Semester of Graduation

Fall 2019


Master of Arts (MA)


Communication Sciences and Disorders

Document Type



Background: The Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) survey was designed explicitly for people with aphasia (PWA). Aphasia is an acquired language disorder that may affect comprehension, expression, reading, and writing deficits. Those with severe aphasia may not be able to read the questionnaire. The literature shows that high-context color photographs accompanying text may assist PWA improve their comprehension of questions. A previous study provided face validity for a set of high-context color photographic representations of the SAQOL-39 items. The present study aimed to determine whether these photographs would aid PWA to rate the SAQOL-39 with more than text alone.

Methods: This within-subject repeated measures experiment included the independent variables for stimuli presentation, AAC-Modified or Text-Only, and three dependent variables, response time, rating consistency, and AAC-Modified helpfulness. A convenience sample of PWA between 40 and 89 years old (n=4) attended two separate 1-hour experimental sessions on different days. Stimuli were randomized by the two conditions (AAC-Modified and Text-Only) on day one and then reversed on the second day. The stimuli were presented via E-Prime on a laptop computer, which recorded responses and response time. Helpfulness was rated on a visual analog scale.

Results: Parametric and non-parametric tests indicated no significant difference in response time (t=-1.26, p > .10; Z = -.730, p = .465) between the two conditions. Consistency of ratings between the two conditions was analyzed descriptively and showed no differences between means (AAC-Modified [M = 3.64 ms, SD = 0.46]; Text-Only [M = 3.69, SD =0.42]). Finally, three of the four participants rated the AAC modifications “very helpful,” above 80% helpful, on the visual analog scale.

Discussion: Unfortunately, the sample size was too small to draw definitive conclusions about whether the photographic representations of the SAQOL-39 items are objectively helpful for PWA or not. However, the majority of participants (75%) found the pictures to be “very helpful” in assisting them to self-report their own quality of life after aphasia. Further research with a larger sample size is necessary.

Committee Chair

Neila Donovan