Master of Arts (MA)


Communication Sciences and Disorders

Document Type



Speech-language pathologists must consider the clients’ quality of life (QoL) to provide effective and meaningful evidence-based treatment (ASHA, 2005). Quality of life assessment goes beyond language impairments and is often a key part of planning intervention. However, few QoL measures exist for people with aphasia (PWA). The Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39; Hilari, 2003) is one of the few valid and reliable measures used to assess QoL in people with mild to moderate aphasia. However, the validity and reliability of the SAQOL-39 has not been established for individuals with severe aphasia who are unable to read and comprehend the written items (Hilari & Byng, 2001). Proxy reports for people with severe aphasia are not reliable and can contribute to misinterpretation of people with severe aphasia and their QoL (Hilari & Byng, 2009). High-context color photographs may access intact linguistic processes in PWA by bypassing their reading deficits (McKelvey, Hux, Dietz, & Beukelman, 2010). Therefore, visual aids may enhance accessibility of written assessments like the SAQOL-39 for people with severe aphasia. Preliminary content validity has been established for high-context color photographs paired with SAQOL-39 items by normal aging adults (Brouwer, 2013). The present study aimed to continue to establish the content validity of the photographs by investigating how 10 adults with mild to moderate aphasia, aged 30-89 years, rated similarities of photographic representations of SAQOL-39 items, rated on a 7-point Likert scale. The present results supported high content validity of photographic representations. The overall mean rating of items was 6.40 and 92% of the photographs were rated a 6 or 7 at least 60% of the time, indicating most people with mild to moderate aphasia rated photographs highly similar to the written questions they were paired with. This study’s results suggest the photographs may make the SAQOL-39 more accessible for people with severe aphasia to self-report on their QoL. Further research is warranted to investigate accessibility of the photographs among the severe aphasia population.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Donovan, Neila