Validity and satisfaction in telehealth aphasia assessment: videoconference administration of the Comprehensive Aphasia Test-Hungarian

ABSTRACT

Background

The demand for telehealth aphasia assessment is increasing, yet only a limited number of instruments’ validity and feasibility in telehealth have been evaluated. The Comprehensive Aphasia Test (CAT) is a widely available language test with established psychometric properties in several languages, including Hungarian.

Aims

The current study aimed to evaluate the validity of administering the Hungarian version of the CAT (CAT-H) via videoconference and explore the satisfaction of people with aphasia (PWA) with videoconference assessment compared to in-person assessment.

Methods & Procedures

Twelve PWA with left hemisphere stroke (mean age = 50.83 years, mean post-onset = 19 months), exhibiting mild-to-moderate aphasia, completed both in-person and videoconference assessments using the CAT-H Language Battery. The study used a comparison design, incorporating elements of counterbalancing and blinding. The assessments were conducted by speech-language pathologists (SLPs), with one person leading the in-person assessment and another leading the videoconference assessment for each participant. The order of administration (in-person or videoconference) was counterbalanced across participants. SLPs leading the second assessments were blind to the results of the first assessments. One key adjustment for the videoconference assessment was the utilisation of the screen sharing and/or control sharing features within the videoconferencing software. Participants also filled out a satisfaction questionnaire after each assessment and expressed their preference between the two assessment methods at the end of the study. Intraclass correlation coefficients (ICCs) were calculated to compare the CAT-H modality summary scores and the CAT-H language battery score between in-person and videoconference assessments.

Outcomes & Results

There was good-to-excellent agreement between in-person and videoconference assessments, with ICCs ranging from 0.80 to 0.96 (p < 0.001) for the CAT-H modalities and an ICC of 0.97 for the CAT-H language battery score. At the individual level, minor inconsistencies were observed in the language battery score between the two assessments. Participants reported high satisfaction with both assessment methods, with satisfaction levels for the videoconference assessment being comparable to those for the in-person assessment. While the majority of participants did not exhibit a preference between the two methods in terms of understanding the clinician, approximately half of them favoured the in-person assessment for expressing themselves and comfort.

Conclusions

Obtained results suggest that the CAT-H can be effectively administered via videoconference, offering a viable alternative to in-person assessment when necessary. Future studies should replicate these findings with a larger and more diverse study sample, involving participants with moderately severe and severe aphasia.

KEYWORDS:

• Aphasia
• videoconference assessment
• telehealth
• Comprehensive Aphasia Test
• feasibility

Acknowledgements

We thank all participants for taking part in the study; and the chief physicians and the medical director of the hospital for supporting the study.

Disclosure statement

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

Author contribution

Conceptualization: Lilla Zakariás

Data curation: Nóra Földesi-Ozvald, Csenge Magyar, Vivien Vásári, Lilla Zakariás, Lili Buzás

Formal analysis: Lilla Zakariás

acquisition: Lilla Zakariás

Methodology: Lilla Zakariás, Nóra Földesi-Ozvald, Csenge Magyar

Supervision: Lilla Zakariás

Visualization: Lilla Zakariás

Writing – original draft: Lilla Zakariás

Writing – review & editing: Lilla Zakariás, Nóra Földesi-Ozvald, Csenge Magyar, Vivien Vásári, Lili Buzás

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02687038.2024.2362864

Notes

1. Please note that participants were included in the study based on their WAB results. Thus, scoring above the cut-off in the CAT-H was not a reason to exclude participants from the study.

Additional information

Funding

LZ was supported by the Hungarian National Research, Development and Innovation Office under Grant FK 131828 (principal investigator: LZ).