The Holden Communication Scale (HCS)

The Holden communication scale (HCS) has been developed by Una Holden and includes 12
items. The score range from 0-48 and the higher score the more difficulties. Choose only ONE
answer. The HCS was psychometric tested in 2016 (Strøm, Engedal, Saltyte Benth, & Grov,
2016).
Holden Score
Conversation
1.Response 0. Initiates conversation deeply involved with anyone
1.Good for those familiar to person
2.Fair response to those close by; no initiation of
conversation
3.Rather confused; poor comprehension
4.Rarely or never converse
2.Interest in past 0.Long, full account of past events
events 1.Fairly good description
2.Short description; a little confused
3.Confused or disinterested
4.No response
3.Pleasure 0.Shows real pleasure in situation /achievement
1.Smiles and shows interest
2.Variable response; slight smile; vague
3.Rarely shows even a smile
4.No response of just weeps
4.Humour 0.Creates situation or tells funny story on own initiative
1.Enjoys comic situations or stories
2.Needs an explanation and encouragement to respond
3.Vague smile; simply copies others
4.No response or negativistic
Awareness and
knowledge
5.Names 0.Knows most people’s names on ward
1.Knows a few names
2.Needs a constant reminder
3.Knows own name only
4.Forgotten even own name
6.General 0.Knows day, month, weather and whereabouts
orientation 1.Can forget one or two items
2.Usually gets two right but tries
3.Vague; may guess one
4.Very confused
7.General 0.Good om current events; generally able
knowledge 1.Outstanding events only; fair on general knowledge
 2.No current knowledge; poor general information
3.Confused about many things; gets anxious and upset
4.Confused about everything; does not respond
8.Ability to join 0.Joins in games and activities with ease
in games etc. 1.Requieres careful instructions but joins in
2.Can only join in simple activities
3.Becomes anxious and upset
4.Cannot or will not join in
Communication
9.Speech 0.No known difficulty
1.Slight hesitation or odd wording
2.Very few words; mainly automatic phrases
3.Inappropriate words; odd wounds; nodding
4.Little or no verbalisation
10.Attempts at 0.Communicates with ease
communication 1.Tries hard to speak clearly
2.Tries to draw; gesticulates needs etc.
3.Euphoric laughter; weeping; aggressive
4.No attempt
11.Interest and 0.Responds with interest and comment
response to 1.Despite difficulties shows interest
objects 2.Shows some interest, but rather vague
3.Weeps; rejects objects; shows aggression
4.No response; no comprehension
12.Success in 0.Clearly understood
communication 1.Uses gestures and sounds effectively
2.Understanding restricted to a few people
3.Becomes frustrated and angry
4.Makes no attempt
Total score
Sign
Date

References
Strøm, B. S., Engedal, K., Saltyte Benth, J., & Grov, E. K. (2016). Psychometric evaluation of
the Holden Communication Scale (HCS) for persons with dementia. BMJ Open, 6(12),
e013447. doi:10.1136/bmjopen-2016-013447