Validity and Reliability of the Turkish Version of the Communicative Effectiveness Index (CETI-TR) in Post-Stroke Aphasia.

BACKGROUND

Assessment of communication in individuals with aphasia requires tools that capture not only linguistic abilities but also functional communication in everyday life. The Communicative Effectiveness Index (CETI) is a widely used caregiver-reported measure; however, a validated Turkish version is not currently available.

OBJECTIVE

This study aimed to culturally adapt the CETI into Turkish (CETI-TR) and to examine its validity and reliability in individuals with aphasia.

METHODS

This cross-sectional study included 55 individuals with stroke (20 with aphasia, 35 without aphasia) and their caregivers. The adaptation process involved translation, back-translation, expert review, and pilot testing. Participants were assessed using the CETI-TR, the Language Assessment Test for Aphasia (LATA), and Quick Aphasia Battery-Turkish Version (QAB-TR). Internal consistency was evaluated using Cronbach's alpha. Test-retest and cross-informant agreement (between caregivers and clinicians) were assessed using correlation analysis and intraclass correlation coefficients (ICCs). Criterion validity was examined through correlations with LATA and QAB-TR scores, while discriminant validity was evaluated by comparing individuals with and without aphasia.

RESULTS

The CETI-TR demonstrated excellent internal consistency (Cronbach's alpha = 0.984), with item-total correlations ranging from 0.766 to 0.964. Test-retest reliability showed high stability (ICC = 0.972). Cross-informant agreement between caregivers and speech-language therapists was high (ICC = 0.936), with no significant difference between ratings (p = 0.246). Moderate, significant correlations were found between CETI-TR scores and LATA (r = 0.439, p = 0.001) and QAB-TR (r = 0.524, p < 0.001). Individuals with aphasia had significantly lower CETI-TR scores than those without aphasia (p < 0.001).

CONCLUSION

The CETI-TR is a valid, reliable, and clinically applicable tool for assessing functional communication in Turkish-speaking individuals with post-stroke aphasia. It provides an ecologically valid measure that can support clinical evaluation, intervention planning, and outcome monitoring in aphasia rehabilitation.