Communicative Effectiveness Index (CETI)
A 16-item caregiver-rated scale of everyday communication effectiveness.
By Claire White
- Usually completed by a family member or close communication partner rather than the person with aphasia.
- 16 everyday communication situations, 10 verbal and 6 non-verbal.
- Each situation rated on a 10 cm visual analogue scale, averaged to a score from 0 to 100.
Psychometrics
From the Greek adaptation (Charalambous et al., 2024), 30 people with chronic aphasia and their carers. Higher is better.
What does the CETI measure?
The CETI asks a familiar communication partner to rate how well the person with aphasia communicates in 16 real-life situations. Ten of them involve speaking and six do not, so gesture, expression, and the other ways people get meaning across all count toward the score. Each situation is marked on a 10 centimetre line running from ‘not able at all’ to ‘as able as before’.
The situations were not written by clinicians. Groups of people with aphasia and their spouses generated the ones that mattered in their own daily lives, a list of 36 was narrowed to the 16 that generalised across people, times, and places.
What does a CETI score mean?
The 16 ratings are averaged into one score from 0 to 100, where higher is better. There are no published cut-offs and no severity bands, so the score is not read as a threshold. It is read as a change. A rise between two administrations means the partner is seeing communication work better in the situations they care about.
What it adds to a language battery is the gap between test performance and daily life. Those two can move independently, and the CETI is the one that tracks the second. It is reference information for the care team rather than a diagnosis.
How the CETI is administered
- Completed by
- A family member or close communication partner. People with aphasia can also complete it about themselves.
- Time to administer
- 10 to 15 minutes
- Format
- 16 situations, each marked on a 10 cm line running from 'not able at all' to 'as able as before'
- Age range
- Adults
- Available languages
- English, with validated adaptations including Greek
Which conditions is the CETI used for?
Related instruments
- Stroke and Aphasia Quality of Life Scale (SAQOL-39)The same daily-life view, reported by the person themselves rather than a partner
- Western Aphasia Battery (WAB-R)What language testing measures, as against what the partner sees at home
- Philadelphia Naming Test (PNT)Naming in depth, when word-finding is the specific problem
- Mississippi Aphasia Screening Test (MAST)A 5 to 10 minute clinician screen
CETI questions, answered
Who fills in the CETI?
Usually a spouse, family member, or someone else who talks with the person every day. That is the design, not a shortcut. The questions ask how well communication actually works in real situations, and the person best placed to answer that is the one on the other side of the conversation. People with aphasia can also complete it about themselves.
How is the CETI scored?
Each of the 16 situations is marked on a 10 centimetre line running from 'not able at all' to 'as able as before'. Each mark converts to a score out of 100, and the 16 scores are averaged to give one number from 0 to 100. Higher is better.
How long does the CETI take?
10 to 15 minutes.
What is a good CETI score?
There are no published cut-offs or severity bands, so no single score counts as passing. The measure earns its keep as a repeated one. A rise between two administrations means the partner is seeing communication work better in situations that matter to them, which is the outcome treatment is aiming at.
Why does the CETI measure communication rather than language?
Because they come apart. Someone can score poorly on a language battery and still get their meaning across at home with gesture, context, and a partner who knows them. Someone else can test better and struggle more. The CETI captures the second thing, which is why it is used alongside a battery such as the WAB-R rather than instead of one.
Does the CETI diagnose aphasia?
No. It measures everyday communication and produces reference information. Diagnosis stays with your clinician.
Evidence, psychometrics and provenance
Developed by Lomas and colleagues and published in 1989. The original validation reported that the CETI was internally consistent with acceptable test-retest and inter-rater reliability, but published no coefficients for those properties. The numbers below come from the Greek adaptation, which is the study that reports them.
- Original validation
- Internally consistent, with acceptable test-retest and inter-rater reliability. No coefficients were published (Lomas et al., 1989).
- Construct validity
- Correlates with the WAB Aphasia Quotient and its Speaking and Understanding subscales (Lomas et al., 1989)
- Concurrent validity
- ρ 0.574 with the Aphasia Severity Rating Scale (Charalambous et al., 2024)
References
- 1.Lomas J, Pickard L, Bester S, Elbard H, Finlayson A, Zoghaib C. The communicative effectiveness index: development and psychometric evaluation of a functional communication measure for adult aphasia. J Speech Hear Disord. 1989;54(1):113-124.
- 2.Charalambous M, Phylactou P, Antoniou E, Christodoulou M, Kambanaros M. The adaptation of the Communicative Effectiveness Index (CETI) into Greek: a reliability and validity study. Brain Sci. 2024;14(7):689.
This assessment uses a validated instrument and is reference information, not a diagnosis.