American Speech-Language-Hearing Association Functional Assessment of Communication Skills for adults (ASHA-FACS)

Purpose

The ASHA-FACS is a measure of functional communication. It does not aim to measure impairment. Rather, the assessment aims to measure how specific speech, language, hearing and/or cognitive deficits affect the performance of daily life activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
(Frattali, Holland, Thompson, Wohl, & Ferketic, 1995).

In-Depth Review

Purpose of the measure

The ASHA-FACS is a measure of functional communication. It does not aim to measure impairment. Rather, the assessment aims to measure how specific speech, language, hearing and/or cognitive deficits affect the performance of daily life activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
(Frattali, Holland, Thompson, Wohl, & Ferketic, 1995).

Available versions

The ASHA-FACS was developed in 1995 by Frattali, Holland, Thompson, Wohl, and Ferketic.

Features of the measure

Items:
The ASHA-FACS consists of 43 items. The items within the ASHA-FACS address four domains: social communication; communication of basic needs; reading, writing and number concepts; and daily planningPlanning ability involves anticipating future events, formulating a goal or endpoint, and devising a sequence of steps or actions that will achieve the goal or endpoint” (Anderson, 2008, p. 17)
. It covers different activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living (ADLs) such as understanding television and radio, responding in an emergency, and using a calendar (Frattali et al., 1995).

The ASHA-FACS is also subdivided into 2 scales: Communicative Independence and Qualitative Dimensions of Communication. These scales measure the level of independence, and the nature of the functional deficit, respectively (Frattali et al., 1995).

The ASHA-FACS is in an observational format, and requires that the examiner be familiar with the client prior to rating his/her communication. A major strength of the ASHA-FACS is that it has simple wording and behavioral operationalization of item content (Glueckauf, Blonder, Ecklund-Jonhson, Maher, Crosson & Gonzalez-Rothi, 2003).

The examiner can also solicit judgments from the significant others, in order to augment his/her observations (Frattali et al., 1995). It has been recommended that three observational sessions are required before ratings are made (Worrall & Yiu, 2000).

Scoring:
The items are rated after observing functional communication on the two scales.

The Communicative Independence Scale is rated on a 7-point scale ranging from 1) “does not perform the behavior” to 7) “does perform the behavior”. It reflects the extent of assistance the individual requires to perform routine verbal and nonverbal transactions. The Qualitative Dimensions of Communication Scale is rated on a 5-point scale reflecting adequacy, appropriateness, and promptness of communication and communication sharing.

The total score is obtained by summing the scores on each item and then dividing by the number of items (means). It is also possible to calculate both abovementioned scale scores by calculating the means of interest (Frattali et al., 1995).

Lower scores are indicative of greater impairment.

Time:
The ASHA-FACS takes, on average, 20 minutes to score. Administration will vary according to the time spent on the observational sessions (Frattali et al., 1995).

Subscales:
The ASHA-FACS is comprised of 2 subscales (Frattali et al., 1995):
– Communicative Independence
– Qualitative Dimensions of Communication

Equipment:
Not reported.

Training:
Not reported.

Alternative forms of the ASHA-FACS

None.

Client suitability

Can be used with:

• Clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
• Clients with communicative deficits.

Should not be used in:

• The ASHA-FACS should not be used with clients that are not able to communicate.

In what languages is the measure available?

English (Frattali et al., 1995)

