Master of Arts (MA)


Communication Sciences and Disorders

Document Type



Background: The Stroke and Aphasia Quality of Life-39 (SAQOL-39) is a valid and reliable measure of quality of life (QOL) for stroke survivors and people with mild-to-moderate aphasia However, it could not be validated for people with severe aphasia due to their language deficits. Research has shown that combining pictures with written text can support communication effectiveness of people with aphasia. Combining language modalities in this way is a form of alternative or augmentative communication (AAC). The use of AAC has been explored as a possibility to improve communication for people with severe aphasia (Dietz, McKelvey & Beukelman, 2006). Aim: This study sought to examine whether photographic representations of the SAQOL-39 would improve self-reported ratings when completed by people with moderate to severe aphasia. Methods: This study was a prospective, within group design. Four adults with moderate to severe aphasia self-reported their QOL rating through the SAQOL-39. All participants completed the SAQOL-39 in two conditions: written text only, and written-text paired with photographic representations. A 5-point rating scale, derived from the SAQOL-39, was displayed onscreen for participant rating of the degree to which they believed specific aspects of QOL had been impacted by their aphasia. Levels of instruction required to elicit a response were recorded for every item to conclude whether the photographs reduced the amount of researcher cueing required for each item. The mean response time for each item was also recorded. Results: The method of data analysis was changed secondary to recruitment of only four participants. Results of the Wilcoxon Signed Ranks Test (a = .05) showed that the text plus photograph condition compared to the text only condition did not result in QOL rating changes [(Mdn = 0), Z = -.66, p = .551]. Likewise, the Wilcoxon Signed Ranks Test (a = .05) showed that the text plus photograph condition compared to the text only condition did not result in faster rating response time [(Mdn = 0), Z = -.94, p = .348]. Descriptively, comparison of changes in level of instruction between the two conditions showed no differences either. Discussion: Further research is encouraged to discover an approach for allowing people with severe receptive aphasia to self-report on their QOL. Replication of this study with a larger sample size is essential to further investigate the effect of using photographic representations of the SAQOL-39 to improve ratings with people with severe receptive aphasia.



Document Availability at the Time of Submission

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Committee Chair

Donovan, Neila