Measures of functional, real-world communication for aphasia: a critical review

Aims: The aim of this article is to identify which existing instrument of functional communication from the aphasia literature best fits with a theoretically founded definition of real-world communication.Background: Aphasia is a language impairment caused by acquired brain damage such as stroke. For successful rehabilitation, a thorough understanding of naturalistic, real-world communication is imperative, as this is the behaviour speech and language therapy (SLT) ultimately aims to improve. In the field of aphasiology, there currently is a lack of consensus about the way in which communication should be measured. Underlying this is a fundamental lack of agreement over what real-world communication entails and how it should be defined.Methods & procedures: In this critical review, we review the instruments that are currently used to quantify functional, real-world communication in people with aphasia (PWA). Each measure is checked against a newly proposed, comprehensive, theoretical framework of situated language use, which defines communication as (1) interactive, (2) multimodal, and (3) based on context (common ground).Outcomes & results: The instrument that best fits the theoretical definition of situated language use and allows for the quantification of communicative ability is the Scenario Test.Conclusions: This article provides a start in a more systematic and theoretically founded approach to the study and measurement of functional, real-world communication in aphasia. More work is needed to develop an instrument that can quantify communicative ability across different aphasia types and severities.