The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation Purpose The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative functioning. The ... Research Article
Research Article  |   June 01, 2015
The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation
 
Author Affiliations & Notes
  • William D. Hula
    VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center, PA
    University of Pittsburgh, PA
  • Patrick J. Doyle
    VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center, PA
    University of Pittsburgh, PA
  • Clement A. Stone
    University of Pittsburgh, PA
  • Shannon N. Austermann Hula
    VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center, PA
  • Stacey Kellough
    VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center, PA
  • Julie L. Wambaugh
    VA Salt Lake City Healthcare System, UT
    University of Utah, Salt Lake City
  • Katherine B. Ross
    Phoenix VA Healthcare System, AZ
  • James G. Schumacher
    VA Pittsburgh Healthcare System Geriatric Research, Education, and Clinical Center, PA
  • Ann St. Jacque
    Minneapolis VA Healthcare System, MN
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to William Hula: william.hula@va.gov
  • Editor: Rhea Paul
    Editor: Rhea Paul×
  • Associate Editor: Kristine Lundgren
    Associate Editor: Kristine Lundgren×
Article Information
Language Disorders / Aphasia / Language / Research Articles
Research Article   |   June 01, 2015
The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 906-919. doi:10.1044/2015_JSLHR-L-14-0235
History: Received August 22, 2014 , Revised January 12, 2015 , Accepted February 18, 2015
 
Journal of Speech, Language, and Hearing Research, June 2015, Vol. 58, 906-919. doi:10.1044/2015_JSLHR-L-14-0235
History: Received August 22, 2014; Revised January 12, 2015; Accepted February 18, 2015
Web of Science® Times Cited: 1

Purpose The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia.

Method Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative functioning. The data were analyzed using a categorical item factor analysis approach. Validity of ACOM scores on the basis of their convergence with performance-based, clinician-reported, and surrogate-reported assessments of communication was also assessed.

Results Fifty-nine items that obtained adequate fit to a modified bifactor measurement model and functioned similarly across several demographic and clinical subgroupings were identified. The factor model estimates were transformed to item response theory graded response model parameters, and the resulting score estimates showed good precision and moderately strong convergence with other measures of communicative ability and functioning. A free software application for administration and scoring of the ACOM item bank is available from the first author.

Conclusions The ACOM provides reliable measurement of patient-reported communicative functioning in aphasia. The results supported the validity of ACOM scores insofar as (a) factor analyses provided support for a coherent measurement model, (b) items functioned similarly across demographic and clinical subgroups, and (c) scores showed good convergence with measures of related constructs.

Acknowledgments
This work was supported by VA Rehabilitation Research & Development Merit Review Award 6098R (principal investigator: Patrick Doyle), Career Development Award C7476W (principal investigator: William Hula), and the VA Pittsburgh Healthcare System Geriatric Research Education and Clinical Center. The authors would like to thank Beth Friedman, Janet Malotky, Martha Manthie, Christina Nessler, Rebecca Owens, Jessica Rapier, Mary Sullivan, Brooke Swoyer, Neil Szuminsky, and Sandra Wright for their assistance with data collection and management. We would also like to thank the aforementioned along with Michael Dickey, Malcolm McNeil, Christine Matthews, Ronda Winans-Mitrik, and Gerasimos Fergadiotis for helpful discussions during the development and execution of this project. The contents of this article do not represent the views of the Department of Veterans Affairs or the United States government.
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