Validity, reliability and sensitivity of the NORLA-6: Naming and oral reading for language in aphasia 6-point scale.
Laura L Pitts, Rosalind Hurwitz, Jaime B Lee and 2 others
PMID 28425326WHAT IT FOUND
The NORLA-6 scale accurately tracks oral reading and naming progress in people with nonfluent aphasia.
Unlike standard tests that often score severely impaired patients as zero, it captures partial responses. This allows therapists to measure small gains and justify treatment without lengthy assessments.
Key findings
01The scale correlates strongly with established tests for oral reading and naming, confirming it measures the same language abilities.
02Therapists can learn to use the scale reliably within two to three hours, and it requires no special training to interpret.
03The scale detects significant improvement in oral reading accuracy and rate after six weeks of treatment, even when standard tests show floor effects.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The validation applies only to the specific sentence and picture stimuli used in this study; it may not work the same way for other materials. The study only included people with nonfluent aphasia, so it is unclear if the scale is equally valid for fluent aphasia or other causes like traumatic brain injury. The scale measures only verbal responses and does not account for nonverbal communication, which is often significant in aphasia. The statistical assumption that the ordinal scores (0-5) can be averaged and treated as interval data has not been empirically confirmed.
Declared interests
The study was supported by the National Institute on Deafness and Other Communication Disorders (NIDCD) and the National Institute of Neurological Disorders and Stroke (NINDS). No commercial conflicts of interest were reported.
The easy way to misread this
Do not assume the scale is validated for all types of aphasia or all language tasks. The study only tested people with nonfluent aphasia using specific reading and naming probes. Using it for fluent aphasia, writing, or conversation may not yield valid results.