6 - Standardized Aphasia Assessment Flashcards
When do Aphasia Assessments often begin?
Screenings at bedside
What do Aphasia Screenings give us a general sense of?
Nature and severity of deficits
What do Aphasia Screenings determines the need for?
More comprehensive examination
Who frequently designs Aphasia Screening Tools?
Clinicians
Where are Aphasia Screening Tools typically used?
(3)
In acute care settings
Environments where little time is available for assessment
Environments where only general info concerning a patient’s linguistic abilities is needed
What is the Purpose of Aphasia Screening Tools?
To establish efficiently the presence/absence of language disorders
What do Aphasia Screening Tools not provide?
A detailed description of the severity and characteristics of patient’s aphasia
What are two characteristics of Aphasia Screening Tools?
Short in length
Sample only a narrow range of language behaviors
When might a clinician chose to use an Aphasia Screening Tool in lieu of a full diagnostic battery?
(4)
Patient is in the early or acute stages of recovery from stroke
Patient is too ill or fatigued to undergo a full evaluation
Patient’s length of stay (LOS) in facility is short
Cost dictates immediate clinical information w/o extensive testing
What are the two options of Aphasia Screening Tools?
Create your own screening tool
Utilize commercially available tests
What is the Language Screening Test (LAST)?
How many items does it contain?
Bedside test designed for “emergency” settings
15 items in 5 subtests
What are the two indexes in the Language Screening Test (LAST)?
Expression Index
Receptive Index
What are contained in the Expression Index portion of the Language Screening Test (LAST)?
(3)
Naming
Repetition
Automatic Speech
What are contained in the Receptive Index portion of the Language Screening Test (LAST)?
(2)
Recognition
Verbal Instructions
What is The Aphasia Rapid Test? (2)
How many items does it have?
An NIHSS-like aphasia test
Rates aphasia severity in acute stroke patients
//
26
Where is The Aphasia Rapid Test designed to be administered?
How long does it take?
Patient’s bedside
< 3 minutes
What areas do Comprehensive Aphasia Test Batteries assess?
(5)
Auditory Comprehension
Verbal Expression
Reading
Writing
Sometimes Cognition
How can Auditory Comprehension be tested in Comprehensive Aphasia Test Batteries?
(3)
Single Word Comprehension
Sentence Comprehension
Spoken Discourse
How can Single Word Comprehension be tested in Comprehensive Aphasia Test Batteries?
(2)
Select-from-an-array procedure
Test of single-word comprehension
How can the “select-from-an-array procedure” type of Single Word Comprehension be tested in Comprehensive Aphasia Test Batteries?
(2)
Pictures (actions, letters, numbers, shapes, colors)
Objects
How can the “test of single-word comprehension” type of Single Word Comprehension be tested in Comprehensive Aphasia Test Batteries?
PPVT (Peabody Picture Vocabulary Test)
What variables can influence tests of Single Word Comprehension in Comprehensive Aphasia Test Batteries?
(4)
Frequency of occurrence
Semantic or acoustic relationship to foils (semantic or phonetic similarities)
Part of speech
Ambiguity
What variables can influence tests of Sentence Comprehension in Comprehensive Aphasia Test Batteries?
(4)
Length and syntactic comprehension
Reversibility and plausibility
Predictability
Personal reference
How can Sentence Comprehension be tested in Comprehensive Aphasia Test Batteries?
(2)
Included in standardized language batteries
Tests of sentence comprehension
What are two tests of Sentence Comprehension that can be used in Comprehensive Aphasia Test Batteries?
Token Test
Northwestern Syntax Screening Test
What variables can influence tests of Discourse Comprehension in Comprehensive Aphasia Test Batteries?
(5)
Salience
Directness
Redundancy
Cohesion and coherence
Rate and emphatic stress
How can Discourse Comprehension be tested in Comprehensive Aphasia Test Batteries?
(2)
Included in standardized language batteries
Tests of discourse comprehension
What test for Discourse Comprehension can be used in Comprehensive Aphasia Test Batteries?
The Discourse Comprehension Test
What Speech Characteristics are looked at when testing Verbal Expression in Comprehensive Aphasia Test Batteries?
(6)
Paraphasias
Neologisms ( Non-Words)
Stereotypies (Repeated Words)
Jargon (Speech sounds normal but doesn’t make sense)
Agrammatism
Paragrammatism
What are Paraphasias?
Incorrect word substituted for an intended or target word
What are Neologisms?
Nonsense Words
What are Stereotypies?
Word or nonword used repeatedly by a patient, as if it were the only language form available
What is Jargon?
(2)
Lengthy, fluently articulated utterance which makes little or no sense to the listener
Can consist of real or nonwords
What is Agrammatism?
Inability to speak in a grammatically correct fashion
What is Paragrammatism?
Confused or incomplete use of grammatical structures
How can Verbal Expression be tested in Comprehensive Aphasia Test Batteries?
(6)
Simple speech production tests
Naming
Sentence Production
Discourse Production
Speech Fluency
Intelligibility
How can Simple Speech Production Tests be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
(3)
Recitations, rhymes, and automatized sequences
Sentence completion
Repetition
How can Naming be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
(2)
Confrontational naming (What is this?)
Responsive naming (“The grass is _____.”)
What variables can influence Naming Accuracy in Verbal Comprehension in Comprehensive Aphasia Test Batteries?
