PONE-D-23-32749Validation of a Cantonese Version of the Amsterdam Nijmegen Everyday Language Test (CANELT): A functional approachPLOS ONE

Dear Dr. Wong,

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Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The study validated the Cantonese version of the Amsterdam-Nijmegen Everyday Language Test (CANELT) for individuals with aphasia. Using quantitative scoring, it assessed communication abilities in both aphasic and healthy individuals. Responses from 56 people with aphasia and 100 healthy Cantonese speakers were orthographically transcribed and analyzed for completeness and information. The author provides a detailed description of the task, its real-life application, and compares it with other available assessments like ASHA FACS.

The differences between ANELT and CANELT lack clarity, and the rationale for using CANELT over ANELT needs further explanation.

The present study demonstrates the adaptation of CANELT for Cantonese speakers, combining data from current and previous studies. However, it's unclear if the same protocol was consistently applied across these studies for test administration and results' analysis. Clarity is needed regarding the re-analysis of orthographic transcriptions from previous studies and any considerations for inter-rater consistency in transcription in both present and previous studies.

Further information is necessary regarding participant recruitment and diagnosis. Were assessments conducted by registered speech pathologists, psychologists, or neurologists? How were neurodegenerative conditions ruled out?

Concerning Table 1, while the left column presents data from healthy adults and the right from people with aphasia, the final row seems to reference fluent/non-fluent aphasia in PWA, with specific aphasia types listed on the right. To avoid confusion, the table format could be split into two or restructured for clarity, as the current presentation may be misleading.

The results' presentation justifies the statistical analysis conducted.

Detailed procedures for translation and cultural adaptation from Dutch to Cantonese are provided.

Overall, the study significantly contributes to cross-linguistic research and the expansion of culturally adapted, language-specific assessment tools

Reviewer #2: In paper Validation of a Cantonese Version of the Amsterdam Nijmegen Everyday Language Test (CANELT): A functional approach autor test the psychometric properties of the ANELT in Cantonese. The paper is well written and the way the data is analysed is very interesting, i.e. it differs significantly from similar studies. Namely, the author provides an overview of how the Cantonese authors develop the scoring system for the CANELT. Analyses based on main concepts provide direct information about the informativeness of discourse production at the macrostructure level as well as opening and new information at the propositional level. In this way, the authors have developed a comprehensive approach to analysing discourse processing and production, which is a prerequisite for effective functional communication. I can recommend the publication of the paper. I have only a few comments that should be taken into account:

Line 61: Can you conclude the sentence with an example of some of the tools; among them, please mention the Scenario Test, as you mention it later in the manuscript. The same sentence – several assessment tools for measuring discourse production…. – actually, there should be - several assessment instruments to measure functional communication based on monologic discourse… because there are many instruments that measure discourse production but not functional communication. For example, in the Boston test or CAT test, there are picture description tasks that measure discourse production but not functional communication.

Line 81 – can you very briefly define Comprehensibility A-Scale and Intelligibilty B-Scale

You use different terms for the control group – neurological healthy individuals, normal controls, healthy normals - ... - please use a single term and use it consistently throughout the manuscript.

In the "Participants" section, provide additional demographic data of PwA – are they all monolingual? What is their level of education? What is their gender?

Line 174 – Indicate the exact number of subjects taken from other authors: ...the rest were based on data collected in other studies: n=? from Law and Lo`s (15), n=? form Yip`s (18) and n=? from Lor`s study (19)

Line 185 – is the Duch-speaking aphasiologist the author of the ANELT? It is important to have the author's permission to translate the test into another language or the publisher's copyright – this is ethically more important than knowing who gave you the test.

Lines 191 and 192 – can you briefly describe five situations that were culturally inappropriate – this may be interesting for readers when confronted with a specific example of cultural bias.

Data analysis section – can you give a very brief and basic definition of each parameter of validity and reliability?

Line 254 – do not use "people with/without aphasia" – when I first read this sentence I thought you were talking about people who have had a stroke but have and do not have aphasia; in fact you are talking about PwA and healthy speakers – this is another example of why it is important that you use terminology consistently.

Lines 266 – 267 – please revise the last part of the sentence - Items with low face validity, i.e., 30% or more respondents rated the item as ‘poor’ in assessing one’s communication ability, were excluded– should be excluded.

Line 349 - which serves as a diagnostic tool – for what? Add: functional communication of Cantonese-speaking PwA

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Reviewer #1: No

Reviewer #2: Yes: Jelena Kuvač Kraljević

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PONE-D-23-32749R1Validation of a Cantonese Version of the Amsterdam Nijmegen Everyday Language Test (CANELT): A functional approachPLOS ONE

Dear Dr. Wong,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we are pleased to inform you that your work has been found to have merit for publication. However, in order to ensure its readiness for publication, some minor revisions are required, as suggested by one of the reviewers. Specifically, the reviewer has recommended language edits and corrections for typographical errors. These adjustments are standard procedure and will contribute to the overall clarity and readability of your manuscript. We kindly ask that you review the suggested edits and make necessary revisions accordingly. Once these adjustments are completed, we encourage you to resubmit the final version of your paper at your earliest convenience. We appreciate your attention to these revisions and look forward to the continued progress of your manuscript.

Please submit your revised manuscript by Jun 01 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Elena Theodorou

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review the revised version of the manuscript. I acknowledge that all issues raised in the previous review round have been satisfactorily addressed.

Reviewer #2: As I said in my first review, I like the paper because it is not a classical, i.e. rather technical paper that only provides data on the validity and reliability of the test. This paper contains detailed information about the reasons (motivations) for the development of the CANELT, its advantages and disadvantages and, most importantly, about all the innovations that various authors have introduced over the last five years of its development to improve it in part of the test items and in the scoring section.

I have only a few small corrections:

Line 66: I would not say: among these measures …rather say Among these assessment tools…

In general, I would not speak of normative performance, since performance is always variable and therefore needs to be normed – I would replace this syntagm normative performance accordantly in the paper with normative data (e.g. lines 192, 261, 267, etc).

The sentence in lines 68-70 has the same content as the sentence in lines 80-82. Delete the sentence in lines 80-82.

Line 86: explanation of B-Scale is somewhat unclear – I recommend that you add…examines the perception of utterances in such a way that words are recognizable regardless of their meaning.

Line 158 – add reference number [24] after Lor

Line 186 – please use the terminology speech-language therapist and use this term accordingly (e.g. in line 223).

Line 223 – add trained – who was either a trained speech-language therapy student…

Line 187 – delete therapy – The trained students had ….

Line 272 – add neurologically – among neurologically healthy controls…

Lines 341 -351 – the results show a decrease in performance on the variables Opening and New Information in both groups – it would be interesting to hear the author’s explanation for these results, especially for neurologically healthy controls, in the discussion section. (*This is just an idea for a new study - it would be intersting to analyse the data from neurologically healthy controls in two age groups only – for example, younger adults (30 to 59 years) and older (60+ years), as the data presented in this paper shows a trend of performance change around age 60. This aligns with Lor`s idea in lines 158-161, who attempted to develop age-based norms – perhaps with such a wide range of age groups, age differences can be captured).

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Jelena Kuvač Kraljević

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Validation of a Cantonese Version of the Amsterdam Nijmegen Everyday Language Test (CANELT): A functional approach

PONE-D-23-32749R2

Dear Dr. Wong 

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Elena Theodorou

Academic Editor

PLOS ONE

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