Development and standardization of an Aphasia Test battery in the Gujarati language

Background Most aphasia assessment tools currently available in India are largely translated or adapted from Western batteries. This practice fails to account for the phonological, morphological, syntactic, and sociocultural characteristics unique to individual Indian languages. A standardized, psychometrically validated aphasia battery does not currently exist for Gujarati, one of the major languages of India. The purpose of this study was to develop and standardize the Aphasia Test Battery in Gujarati (ATB-G), a culturally appropriate and linguistically valid tool for identifying and characterizing aphasia in Gujarati-speaking adults.Methods The novel development of the test battery involved a multi-phase process that began with item construction, content validation by speech-language pathologists, and pilot testing. This led to the final structure of the Aphasia Test Battery in Gujarati (ATB-G). The battery assesses four domains: spoken comprehension, written comprehension, oral expression, and written expression. It was administered to native Gujarati speakers: 120 neurotypical individuals (18–75 years) and 55 persons with aphasia (20–78 years) following stroke.Results and Discussion The Content Validity Index (CVI) at the item level (I-CVI) and scale level (S-CVI/Ave) was 1.00. The internal consistency across the combined sample (N = 175) was excellent, with domain-level Cronbach’s alpha ranging from .933 to .970 and an overall battery coefficient of .977. ROC curve analysis demonstrated near-perfect discriminant validity between the NTI and PWA groups (AUC = .9998), with an optimal diagnostic cut-off yielding 100% sensitivity, 98.3% specificity, and 98.9% overall classification accuracy. Kruskal-Wallis H tests with Bonferroni-corrected Dunn’s post-hoc comparisons showed statistically significant differences in ATB-G domain scores across the eight aphasia subtypes, providing preliminary evidence that ATB-G profiles vary across subtypes and supporting construct validity. Inter-domain correlational analysis further supported a theoretically coherent pattern of relationships among the four language domains within the PWA group.Conclusion The ATB-G is the first standardized, culturally and linguistically grounded aphasia assessment battery developed specifically for Gujarati-speaking adults. It provides a valid and reliable tool for identifying and profiling language impairment.