Assessing functional communication in aphasia: clinical utility and time demands of three methods

A variety of methods has recently been used to assess everyday communication abilities in aphasic adults. This study compares three such methods for their clinical utility and the amount of a therapist's time they use. The three methods employed a standard rating schedule completed by relatives, analysis of speech elicited through role-play and a partial analysis of everyday conversation samples. The utility of these assessments as a clinical tool was measured in terms of the therapist's time needed, and the assessment's ability to show stability or change of communicative effectiveness on test-re-test measures and to illuminate areas for therapeutic intervention. Eight aphasic adults (five acute and three chronic) were tested on all three assessments, then re-tested after a period of 3 months. The results suggested that, although more time-consuming, the partial conversational analysis was a more sensitive measure of stability or change of communicative effectiveness over time than the other two measures, and had the potential advantage for indirect intervention of revealing conversational strategies used by the partner as well as those used by the aphasic individual.