Development and validation of Thought, Language, and Communication Assessment Scale for Persons with Aphasia

Introduction: Aphasia impacts language and thought organization, disrupting effective communication. Thought, Language, and Communication (TLC) are interrelated, and breakdowns in one domain often affect the others. A comprehensive assessment tool is essential to understand and address these interlinks. This study aimed to develop and validate the Thought, Language, and Communication Assessment Scale for Persons with Aphasia (TLCAS-PWA) for Persons with Aphasia (PWA) and Neurotypical Individuals (NTI).

Method: The tool was developed through literature review and expert validation, comprising 14 parameters across communication, language, and thought domains, rated on a 5-point scale. It was administered to 20 PWA and 20 NTI.

Results: Among PWA, PCS showed the highest mean scores, while Self-reference was least frequent. At the domain level, both PWA and NTI had higher scores in Communication Disorder and lower in Language Disorder. Mann-Whitney U tests revealed significant differences between groups across all the domains. Psychometric analysis showed good internal consistency (α = 0.88), excellent inter-rater reliability (ICC = 0.98), and stable test–retest reliability.

Conclusion: TLCAS-PWA is a valid tool that aids clinicians in assessing TLC in aphasia, supporting diagnosis, intervention, and progress monitoring.