Relationship between Aphasia Impairment and Communication Confidence in Mild Aphasia

ABSTRACT

Purpose

Aphasia is a post-stroke condition that can dramatically impact a person with aphasia’s (PWA) communication abilities. However, clinicians often focus on level of impairment as their primary outcome of interest. An emerging literature suggests that greater emphasis should be placed on the impact that aphasia has on communication confidence and how it is influenced by the level of aphasia impairment.

Methods

To examine the interrelationship between aphasia impairment and communication confidence in individuals with mild aphasia, data from 12 PWA related to impairment and communication confidence were collected at the time of enrollment in a telepractice rehabilitation program. Impairment was measured with the Western Aphasia Battery – Revised (WAB-R) aphasia quotient (AQ) as well as individual subtest scores and communication confidence was measured using the Communication Confidence Rating Scale for Aphasia (CCRSA). Bayesian descriptive statistics and regression estimation were used to examine the interrelationship between these instruments controlling for basic demographic heterogeneity.

Results

Bayesian discrete dependent variable analysis showed that CCRSA was positively correlated with age (β =0.015, sd=0.00012), education level (β=0.023, sd=0.00052), and WAB-R repetition (β=0.0276, sd=0.00321), but only slightly, negatively related to WAB-R AQ (β= -0.0013, sd=0.0002), WAB-R auditory comprehension (β= -0.223, sd=0.26926), and WAB-R naming (β= -0.5425, sd=0.38406).

Conclusions

Communication of confidence was only slightly correlated with aphasia impairment, but significantly and positively correlated with age and educational level in individuals mild with aphasia. These findings suggest that in individuals with the mildest form of aphasia, communication confidence is primarily driven by specific individual, nonclinical characteristics unique to the PWA and their communication demands rather than the absolute level of communication impairment.

KEYWORDS:

• aphasia
• impairment
• communication confidence

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Agency for Healthcare Research and Quality Grant #: 1 R03 HS025043-01A1 awarded to the last author.