Linguistic and cultural properties of the Spanish adaptation of the CAT (SP-CAT): pilot results from neurotypical subjects

Abstract

[Abstract] Introduction. Aphasia assessments in languages other than English are scarce. In the case of Spanish, this scarcity includes a need for assessments with linguistic and cultural adaptations that consider dialectal varieties and cultural traits across Spanish-speaking populations. Aims of the study. This study discusses the linguistic and cultural adaptation of the Comprehensive Aphasia Test (CAT) to Spanish (SP-CAT), a version that can be used in Spain and Spanish-speaking Latin American countries, and provide pilot results assessing whether performance is comparable across samples. Methods. For the linguistic adaptation, we discuss considerations such as typological differences between English and Spanish, Spanish varieties, gender cues, spelling-sound regularities, transparency, and other syntax-related aspects. For the cultural adaptation, we discuss considerations such as culturally relevant items and images, and covering different Spanish varieties within the SP-CAT. The pre-testing of items for the SP-CAT included controlling variables such as name agreement of visual stimuli (examined in n=237 healthy participants), imageability (examined in n=244 healthy participants), and lexical frequency (from the Corpus of Reference of Current Spanish). We also conducted a pilot study of the SP-CAT with 82 healthy participants from Chile, Colombia, and Spain to assess differences in performance within tasks between the included countries; analysis of such differences was completed within a Bayesian framework. Results. The SP-CAT provides a linguistic and cultural adaptation of the original English CAT. Item pre-testing included name agreement, lexical frequency, and imageability tests to ensure comparability with the English original version. Our pilot study confirmed that there are no clinically significant differences in performance within tasks between the included countries in healthy participants, a necessary step towards the final validation of a test for the Spanish-speaking world. Discussion. The SP-CAT responds to a need to develop linguistically and culturally sensitive adaptations of assessments for Spanish-speaking people with aphasia to be used in clinical practice. Pilot results indicate that the adaptation meets the criteria to be used across Spanish varieties. In light of promising pilot results, the next phase of this study will assess the validity and reliability of the SP-CAT, providing normative data for its administration.