Instrument for Assessment of Neurodegenerative Aphasia in Indonesia or Instrumen Afasia Neurodegeneratif Indonesia (IRFANI): Development and pilot study

印度尼西亚神经退行性失语症评估工具或印度尼西亚失语神经退行性工具 (IRFANI):开发和试点研究

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Abstract

BACKGROUND: Primary progressive aphasia (PPA) is a neurodegenerative disorder causing progressive language impairment. Early diagnosis is crucial for treatment planning, yet no standardized assessment exists for Indonesian speakers. OBJECTIVE: This study describes the initial development of the Instrumen Afasia Neurodegeneratif Indonesia (IRFANI), focusing on test construction, content validity, and pilot testing. METHODS: IRFANI was designed to assess syntax, motor speech, semantics, and phonology, following Gorno-Tempini et al. (2011) diagnostic criteria. The blueprint covered key domains, including confrontation naming (nouns/verbs), sentence production/comprehension, single-word comprehension, semantic association, and repetition tasks. Verbal stimuli were selected based on expert input and Indonesian word frequency lists, while custom black-and-white illustrations ensured linguistic and cultural relevance. Five neurobehavioral neurologists assessed content validity using Aiken's Content Validity Index (CVI). A pilot study was conducted with 30 participants diverse in age, sex, education, and ethnicity. RESULTS: Expert consultations refined the test blueprint. Qualitative analysis identified ambiguous images, multiple correct answers, and unclear phrasing in naming and sentence tasks. Issues included visually similar images and ambiguous sentence structures. Quantitative validation (CVI = 0.9) confirmed strong expert agreement, with items scoring below 0.8 excluded. The pilot study demonstrated good reliability (0.923) and provided insights for further refinement. CONCLUSIONS: IRFANI was systematically developed through expert validation, pilot testing, and iterative refinement, ensuring clarity and strong content validity. Further studies are needed to confirm its construct validity, reliability, and diagnostic accuracy.

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