Development and validation of Thought, Language, and Communication Assessment Scale for Persons with Aphasia

Sampath Muthu Lakshmipriya 

Department of Speech-Language Pathology, School of Rehabilitation and Behavioral Sciences, Vinayaka Mission’s Research Foundation (DU), Puducherry, India 

https://orcid.org/0009-0003-7362-3129

Nagaraj Hema 

Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, India

https://orcid.org/0009-0001-4177-6839

https://doi.org/10.33700/jhrs.4.2.165

Abstract

Introduction: Aphasia impacts language and thought organization, disrupting effective communication. Thought, Language, and Communication (TLC) are interrelated, and breakdowns in one domain often affect the others. A comprehensive assessment tool is essential to understand and address these interlinks. This study aimed to develop and validate the Thought, Language, and Communication Assessment Scale for Persons with Aphasia (TLCAS-PWA) for Persons with Aphasia (PWA) and Neurotypical Individuals (NTI).
Method: The tool was developed through literature review and expert validation, comprising 14 parameters across communication, language, and thought domains, rated on a 5-point scale. It was administered to 20 PWA and 20 NTI.
Results: Among PWA, PCS showed the highest mean scores, while Self-reference was least frequent. At the domain level, both PWA and NTI had higher scores in Communication Disorder and lower in Language Disorder. Mann-Whitney U tests revealed significant differences between groups across all the domains. Psychometric analysis showed good internal consistency (α = 0.88), excellent inter-rater reliability (ICC = 0.98), and stable test–retest reliability.
Conclusion: TLCAS-PWA is a valid tool that aids clinicians in assessing TLC in aphasia, supporting diagnosis, intervention, and progress monitoring.

Keywords: TLCAS-PWA, Language and Thought Impairment, Aphasia, TLC interrelated

Full Text Article

Evaluation of horizontal fusional vergence in young children with intermittent exotropia using the synoptophore and prism bar

Rajesh Kumar 

Department of Optometry, Nims College of Allied & Health care Sciences, NIMS University Rajasthan, Jaipur, Rajasthan, 303121 India

https://orcid.org/0000-0002-6032-2437

Malhar Tushar Vyas 

Department of Ophthalmology, Nims University Rajasthan, Jaipur, Rajasthan, India

https://orcid.org/0009-0004-2123-6634

Neebha Passi 

Regional Institute of Ophthalmology, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

https://orcid.org/0000-0003-4387-3357

https://doi.org/10.33700/jhrs.4.2.159

Abstract

Purpose: The aim of the study was to compare the synoptophore and prism bar for assessing horizontal fusional vergence (HFV) in young children with intermittent exotropia (IXT).
Methods: The research involved ninety-eight subjects with IXT, aged between six and sixteen years. The examination included vision assessment, a cover test, identification of the dominant eye, and measurement of the angle of deviation using a prism bar. The subjects' HFV (positive and negative fusional vergence) was assessed using a horizontal prism bar and synoptophore at both near and far distances. We assessed IXT's control utilizing the Newcastle score for both near and far distances.
Results: The positive fusional vergence (PFV) break points of the synoptophore above those of the prism bar at both near and distance ranges (P < 0.01). There was a statistically significant difference in PFV recovery points for both near (P < 0.01) and distance (P < 0.01). There were no statistically significant changes in the near-negative fusional vergence (NFV) blur and break points as determined by the prism bar and synoptophore. The distance, NFV blur, and break points were larger on the synoptophore compared to the prism bar (P < 0.01).The difference in NFV recovery points was statistically significant at both near (P = 0.05) and distance (P = 0.03).
Conclusion: It is essential to exercise caution when assessing the PFV and NFV in young children with IXT, as the synoptophore and prism bar are not comparable in these kinds of situations.

Keywords: Intermittent exotropia, Horizontal Fusional vergence, synoptophore, prism bar, office control score, step vergence method

Full Text Article

Functional and Anatomical Outcomes Following Intravitreal Bevacizumab in Treatment-Naïve Centre-Involving Diabetic Macular Edema: A 3-Month Prospective Evaluation

Sanjay Kumar Mishra 

Nims College of Allied and Health Care Sciences, Nims University Rajasthan, Jaipur Rajasthan, India

https://orcid.org/0009-0003-0636-7727

Tejinder Singh Ahluwalia 

Department of Ophthalmology, Nims University, Rajasthan, Jaipur, India

https://orcid.org/0009-0002-3527-061X

Rajpal Vohra 

Vitreo-Retina Services at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India

https://orcid.org/0000-0003-3308-969X

Rohan Chawla 

Vitreo-Retina Services at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India

https://orcid.org/0000-0002-6791-4435

https://doi.org/10.33700/jhrs.4.2.172

Abstract

Introduction: Diabetic macular edema (DME) remains a major cause of vision impairment worldwide. Intravitreal bevacizumab, though used off-label, is an established therapy for centre-involved DME (CI-DME). This study evaluated how effectively microperimetry complements standard measures—best-corrected visual acuity (BCVA) and central macular thickness (CMT)—in assessing treatment outcomes.

Methods: In this prospective observational study, 52 eyes with treatment-naïve CI-DME received three monthly bevacizumab injections. BCVA, CMT (via OCT), and mean retinal sensitivity (by microperimetry) were recorded at baseline, one month, and three months. Statistical analyses included the Wilcoxon signed-rank test for repeated measures and Spearman’s rank correlation for structure–function relationships.

Results: After three months, mean BCVA improved from 0.50 ± 0.095 to 0.67 ± 0.088 (p < 0.001), while CMT decreased from 401.9 ± 87.6 µm to 329.5 ± 23.2 µm (p < 0.001). Mean retinal sensitivity rose from 14.96 ± 1.01 dB to 16.50 ± 1.39 dB (p < 0.001). Improvement in BCVA correlated positively with both CMT reduction (ρ = 0.340, p = 0.014) and sensitivity gain (ρ = 0.412, p = 0.004), while CMT reduction correlated inversely with sensitivity improvement (ρ = –0.367, p = 0.009).

Conclusion: Three consecutive bevacizumab injections resulted in significant anatomical and functional recovery in eyes with CI-DME. The consistent correlations between macular structure and function underscore the value of microperimetry as a sensitive, complementary tool for evaluating therapeutic response beyond standard acuity and OCT metrics.

Keywords: Diabetic Macular Edema, Bevacizumab, Central Macular Thickness, Anti-VEGF, Retinal Sensitivity, Microperimetry, OCT, Intravitreal Injection

Full Text Article

The latest issue (Vol.4, No.2, 2025) has been published

Dear Colleagues and Readers,

We are pleased to announce that Volume 4, Issue 2 of the Journal of Health and Rehabilitation Sciences (JHRS) has been published online today, December 20, 2025. This issue comprises a total of seven peer-reviewed articles. The forthcoming issue, Volume 5, Issue 1 (2026), is scheduled for publication by June 30, 2026.

 
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Journal of Health and Rehabilitation Sciences