SLPSystematic ReviewInternational journal of language & communication disorders2025

Assessing Functional Communication in Persons With Aphasia: A Scoping Review of Formal and Informal Measures.

Lauren Hammond, Thomas Christensen, Julius Fridriksson and 1 others

PMID 40346989

WHAT IT FOUND

No standardized aphasia assessment fully captures real-world communication.

Formal tools miss multimodal or interactive elements. Informal tools vary widely in definition. Clinicians must combine tests to see the whole picture of patient function.

Key findings

01No standardized functional communication assessment for aphasia explicitly addresses contextuality, multimodality, and interactiveness together.

02Only two informal assessments were identified that comprehensively evaluate all three criteria: real-life context, multiple communication modes, and interactive exchange.

03Informal non-standardized measures make up almost 90% of the functional communication assessments identified, leading to inconsistent definitions of what is being measured.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The definition of 'functional communication' is inconsistent in the literature, making it difficult to set clear boundaries for which tools to include. The review only included studies published in English, potentially excluding relevant tools developed in other languages. The review focused exclusively on aphasia, excluding other communication disorders that might share assessment tools. The classification of tools into formal and informal was based on the authors' criteria, which may not align with all clinical perspectives.

Declared interests

No conflicts of interest or funding sources are explicitly declared in the provided text.

The easy way to misread this

Do not assume that a low score on a standardized test like the ANELT or CADL-3 means the patient has no functional communication abilities. These tests may miss multimodal or interactive strengths that are better captured by informal assessments.

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