A Tablet-Based Aphasia Assessment System “STELA”: Feasibility and Validation Study

Abstract

Background There is an extensive library of language tests, each with excellent psychometric properties; however, many of the tests available take considerable administration time, possibly bearing psychological strain on patients. The Short and Tailored Evaluation of Language Ability (STELA) is a simplified, tablet-based language ability assessment system developed to address this issue, with a reduced number of items and automated testing process. Objective The aim of this paper is to assess the administration time, internal consistency, and validity of the STELA. Methods The STELA consists of a tablet app, a microphone, and an input keypad for clinician’s use. The system is designed to assess language ability with 52 questions grouped into 2 comprehension modalities (auditory comprehension and reading comprehension) and 3 expression modalities (naming and sentence formation, repetition, and reading aloud). Performance in each modality was scored as the correct answer rate (0-100), and overall performance expressed as the sum of modality scores (out of 500 points). Results The time taken to complete the STELA was significantly less than the time for the WAB (mean 16.2, SD 9.4 vs mean 149.3, SD 64.1 minutes; P<.001). The STELA’s total score was strongly correlated with the WAB Aphasia Quotient (r=0.93, P<.001), supporting the former’s concurrent validity concerning the WAB, which is a gold-standard aphasia assessment. Strong correlations were also observed at the subscale level; STELA auditory comprehension versus WAB auditory comprehension (r=0.75, P<.001), STELA repetition versus WAB repetition (r=0.96, P<.001), STELA naming and sentence formation versus WAB naming and word finding (r=0.81, P<.001), and the sum of STELA reading comprehension or reading aloud versus WAB reading (r=0.82, P<.001). Cronbach α obtained for each modality was .862 for auditory comprehension, .872 for reading comprehension, .902 for naming and sentence formation, .787 for repetition, and .892 for reading aloud. Global Cronbach α was .961. The average of the values of item-total correlation to each subscale was 0.61 (SD 0.17). Conclusions Our study confirmed significant time reduction in the assessment of language ability and provided evidence for good internal consistency and validity of the STELA tablet-based aphasia assessment system.

Research hotspots and frontiers of post-stroke aphasia rehabilitation: a bibliometric study and visualization analysis

“…In addition, various language function screening tools such as the Language Screening Test (LAST) (Flamand-Roze et al, 2011), ScreeLing (Doesborgh et al, 2003), etc., have been developed to enable treatment-oriented assessment of language function in a short period of time in a clinical setting (El Hachioui et al, 2017). Among them, The Short and Tailored Evaluation of Language Ability (STELA), a newly developed computer-based Japanese language proficiency assessment system for patients with aphasia, simplifies the administration of test entries by computer, automates the recording of scores and supplements them with additional objective measurements (e.g., reaction time), greatly reducing the testing time for patients (Inamoto et al, 2023). Since most current tools for assessing language function follow neural models rather than psycholinguistic theories, the assessment validity of post-stroke aphasia patients may be affected if they also have cognitive impairment or psycho-behavioral disorders, and other coexisting neurological deficits, such as apraxia or visual field deficits, may hinder the prognostic outcome of post-stroke aphasic patients and need to be evaluated together (Kertesz, 2022).…”