Date of Award


Document Type



Edith Cowan University

Degree Name

Bachelor of Speech Pathology (Honours)


School of Psychology and Social Science


Faculty of Health, Engineering and Science

First Supervisor

Dr Natalie Ciccone

Second Supervisor

Professor Andrew Whitehouse


Background and aims: Standardised and non-standardised assessments are used in speech pathology to evaluate an individual’s communication abilities post traumatic brain injury (TBI; e.g. Turkstra et al., 2005b). However, valid, reliable and norm-referenced standardised assessments that examine functional communication abilities of individuals post TBI outside of the clinical environment are limited. This study sought to investigate the validity of the Communication Checklist - Adults (CC-A; Whitehouse & Bishop, 2009), a caregiver questionnaire that assesses the communication abilities of individuals post TBI.

Method: The project recruited 14 participants post TBI with varying communicative impairment severities. Each participant completed a routine communication assessment (RCA) which involved administration of a range of assessments. These were 1) the Communication Activities of Daily Living - Second Edition - (CADL-2; Holland, Frattali, & Fromm, 1999), a clinician-administered language assessment that generates percentile scores, with a higher percentile indicating better performance; 2) participation in a conversation which was analysed using Prutting and Kirchner’s pragmatic protocol (PKPP; Prutting & Kirchner, 1987); 3) collection of a monologic discourse sample through two single picture descriptions and description of two picture sequences. Discourse samples were transcribed and a composite of linguistic and pragmatic abilities were generated using measures derived from the Systematic Analysis of Language Transcription (SALT; Miller & Iglesias, 2008), where higher totals on test scoring indicated greater language difficulties. A caregiver or relative of the individual with TBI was also asked to complete the CC-A regarding the individual’s communication ability. The CC-A generated z scores that provided an overall measure of language abilities, as well as subscale measures of linguistic (Language Structure subscale) and pragmatic (Pragmatic Skills subscale and Social Engagement subscale) competence. Lower scores indicated greater difficulties.

Results: Pearson’s correlation coefficients identified a strong positive correlation between the CC-A Overall z-scores and the CADL-2 percentile scores (r(14) = .70, p = .01). There were also statistically significant negative correlations between the CC-A Language Structure z-scores and the SALT Linguistic Composite totals, r(14) = -.65, p = .01, as well as between the CC-A Pragmatic Skills z-scores and SALT Pragmatic Composite totals, r(14) = -.53, p = .05. There were statistical trends for an association between CC-A Social Engagement z-scores and the PKPP ratings (r(14) = .48, p = .08) and between Social Engagement z-scores and the SALT Pragmatic Composite totals (r(14) = -.40, p = .15), but these correlations did not achieve statistical significance.

Discussion: The results of this study provide preliminary evidence that the CC-A is a valid measure of the communication difficulties experienced by individuals with TBI. Future studies that assess a larger number of patients with a greater range of difficulties, will build on the findings presented here.