Summary

What does the tool measure?	The ASHA-FACS is a measure of functional communication.
What types of clients can the tool be used for?	The ASHA-FACS can be used with, but is not limited to clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	Assessment
Time to administer	The ASHA-FACS takes approximately 20 minutes to administer
Versions	None
Other Languages	English
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.: One study examined the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the ASHA-FACS and reported that, after deleting items with low correlations, all the other items scores and domain scores correlated well with the overall score. Intra-rater: One study examined the intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings. of the ASHA-FACS and reported excellent reliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest . using Pearson correlations. Inter-rater: One study examined the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. of the ASHA-FACS and reported excellent reliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest . using Pearson correlations.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: One study examined the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. of the ASHA-FACS and reported the ASHA-FACS items are representative of the everyday communication of older individuals in Australia. Construct: Convergent: Two studies examined the convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other. of the ASHA-FACS and reported excellent correlations between the social communication domain of the ASHA-FACS and the FOQ; moderate correlations between the ASHA-FACS and Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury. An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery, SCATBI, the communication domain of the Functional Independence Measure, the Rancho Los Amigos Levels of Cognitive Functioning and poor correlations between the ASHA-FACS and the SF-36. Known Groups: One study examined known groups validityKnown groups validity is a form of construct validation in which the validity is determined by the degree to which an instrument can demonstate different scores for groups know to vary on the variables being measured. of the ASHA-FACS using Wilcoxon W and reported that the ASHA-FACS is able to discriminate between healthy individuals and those with communicative impairments.
Floor/Ceiling Effects	No studies have examined floor/ceiling effects of the ASHA-FACS in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
SensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” / SpecificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).	One study examined the sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” /specificity of the ASHA-FACS by comparing it with the AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury. An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Checklist Score, as the gold standardA measurement that is widely accepted as being the best available to measure a construct. and reported that a cut-off of 6.99 in the Communication Independence domain yields a sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” of 90% and a specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative). of 70% while a cut-off of 4.81 in the Communications Dimensions yields a sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.” of 100% and a specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative). of 90%.
Does the tool detect change in patients?	No studies have examined the responsivenessThe ability of an instrument to detect clinically important change over time. of the ASHA-FACS in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Acceptability	Examiners must have adequate opportunity for direct observation of communication at home or in the community. Additional information, as required, may be obtained from the significant other.
Feasibility	The administration of the ASHA-FACS is quick and simple.
How to obtain the tool?	The ASHA-FACS can be purchased from the ASHA website: http://www.asha.org/eWeb/OLSDynamicPage.aspx?Webcode=olsdetails&title=Functional+Assessment+of+Communication+Skills+for+Adults+(ASHA+FACS)

Psychometric Properties

Overview

We conducted a literature search to identify all relevant publications on the psychometric properties of the ASHA-FACS in individuals with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. We identified 5 studies.

Floor/Ceiling Effects

No studies have reported floor or ceiling effects of the ASHA-FACS in clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Reliability

Internal ConsistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.:
Frattali, Holland, Thompson, Wohl, and Ferketic (1995) verified the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the ASHA-FACS in 32 subjects with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and 26 with traumatic brain injury. Items with correlations lower than 0.70 were deleted. All the other item scores and domain scores correlated well with the overall score.

Intra-rater:
Frattali et al. (1995) analyzed the Intra-rater reliabilityThis is a type of reliability assessment in which the same assessment is completed by the same rater on two or more occasions. These different ratings are then compared, generally by means of correlation. Since the same individual is completing both assessments, the rater’s subsequent ratings are contaminated by knowledge of earlier ratings.
, as calculated using Pearson CorrelationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
Coefficient, was excellent (r = 0.99).

Inter-rater:
Frattali et al. (1995) evaluated the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the ASHA-FACS. Speech language pathologists from five different centers throughout the US evaluated 32 subjects with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and 26 with traumatic brain injury. Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
, as calculated using Pearson CorrelationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases - for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases - for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
Coefficient, was excellent (r = 0.82).
Note: the exact number of therapists was not provided.

Validity

Content:
Davidson, Worral and Hickson (2003) analyzed the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension.
of the ASHA-FACS among 30 older Australians (15 with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) and 15 healthy individuals). This observational study reported that the ASHA-FACS items are representative of the everyday communication of older individuals in Australia.

Criterion:
Concurrent:
No studies have reported the concurrent validityTo validate a new measure, the results of the measure are compared to the results of the gold standard obtained at approximately the same point in time (concurrently), so they both reflect the same construct. This approach is useful in situations when a new or untested tool is potentially more efficient, easier to administer, more practical, or safer than another more established method and is being proposed as an alternative instrument. See also “gold standard.”
of the ASHA-FACS in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Predictive:
No studies have reported the predictive validityA form of criterion validity that examines a measure’s ability to predict some subsequent event. Example: can the Berg Balance Scale predict falls over the following 6 weeks? The criterion standard in this example would be whether the patient fell over the next 6 weeks.
of the ASHA-FACS in clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

SensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
/ SpecificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
:
Ross and Wertz (2004) estimated the sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
and specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
of the ASHA-FACS by comparing it with the AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Checklist Score (Ross and Wertz, 2004), as the gold standardA measurement that is widely accepted as being the best available to measure a construct.
, in 10 clients with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada). The aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) checklist score is a diagnostic test that takes into account information collected from the medical records and the World Health Organization’s concepts of disability. In the Communication Independence scale a cut-off of 6.99 yielded a sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
of 90% and a specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
of 70%. In the Communications Dimensions scale a cut-off of 4.81 produced 100% sensitivitySensitivity refers to the probability that a diagnostic technique will detect a particular disease or condition when it does indeed exist in a patient (National Multiple Sclerosis Society). See also “Specificity.”
and 90% specificitySpecificity refers to the probability that a diagnostic technique will indicate a negative test result when the condition is absent (true negative).
.

