post-stroke. Brain. 2022 Apr 1;145(4):1354-67.
5. Grönberg A, Henriksson I, Stenman M, Lindgren AG. Incidence of aphasia in ischemic stroke. Neuroepidemiology. 2022 Aug 2;56(3):174-82.
6. Yourganov G, Smith KG, Fridriksson J, Rorden C. Predicting aphasia type from brain damage measured with structural MRI. Cortex. 2015;73:203–215
7. Ansaldo AI, Marcotte K, Scherer L, Raboyeau G. Language therapy and bilingual aphasia: Clinical implications of psycholinguistic and neuroimaging research. J Neurolinguistics. 2008;21(6):539-557. doi: 10.1016/j.jneuroling.2008.02.001
8. Ivanova MV, Hallowell B. A tutorial on aphasia test development in any language: Key substantive and psychometric considerations. Aphasiology. 2013 Aug 1;27(8):891-920.
9. Ali N, Rafi MS. Bilingual Aphasia Test in Urdu and its Clinical Implications. Pak J Med Sci. 2021 Sep-Oct;37(5):1545-1546. doi: 10.12669/pjms.37.5.4572.
10. Badar F, Naz S, Mumtaz N, Babur MN, Saqulain G. Aphasia-Diagnostic Challenges and Trends: Speech-Language Pathologist’s Perspective. Pak J Med Sci. 2021;37(5):1461-1466. doi.org/10.12669/pjms.37.5.2314
11. Riaz W, Ali G, Abid M, Butt IN, Shahzad A, Shahid S. An Exploratory Study on Supporting Persons with Aphasia in Pakistan: Challenges and Opportunities. InProceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility 2020 Oct 26 (pp. 1-4).
12. Kaufman DM. Clinical neurology for psychiatrist, 6th Edition. 2007. Saunder Elsevier. USA.
13. Kim HH`, Kim JW, Heo JH, Kim DY, Sung SJ.Content Validity of Aphasia Screening Test Protocol Commun Sci Disord. 2008;13(3):353-380.
14. Alsawaiti FY. Content Validation of the JAAT: An Aphasia Assessment Designed for Jordanian-Arabic Speaking Population. (2019). 154 pp. Available from: https://libres.uncg.edu/ir/uncg/f/Alswaiti_uncg_0154D_12843.pdf
15. Country Report of Pakistan Regarding Accelerating millennium development goals. Islamabad: Ministry of Education and Training, Government of Pakistan. 2013. Retrieved from http://202.83.164.29/mopttm/userfiles1/file/Year%20Books/Country%20Report%20Pakistan%20Framework%20for%20Education%20MDGs%20Progress%20(Final).pdf
16. Spreen O, Risser AH. Assessment of Aphasia (Third Edition), 1998
17. Herbert R, Hickin J, Howard D, Osborne F, Best W. Do picture-naming tests provide a valid assessment of lexical retrieval in conversation in aphasia? Aphasiology. 2008; 22(2): 184-203. doi.10.1080/02687030701262613
18. Ferstl EC, Walther K, Guthke T, von Cramon DY. Assessment of story comprehension deficits after brain damage. J. Clin. Exp. Neuropsychol. 2005 Apr 1;27(3):367-84.
19. Marshall RC, Wright HH. Developing a clinician-friendly aphasia test. Am J Speech Lang Pathol. 2007;16: 295–315. doi.10.1044/1058-0360(2007/035)
20. Wilson SM, Eriksson DK, Schneck SM, Lucanie JM. A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function. PLoS One. 2018;13(2): e0192773. doi: 10.1371/journal. pone.0192773
21. Fama, ME, Turkeltaub, PE. Treatment of poststroke aphasia: current practice and new directions. Semin Neurol. 2014;34:504-513.

Most read articles by the same author(s)