Validity and Reliability of the Turkish Version of the Communicative Effectiveness Index (CETI-TR) in Post-Stroke Aphasia
Brain and Behavior, vol.16, no.8, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 16 Issue: 8
- Publication Date: 2026
- Doi Number: 10.1002/brb3.71711
- Journal Name: Brain and Behavior
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Keywords: aphasia, CETI, communicative effectiveness, functional communication, stroke, validity and reliability
- Ankara Yıldırım Beyazıt University Affiliated: Yes
Abstract
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.