Effects of scheduling on the communicative assessment of aphasic patients

This study determined the influence of morning and afternoon scheduling on the assessment of communicative skills of aphasic patients. Eight short-term (3 to 9 months post-onset) and eight long-term (12 or more months post-onset) aphasic subjects were administered 11 tests from the Porch Index of Communicative Ability (PICA) at specified times in the morning (A.M.) and afternoon (P.M.). Order of scheduling (A.M. first, P.M. second; P.M. first, A.M. second) was determined randomly but balanced between groups. Results indicated an absence of significant main effects for onset, scheduling, and test order; however, significant interactions between the scheduling and test-order factors were evidenced on the naming and auditory identification tests and on all overall measures. Analyses of these interactions revealed that patients scheduled first in the A.M. decreased their mean scores when assessed a second time in the P.M., whereas those scheduled first in the P.M., increased their scores when seen a second time in the A.M. Findings suggest that aphasic patients can be expected to do better on morning than afternoon assessments regardless of the order in which they are scheduled. Clinically, this indicates a need for consistency in the scheduling of periodic assessments for individual aphasic patients.