Construct:
Convergent/Discriminant:
Frattali et al. (1995) assessed the construct validityReflects the ability of an instrument to measure an abstract concept, or construct. For some attributes, no gold standard exists. In the absence of a gold standard , construct validation occurs, where theories about the attribute of interest are formed, and then the extent to which the measure under investigation provides results that are consistent with these theories are assessed.
of the ASHA-FACS by comparing it to the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery (Kertesz, 1982), the Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) (Adamovich & Henderson, 1992), and the communication domain of the Functional Independence Measure (FIM) (Keith, Granger, Hamilton, & Sherwin, 1987) and the Rancho Los Amigos Levels of Cognitive Functioning (Hagen, Malkmus, & Durham, 1972) in 32 subjects with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and 26 with traumatic brain injury. Correlations between the ASHA-FACS and all outcome measures were adequate.
Note: the authors did not report the correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
values.

Glueckauf, Blonder, Ecklund-Jonhson, Maher, Crosson and Gonzalez-Rothi (1993) assessed correlations between the scores of the ASHA-FACS, the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery (Kertesz, 1982), the Functional Outcome Questionnaire for AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) (FOQ-A) (Glueckauf et al., 1993) and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) (Ware & Sherbourne, 1992). All outcome measures were scored by 18 caregivers of individuals with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Correlations were found to be excellent between the social communication domain of the ASHA-FACS and the FOQ-A (r = 0.74) and poor between this domain and the AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient of the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery and the SF-36 (r = 18; r = 0.19, respectively). Correlations between the basic needs domain of the ASHA-FACS and the FOQ-A were adequate (r = 0.58), while correlations between the basic needs domain of the ASHA-FACS and the AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Quotient of the Western AphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person’s ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person’s intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) Battery and the SF-36 were poor (r = -16; r = 0.14), respectively.

Known groups:
Ross and Wertz (2003) verified the ability of the ASHA-FACS to discriminate between healthy elderly individuals (n = 18) and individuals who had experienced strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. and mild aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada) (n = 18). Known groups validityKnown groups validity is a form of construct validation in which the validity is determined by the degree to which an instrument can demonstate different scores for groups know to vary on the variables being measured.
, as calculated using Wilcoxon W, suggested that scores of healthy subjects were significantly higher than the scores of the participants with verbal communicative impairments. Therefore, the ASHA-FACS is able to differentiate between healthy individuals and individuals with mild aphasiaAphasia is an acquired disorder caused by an injury to the brain and affects a person's ability to communicate. It is most often the result of stroke or head injury.
An individual with aphasia may experience difficulty expressing themselves when speaking, difficulty understanding the speech of others, and difficulty reading and writing. Sadly, aphasia can mask a person's intelligence and ability to communicate feelings, thoughts and emotions. (The Aphasia Institute, Canada).

Responsiveness

No studies have reported the responsivenessThe ability of an instrument to detect clinically important change over time.
of the ASHA-FACS in clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

References

• Adamovich, B.B. & Henderson, J. (1992). SCATBI – Scales of Cognitive Ability of Traumatic Brain Injury. Riverside.
• Blomert, L., Kean, M. L., Koster, C., & Schokker, J. (1994). Amsterdam-Nijmegen Everyday Language Test: construction, reliability and validity. Aphasiology, 8, 381-407.
• Davidson, B., Worrall, L., & Hickson, L. (2003). Identifying the communication activities of older people with aphasia: Evidence from naturalistic observation. Aphasiology, 17, 243-264.
• Frattali, C. M., Thompson, C. K., Holland, A. L., Wohl, C., & Ferketic, M. M. (1995). The FACS of Life. ASHA FACS — A Functional Outcome Measure for Adults. ASHA, 7, 40-46.
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See the measure

How to obtain the ASHA-FACS:

The ASHA-FACS can be purchased at the ASHA website and costs $USD165 for a certified non-ASHA member, and $USD124 for an ASHA member. This price does not include taxes and shipping.

Following is the website address for purchasing the ASHA-FACS: https://www.asha.org/