A transcription-less quantitative analysis of aphasic discourse elicited with an adapted version of the Amsterdam-Nijmegen Everyday Language Test (ANELT)

Abstract

ABSTRACT Background For speakers with mild to moderate expressive aphasia the ultimate goal of aphasia therapy is to improve verbal functional communication, which may be assessed with the Amsterdam-Nijmegen Test for Everyday Language (ANELT; Blomert et al., 1995). The ANELT is based on a qualitative and transcription-less method of analysis: the scoring is based on personal judgement and directly made from the recording of the test. Previous research (Ruiter et al., 2011) has shown that a quantitative measure for the ANELT not only allows verbal effectiveness (i.e., the amount of essential information conveyed) to be measured more sensitively, but also allows derivation of a measure of verbal efficiency (i.e., average amount of essential information produced per time unit). Although the quantitative scoring further improved the construct validity of the ANELT, there is a limitation that hinders its clinical application: the quantitative measure requires orthographic transcription of the spoken responses to the test. That is, the quantitative scoring is transcription-based. Aims In order to work towards clinical applicability of the quantitative measure of the ANELT, this study addressed the potential of a transcription-less variant of the quantitative analysis, in which the amount of essential information is directly quantified on the basis of recording, as a valid and reliable procedure for the measurement of verbal effectiveness. Methods & Procedures A total of 56 speakers of Dutch participated: 31 neurologically healthy speakers and 25 persons with aphasia. Monologic discourse elicited with 10 scenarios from an adapted version of the ANELT (Ruiter et al., 2016) was analysed with both a transcription-based quantitative method and a transcription-less quantitative one. Resulting data were systematically compared on the following psychometric properties: internal consistency, inter-rater reliability, construct validity, convergent validity, and known-group validity. Outcomes & Results Internal consistency and inter-rater reliability were good and comparable between both scoring methods. Only for one scenario did the transcription-based scoring method yield higher agreement among the raters. With respect to validity, both scoring methods seem to yield measures of the same underlying constructs, show a strong and positive correlation, and allow differentiation between persons with and without aphasia. Conclusions Although future research is needed to develop norm scores and investigate other psychometric properties, the result from the comparison demonstrated the potential of the transcription-less quantitative method as a valid and reliable method to analyse monologic discourse elicited with the adapted ANELT.