Year of Award


Document Type


Degree Type

Master of Science (MS)

Degree Name

Speech-Language Pathology

Department or School/College

School of Speech, Language, Hearing and Occupational Sciences

Committee Chair

Catherine Off

Commitee Members

Jenna Griffin, Duncan Campbell


: aphasia, depression, patient-reported outcome measures, proxy outcome measures, aphasia-friendly modification, psychosocial well-being


University of Montana

Subject Categories

Speech and Hearing Science | Speech Pathology and Audiology


Persons with aphasia (PWA) experience post-stroke depression more frequently than stroke survivors who do not have aphasia. Currently, no patient reported outcome measures that screen for depression have been created specifically for PWA or modified to be aphasia friendly for PWA. The purpose of this preliminary study is to modify the Patient Health Questionnaire- 8 (PHQ-8) to an aphasia friendly format and to assess the feasibility of administering the modified assessment compared to other patient-reported and proxy-reported outcome measures used to screen depression. This retrospective analysis examined pre- and post-treatment outcome measures of depression for seven stroke-survivors with aphasia. The Patient Health Questionnaire -8 (PHQ-8) was modified to an aphasia friendly format through simplification of questions, increased font size, addition of a calendar representation of possible responses, and addition of pictures related to the question being asked. Prior to and immediately following an intensive comprehensive aphasia program (ICAP) lasting four weeks, stroke-survivors with aphasia were administered the modified PHQ-8 (mPHQ-8). Each stroke survivor also completed the Geriatric Depression Scale (GDS) and the Modified Perceived Stress Scale (mPSS); family caregivers completed a proxy measure, the Stroke Aphasia Depression Questionnaire -10 (SADQ-10). The GDS and SADQ-10 were administered in their original formats. The mPSS was administered in its designed format as an aphasia friendly version of the Perceived Stress Scale. The GDS, mPHQ-8, and SADQ-10 were scored immediately before and after the summer 2019 ICAP at the University of Montana. Undergraduate research assistants not involved in the data collection and blind to research procedures rescored all outcome measures for validity and reliability purposes. Means, standard deviation, and standard error of measurement are reported for each measure. Feedback about the feasibility and ease of administration of these measures was collected from speech-language pathology clinicians immediately following pre- and post-testing, and again approximately three months later. Clinicians report that the mPHQ-8 required less modifications than the GDS, and that responses to the mPHQ-8 were perceived to be more accurate than responses to the GDS. Data from this study provides preliminary support for the use of modified depression screening tools for use with PWA.

Key words: aphasia, depression, patient-reported outcome measures, proxy outcome measures, aphasia-friendly modification, psychosocial well-being



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