Measuring Verbal Reasoning and Executive Strategies in German Speaking People with Cognitive-Communication Disorders: Cross-Cultural Adaptation and Pilot Testing of the FAVRES-DE

Background: Cognitive communication disorders (CCDs) are a hallmark of traumatic brain injury (TBI). Difficulties may be relatively subtle, becoming especially evident in complex communication situations which place a higher cognitive demand on the person affected. To date, no standardised, ecologically valid assessment tool for detecting these subtle CCDs exists for German. The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; (MacDonald, 2005)), available in English and Canadian-French, is designed to detect subtle CCDs after acquired brain-injury (ABI) using real-life scenarios. Aims: This study aims to translate and adapt the FAVRES into German as well as to gather reference data on the performance of neurologically healthy adults. Furthermore, the study conducts a first evaluation of age- and education-specific performance trends and interrater-reliability. Results are compared with the normative data of the original English version and the French-Canadian translation. In addition, an exploratory multiple case analysis of the feasibility of the FAVRES-DE and its capability to detect subtle CCDs on a sample of four adults with TBI is conducted. Methods & Procedures: The original version of the FAVRES was translated and adapted based on the ITC-Guidelines for Translating and Adapting Tests (2016). The resulting German version, the FAVRES-DE, was completed by 60 neurologically healthy adults (32 women) and four adults with chronic CCD after TBI (≥ 6 months post onset) in a pilot cross-sectional study. Results: The FAVRES-DE was feasible with all participants. Age and education had significant influence on the performance of the neurologically healthy group, whose results were comparable to the original version and to the French-Canadian normative study, but analyses revealed differences in several subscores. Two of the four participants with TBI exhibited a significantly lower performance than the control group. Analyses of interrater-reliability revealed a high level of agreement between three independent raters. Discussion: The FAVRES-DE seems to be a sensitive measure to identify CCDs after TBI. The challenges of detecting subtle CCDs are exemplified by one of the TBI cases. Further validation and psychometric testing of the FAVRES-DE on a representative dataset is warranted.