The token test : preliminary normative data and validation for Maltese people with Aphasia

Abstract

Local Speech and Language Pathologists (SLPs) currently lack evaluative tools for assessing Maltese-speaking persons with aphasia (PwA) that have been standardised and normed on the Maltese population. This has resulted in SLPs using informal assessment methods that lack psychometric data to guide them in identifying difficluties and scoring performance. The aim of this research was to improve the clinical use of the Maltese version of the Token Test (TT) by developing preliminary normative data for Maltese-speaking adults and establishing it’s psychometric for PwA. The TT is one of the most popular specific language function tests employed in aphasia, that has been proven to be extremely sensitive in identifying weaknesses that are central to aphasia. The TT was translated to Maltese by Grima in 2016 via a committee approach including a forward-and-backward translation method. In this research TT performance scores were obtained from a sample of 107 individuals without any history of neurological damage and another sample of 19 individuals following a stroke in the subacute phase. The Clock-Drawing Test and the Maltese Aphasia Screening Test were used to control cognitive impairments and language difficulties. The Aphasia Severiy Rating Scale was used for in order to detect and classify the severity of aphasia in neurologically impaired individuals. Descriptive and inferential analysis revealed that typical TT performance was influenced by the participants’ age and level of education. These variables were significant enough for the construction of normative tables stratified by age and education. Gender played no significance on TT performance. The Maltese version of the TT was able to detect typical performance from that of PwA of different severity levels. High levels of validity and reliability were revealed in this research confirming its utility as a clinical tool for Maltese PwA.