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ABSTRACT
Comparative research on aphasia and aphasia rehabilitation is challenged by the lack of comparable assessment tools across different languages. In English, a large array of tools is available, while in most other languages, the selection is more limited. Importantly, assessment tools are often simple translations and do not take into consideration specific linguistic and psycholinguistic parameters of the target languages. As a first step in meeting the needs for comparable assessment tools, the Comprehensive Aphasia Test is currently being adapted into a number of languages spoken in Europe. In this article, some key challenges encountered in the adaptation process and the solutions to ensure that the resulting assessment tools are linguistically and culturally equivalent, are proposed. Specifically, we focus on challenges and solutions related to the use of imageability, frequency, word length, spelling-to-sound regularity and sentence length and complexity as underlying properties in the selection of the testing material.
Acknowledgments
The work reported in this article was undertaken within Working Group 2 (WG2) (Assessment and Outcomes) of COST Action IS1208, Collaboration of Aphasia Trialists (PI and Chair: Marian Brady). Spyridoula Varlokosta was the Lead of WG2 from August 2014 to April 2017 and served as a Deputy Lead from May 2013 to July 2014. Valantis Fyndanis was the Deputy Lead of WG2 from August 2014 to April 2017. We would like to thank Roelien Bastiaanse for leading WG2 from May 2013 to July 2014 and for motivating us to undertake the CAT adaptation project. All authors substantially contributed to the meetings of WG2, where the guidelines for the adaptation process of the CAT were proposed and discussed. The first nine authors and the last author contributed to the writing of the article and to the revisions performed in the review process. The remaining authors provided substantial comments on the original and revised articles. We also thank the following colleagues for their contributions to the work undertaken within WG2: Ingrida Balčiūnienė, Charlotte Jacquemot, Line Haaland-Johansen, Carlos Hernández Sacristán, Monica Blom Johansson, Melita Kovacevic, İlknur Maviş, Carolina Méndez-Orellana, Ingvild Røste, Io Salmons, Ingrid Sör and Müge Tunçer.
Declaration of interest
The authors report no conflicts of interest.
Funding
For the work reported in this article, we were supported by various funding bodies. Our meetings in Working Group 2 were partly supported by grants from COST (European Cooperation in Science and Technology) Action IS1208, Collaboration of Aphasia Trialists. The first author was supported by a Short-Term Scientific Mission grant (reference number COST-STSM-ECOST-STSM-IS1208-131116-080878). The Basque adaptation was partly supported by the MINECO/FEDER (FFI2015-68589-C2-1-P) and the Basque Government (IT983-16 – GIC 15/129). The Catalan adaptation was partly supported by project FFI2014-56968-C4-1-P. The Croatian adaptation was supported by the Croatian Science Foundation through the project Adult language processing (ALP, HRZZ-2421) and by the Operational Programme Human Resources Development through the project Interdisciplinary approach to language model of dyslexia in adult (HR.3.2.01-0247 EU-ESF). The French adaptation was partly supported by Agence Nationale de la Recherche (ANR) grants (#ANR-10- LABX-0087 and #ANR-10-IDEX-0001-02). The Norwegian adaptation was partly supported by the Research Council of Norway through its Centres of Excellence funding scheme, project number 223265. The Serbian adaptation was supported by a project grant (#175012) from the Ministry for Education, Science and Technological Development of the Republic of Serbia. The Spanish adaptation was partly supported by PROGRAM (University of Copenhagen Excellence Programme for Interdisciplinary Research) and projects FFI2015-68589-C2-1-P and FFI2014-61888-EXP (Ministerio de Economía y Competitividad, Spain). The Swedish adaptation was funded by the Swedish National Aphasia Foundation. The Turkish adaptation was partly supported by the Anadolu University Scientific Research Projects Board, project number 1509S632.
Notes
1. Prior to the initiative of our Collaboration, the CAT was adapted to Danish (Swinburn, Porter, & Howard, Citation2014) and Dutch (Visch-Brink, Vandenborre, de Smet, & Mariën, Citation2014). We understand that versions of this test are currently in development for Gulf Arabic, Japanese, Mandarin Chinese, and other languages.
2. Our collaborative network is divided into five WGs. More information on this COST Action can be found here: http://www.aphasiatrials.org/
3. The Bilingual Aphasia Test (Paradis & Libben, Citation1987) has been developed for an impressive range of languages and could have been a candidate for our purposes. However, although it is comprehensive in the sense that it covers a wide range of linguistic domains, it is limited in that it only assesses language. Furthermore, it is long for an assessment tool in a clinical setting, and it is only normed for very few of the languages.
4. Note that several aphasia tests are currently used in different language communities that constitute translations, not adaptations (e.g., the Boston Naming Test; for French: Lapointe-Goupil, Everett, Rousseau, Giguère, Laplante, & Keller, Citation2004; Demers, Robillard, Lafleche, Nash, Heyman, & Fillenbaum, Citation1994; for Swedish: Tallberg, Citation2005; for Spanish: Allegri, Villavicencio, Taragano, Rymberg, Mangone, & Baumann, Citation1997). Given our methodological choice, techniques such as forward and backward translation that are often used in translations of questionnaires are not applicable to our work (cf. the World Health Organization’s recommendations at http://www.who.int/substance_abuse/research_tools/translation/en).
5. For more details about the strengths and weaknesses of the CAT, see Howard, Swinburn, & Porter (Citation2010a, Citation2010b), Bruce & Edmundson (Citation2010), and Springer & Mantey (Citation2010), among others.
6. Rofes, Zakariás, Ceder, Lind, Bloom Johansson, Bjekić, Fyndanis, Gavarró, Simonsen, Hernández-Sacristán, Kuvač Kraljević, Martínez-Ferreiro, Mavis, Méndez Orellana, Meteyard, Salmons, Sör, Tunçer, Vuksanovic, Varlokosta, & Howard (Citation2016) found significant and moderate to strong correlations between the imageability ratings of English words and ratings collected for most of the languages under consideration.
7. See Van Heuven, Mandera, Keuleers, & Brysbaert (Citation2014) for an algorithm implementing Zipf’s law on the distribution of frequency values (Zipf, Citation1949).