Abstract :
Background: Post-stroke aphasia affects communication in daily life, participation, and quality of life. The Communicative Effectiveness Index (CETI) is a caregiver-reported measure of functional communication, but a validated Urdu version was not available. Objective: To translate, culturally adapt, and validate CETI in Urdu for caregivers of people with post-stroke aphasia. Methods: A descriptive psychometric validation study was conducted in Rawalpindi, Islamabad, and Chakwal. Translation followed forward translation, reconciliation, back-translation, expert review, and cognitive debriefing. Pilot testing included 5 caregiver-patient dyads, and the main validation included 30 bilingual caregiver-patient dyads. Internal consistency was assessed with Cronbach's alpha, test-retest reliability with the intraclass correlation coefficient in 15 dyads after one week, and convergent validity with Spearman's correlation between Urdu and English CETI scores. Results: CETI-U showed excellent internal consistency (Cronbach's ? = 0.975), excellent test-retest reliability (ICC = 0.998), and a very strong positive correlation with the English CETI (? = 0.980, p < 0.001). Conclusion: CETI-U is a reliable, valid, and culturally appropriate tool for assessing functional communication in Urdu-speaking people with post-stroke aphasia.