Master of Arts (MA)


Communication Sciences and Disorders

Document Type



Background: The Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) is a valid, reliable quality of life (QoL) assessment for PWA (Hilari, 2003; Hilari, Byng, Lamping, & Smith, 2003). However, individuals with severe aphasia are unable to use it because their ability to comprehend the text is too severely impaired for accurate self-report (Hilari & Byng, 2009; Hilari et al., 2003; Hilari, Owen, & Farrelly, 2007). Proxy respondents often report on QoL measures for these individuals; however, studies suggest differences between proxy-reported and self-reported scores in less severe populations (e.g., Cruice, Worrall, Hickson, & Murison, 2005; Engell, Hütter, Willmes, & Huber, 2003; Hilari et al., 2007). Therefore, proxy-reported scores may not be reliable substitutes (Cruice et al., 2005). Incorporating images may increase accessibility of text to individuals with severe aphasia by drawing upon intact visuo-spatial abilities (Dietz, Hux, McKelvey, Beukelman, & Weissling, 2009; Dietz, McKelvey, & Beukelman, 2006; Elmore-Nicholas & Brookshire, 1981; Engell et al., 2003; Rautakoski, Korpijaakko-Huuhka, & Klippi, 2008). Objective: This study assessed similarities between high-context, colored photographs and SAQOL-39 questions. Methods: This study employed a non-experimental, within-group design. Twenty individuals between 65-85 with no history of aphasia completed a 7-point Likert scale rating task wherein they rated the degree of similarity between photographs and SAQOL-39 questions. Three expert reviewers evaluated the photographs before being used as stimuli. Results: Results of the 7-point Likert scale rating task revealed a mean rating of 6.06 (range 5.05 – 6.70) for all 42 photograph-question pairings (i.e., three training items plus 39 items). Thirty-nine of the total 42 photographs (93%) were rated > 6 at least 60% of the time. Thirty-seven of the 39 actual scored SAQOL-39 questions (95%) were rated > 6 at least 60% of the time. The mean standard error of the mean (SEM) for all 42 photographs was 1.44. The average mode was 7.00, and the average median was 6.74. Conclusion: Results indicated that photographs were rated as being similar to SAQOL-39 questions. Further research is warranted to evaluate if the photographs enhance accessibility of the SAQOL-39 to individuals with severe aphasia allowing for self-report.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Donovan, Neila