Purpose: Aphasia is an acquired language disorder in which auditory comprehension skills are one of the distinguishing characteristics used to identify the type of aphasia. Patients can develop symptoms that include deficits of comprehension depending on whether it is retained or damaged, which highlights the evaluation and treatment of aphasia in the care of patients with aphasia. The goal of this study was to examine the validity and reliability of the Word Level Auditory Comprehension Test (SİAT), the first assessment instrument tool in Turkish designed with the purpose of assessing aphasics' auditory comprehension.
Method: 112 participants over 18 (35 with aphasia and 77 healthy) whose native language was Turkish took part in this study. The validity study was carried out with structural and criterion validity analyses and the reliability examination with internal consistency, stability, and coefficients of equivalence. The cut-off score was determined by ROC analysis. In addition, it was examined whether SIAT scores of aphasic and healthy participants differed significantly according to aphasia type (fluent and non-fluent) or demographic variables (age, education, gender).
Results: The SIAT and the ADD subtest of the Auditory Comprehension Assessment revealed a significant positive correlation (r = 0.768; p<0.001). The item analysis verified that item difficulty and item discrimination indices were at acceptable levels, meaning that no items needed to be eliminated. The Cronbach's Alpha (α) coefficient of the sub-sections of SIAT was observed to be quite reliable (α= 0.741, 0.791 and 0.893, respectively). In the test-retest application, a positive and significant relationship was found between the pre- and post-measurements (r=0.972; p<0.05). A composite measure of intra-observer and inter-observer variability, the intraclass correlation coefficient (ICC) was computed to be 0.99 and was found to be completely dependable (%95 CI [0,91-1,00], p<0,001). In terms of inter-rater reliability, it was shown that the variables of aphasia type, age, education level, and gender had an impact on the SIAT scores of the aphasia participants (p<0.05), but the variable that only had an impact on the SIAT scores of the healthy participants was education level (p<0.05). The cut-off score for SIAT was determined to be 34.5 out of 50.
Conclusion: It was determined that the SIAT is a valid and reliable test for assessing the auditory comprehension ability of Turkish-speaking aphasics, and that age, gender, and educational attainment have an impact on the SIAT total score. The cut-off value of 34.5 points can be practically used in both research and clinical practice to differentiate between fluent and non-fluent aphasia.
aphasia, auditory comprehension, Word Level Auditory Comprehension Test- SİAT, validity, reliability
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