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Validity and Reliability of the Transactional EXchanges in Texting for Aphasia Rating Scale
Jaime B Lee1, Jamie H Azios2, Gerasimos Fergadiotis3
1Department of Communication Sciences and Disorders, University of Utah, Salt Lake City.
Journal of Speech, Language, and Hearing Research : JSLHR
|October 29, 2025
Summary
The Transactional EXchanges in Texting for Aphasia (TEXT-A) rating scale demonstrates excellent reliability and validity for assessing texting abilities in individuals with aphasia. This tool is crucial for rehabilitation efforts targeting text messaging communication.
Area of Science:
- Speech and Language Pathology
- Neurorehabilitation
- Clinical Assessment Tools
Background:
- Text messaging is a vital communication method for individuals with aphasia (PWA).
- Aphasia, often chronic, necessitates reliable tools to assess functional communication skills like texting.
- Existing assessment methods may not adequately capture the nuances of text-based communication for PWA.
Purpose of the Study:
- To evaluate the interrater reliability, internal consistency, and criterion validity of the Transactional EXchanges in Texting for Aphasia (TEXT-A) rating scale.
- To establish TEXT-A as a dependable tool for measuring texting proficiency in people with poststroke aphasia.
Main Methods:
- Sixty individuals with poststroke aphasia participated, with texting script performance rated using the TEXT-A scale (scores 0-2).
- Interrater reliability was assessed using Krippendorff's alpha.
- Internal consistency was determined using greatest lower bound and Cronbach's alpha, while criterion validity was evaluated against the Western Aphasia Battery-Revised (WAB-R) scores (AQ, LQ, Writing subscale) via Spearman correlations.
Main Results:
- Excellent interrater reliability was found, with an average Krippendorff's alpha of .902.
- Acceptable internal consistency was indicated by greatest lower bound (.736) and Cronbach's alpha (.73).
- Moderate-to-strong criterion validity was demonstrated through significant correlations between TEXT-A scores and WAB-R AQ (.58), LQ (.73), and Writing subscale (.73) scores (all p < .001).
Conclusions:
- The TEXT-A rating scale exhibits excellent interrater reliability, acceptable internal consistency, and moderate-to-strong criterion validity in a larger, diverse sample of PWA.
- Findings support the use of TEXT-A as a valid and reliable measure for assessing texting abilities in individuals with aphasia.
- The TEXT-A scale can inform rehabilitation strategies aimed at improving text messaging communication for PWA.
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