Rijndam Rehabilitation Centre, Rotterdam, the Netherlands.
Int J Lang Commun Disord. 2010 Jul-Aug;45(4):424-35. doi: 10.3109/13682820903111952.
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.
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 alpha = 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 kappa 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.
本研究旨在探讨情景测试的心理测量学特性，该测试是一种新的评估严重失语症患者日常生活沟通的工具。该测试的创新性在于：（1）检查言语和非言语沟通的有效性；（2）在互动环境中，与支持性沟通伙伴一起评估患者的沟通情况。
确定情景测试的信度、效度和变化敏感性，并讨论其临床价值。
对 122 名中风后失语症患者和 25 名非失语症对照者进行了情景测试。对整个失语症组以及无法进行言语交流的亚组（n=43）进行了分析。使用标准心理测量方法检查了信度（内部一致性、重测信度、评判间和评判内信度）和效度（内部效度、收敛效度、已知组效度）以及变化敏感性。
情景测试显示出较高的信度水平。内部一致性（克朗巴赫的 α=0.96；项目-残差相关=0.58-0.82）和重测信度（ICC=0.98）较高。评分的评判间和评判内一致性良好，表明评判间和评判内信度较高（ICC=0.86-1.00）。单项评分的一致性也很好（平方加权 kapp 值为 0.61-0.92）。该测试表现出较好的效度水平。类别数据的主成分分析确定了两个维度，可解释为一般沟通和交际创造力。与另外三个评估失语症患者沟通的工具，即亚琛失语症测试（AAT）的自发性言语访谈、阿姆斯特丹-奈梅亨日常语言测试（ANELT）和交际效果指数（CETI）之间的相关性为中等至较强（0.50-0.85），表明具有良好的收敛效度。在失语症患者与非失语症对照组之间，以及在无法用言语传达信息的失语症患者与能够进行言语交流的患者之间观察到了组间差异，这表明具有良好的已知组有效性。该测试对 6 个月内的表现变化敏感。
数据支持情景测试作为评估失语症患者日常生活沟通的工具的可靠性和有效性。该测试侧重于多模态沟通；其心理测量特性使未来能够研究替代和增强沟通（AAC）在失语症中的训练效果。
