Validation of Communication Activities of Daily Living- Second Edition (CADL-2) on Arab Aphasics: Controlled Study

Sadeq Ali Saad Al Yaari, Nassr Almaflehi


Background: While language-related tests including communication activities of daily living-second edition (CADL-2) test showed that alike were able to test language-related functional and communication skills, psychoneurolinguists and speech language pathologists/ Therapists (SLP/Ts)’s responses varied between accepting or rejecting the results of this test.

Purpose: Previous studies suggest that results of CADL-2 do not differ with both gender aphasics suffering from different language impairments. Thus, the current study tested the validity and reliability of this test among Arab aphasics.

Design: CADL-2 Pre-and-posttest was administered twice in three weeks to test the communication activities of daily living of 100 aphasic participants of both sexes.
Settings: Al Khars hospital in Al Ahsa’a, Kingdom of Saudi Arabia (KSA).

Participants: A total of 100 (50 men and 50 women) gender aphasic participants who suffer from different language deficits were enrolled in this experimental study.

Procedures: Having the English version of CADL-2 translated into Arabic and standardized by three Arabic language experts, the first CADL-2 (Arabic version) test (pre-test) was administered to the participants under investigation in the first week and after two weeks (exactly at the end of the third week)., the second CADL-2 (posttest) was administered. Both tests were conducted in natural environment without any influence from testers or participants’ families.

Interventions: Results including gender-specific differences were qualitatively and statistically analyzed and comparisons were made to illustrate these results.

Main outcomes & Results: The analysis results of each aphasic participant show that no significant differences were observed in CADL-2 pre-and-posttest. The test could test what it was supposed to test. Moreover, the results of the participants’ pre-and-posttest are similar with mean of percentile in the pre-and-posttest surging 29.5% and 28.6% and Stanine scores surging 3.4% and 3.32% for males in comparison to the female aphasic participants who scored 28.16% and 28.78% in the percentile and 3.38% and 3.38% in the Stanine scores. Taken together, the results demonstrate that the level of aphasics’ communication activities is low. Such results prove that the test is also reliable.

Conclusions & Implications: CADL-2 is considered to be a validated tool for the assessment of Arab aphasic patients of both sexes. These results also provide much needed quantitative data for the diagnosis of language impairments in Arab aphasic patients.

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