Validity, reliability and sensitivity of the NORLA-6: Naming and oral reading for language in aphasia 6-point scale

Abstract

Purpose: Evaluation of the Naming and Oral Reading for Language in Aphasia 6-point scale (NORLA-6), a scoring system of oral reading and naming performance in aphasia.

Method: Data were drawn from 91 participants with non-fluent aphasia secondary to left-hemisphere stroke across four treatment studies. To assess validity, Spearman’s correlations were calculated between the NORLA-6 and the Gray Oral Reading Test-Fourth Edition (GORT-4) Accuracy score, GORT-4 Rate score and the Boston Naming Test (BNT). Inter-rater and test–retest reliability were evaluated using correlations. Sensitivity to change following oral reading intervention was analysed using Wilcoxon Signed Rank tests between pre- and post-treatment NORLA-6 scores.

Result: NORLA-6 performance was significantly correlated (p < 0.001) with all reference tests (GORT-4 Accuracy, r_s=0.84; GORT-4 Rate, r_s= 0.61; and BNT, r_s= 0.92). Inter-rater (ICC ≥0.90) and test–retest (r > 0.92) reliability were both excellent. Sensitivity following oral reading intervention was demonstrated in both oral reading accuracy and rate (p < 0.004).

Conclusion: The NORLA-6 is a valid and reliable measure of oral reading and naming performance. It also demonstrates sensitivity to change in treatment-targeted behaviours. Therefore, the NORLA-6 scale may enhance outcome measurement in both clinical practice and aphasia research.

Keywords:

• Aphasia
• outcomes
• oral reading
• assessment
• validity
• reliability

Acknowledgements

Supported by Grants H133G040269, H133G060055 and H133G070074 (to L.R.C.) from the National Institute on Disability and Rehabilitation Research, Department of Education, and by Grants 5R21DC9876 and 1R01DC011754 (to L.R.C.) from the National Institute on Deafness and Other Communication Disorders, National Institutes of Health. We extend our thanks to Edna M. Babbitt, M.Ed., who contributed to the development of the original version of the NORLA-6. Conclusions and recommendations are those of the authors and do not reflect the views of the funding organisations. Endorsement by the Federal Government should not be assumed.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Supplementary material Appendices A, B, C1 and C2 can be found as supplementary data in the online version of this article at DOI: 10.1080/17549507.2016.1276962