(4)
Frequency of occurrence
Length and phonologic complexity
Semantic categories
Context
How can Sentence Production be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
(2)
Subtests in standardized measures
Independent tests
How can “subtests in standardized measures” type of Sentence Production be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
(2)
Make a sentence from a word
Expressing ideas
What Independent Test for Sentence Production can be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
Reporters Test
How can Discourse Production be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
Picture descriptions
How can Speech Fluency be used to test Verbal Expression in Comprehensive Aphasia Test Batteries?
(3)
Fluent vs non-fluent
Speech tempo
MLU
How is Reading be tested in Comprehensive Aphasia Test Batteries?
All language batteries contain reading subtests
How do Comprehensive Aphasia Test Batteries test Reading?
(4)
Oral reading of words and sentences
Match printed words to pictures or objects
Match printed words to spoken words
Comprehension of printed sentences
How can a “matching printed words to pictures or objects” be used to test reading?
(2)
Word to object matching
Picture to word matching
How is Writing be tested in Comprehensive Aphasia Test Batteries?
Standardized language batteries
How do Standardized Language Batteries test Writing?
(4)
Generating automatized sequences
Copying
Writing to dictation (letters or numbers)
Self formulated material
What is the primary Aphasia Battery that Dr. Ellis wants us to know?
What is the secondary?
Western Aphasia Battery (WAB)
Boston Diagnostic Aphasia Exam
Do Language Symptoms fit neatly into just one aphasia type?
No
Are Language Symptoms of patients within a given aphasia type truly homogeneous?
No
(e.g. some patient with Wernickes aphasia have greater reading comp. than auditory comp.)
____________ are often misleading as both comprehension and production are impaired in most patients.
Dichotomous classification systems
(e.g. receptive vs expressive)
Aphasia classification may be influenced by the ___________
Test battery
Classifications do not specify the nature of the patient’s ___________.
Underlying linguistic problems
(e.g. semantic vs lexical access problem)
What is the first Aphasia Battery to be designed?
Is it still in use?
Minnesota Test for Differential Diagnosis of Aphasia
No
Who designed the Minnesota Test for Differential Diagnosis of Aphasia?
When?
Mildred Schuell
1965
What criteria was the Minnesota Test for Differential Diagnosis of Aphasia designed to meet?
(4)
Explore differences in behavior in all language modalities
Gradiated difficulty within each modality
Variety of non-language tests
Differentiates among clinical syndromes
Who designed the Porch Index of Communicative Ability (PICA)?
When?
Bruce Porch
1981
How many test items are in the Porch Index of Communicative Ability (PICA)?
Under how many subtests?
180 test items
18 subtests
How long does the Porch Index of Communicative Ability (PICA) take to administer?
1 hour (avg.)
How many objects are used in the Porch Index of Communicative Ability (PICA)?
Same 10 objects (for all subtests)
Where is the Porch Index of Communicative Ability (PICA) sometimes used?
VA settings
How is every response scored in the Porch Index of Communicative Ability (PICA)?
With a 16-category, binary (yes or no) system
What can be calculated in the Porch Index of Communicative Ability (PICA)?
Overall mean and modality specific means
What is required to administer the Porch Index of Communicative Ability (PICA)?
Certification
What is the patient asked to perform in the Revised Token Test (R-TT)?
A series of simple tests involving a variety of colored tokens
How many subtests are in the Revised Token Test (R-TT)?
10 brief subtests
How long does it take to administer the Revised Token Test (R-TT)?
30 minutes
What can you calculate if you combine the Revised Token Test (R-TT) with the Western Aphasia Battery?
Cognitive Quotient
What does the Revised Token Test (R-TT) directly measure?
(4)
Auditory short term memory (STM)
Comprehension of various sentence types and transformations
Understanding specific linguistic elements
Comprehension of certain semantic relations
(Only measures comprehension)
Is there a Computerized Version of the Revised Token Test (R-TT)?
Yes
Where is the Aachen Aphasia Test (AAT) commonly used?
What language is it in?
Why is it important to know?
German speaking countries
German
Used often in important research
What 6 subtests are used in the Aachen Aphasia Test (AAT) battery?
Spontaneous speech
Token test
Repetition
Written language
Confrontational naming
Comprehension
Who created the Boston Diagnostic Aphasia Exam-3rd Edition?
(2)
Harold Goodglass
Edith Caplan
What does the Boston Diagnostic Aphasia Exam-3rd Edition do?
Assigns patients to classic aphasia syndromes
What is the standard form of the Boston Diagnostic Aphasia Exam-3rd Edition composed of?
(4)
Structured interview
27 subtests
Boston Naming Test (BNT - 60 items)
9 rating scales
How long does it take to administer the Boston Diagnostic Aphasia Exam-3rd Edition?
2 hours (avg.)
What picture is this?
What test does it come from?
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Cookie Theft Picture
Boston Diagnostic Aphasia Exam (BDAE)
What does the Boston Diagnostic Aphasia Exam measure?
(2)
Aphasia classification
Aphasia severity
In BDAE Aphasia Severity Rating Scale, what type of aphasia is represented below?
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Broca’s
In BDAE Aphasia Severity Rating Scale, what type of aphasia is represented below?
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Wernicke’s
What is the Western Aphasia Battery (WAB)?
Similar to BDAE but psychometrically more sophisticated
Who created the Western Aphasia Battery (WAB)?
When?
Andrew Kertesz
1979
What are patients assigned to in the Western Aphasia Battery (WAB)?
Diagnostic categories according to scores on 4 language subtests
What are the 4 subtests in the Western Aphasia Battery (WAB)?
Spontaneous speech
Auditory comprehension
Repetition
Naming
What three quotients are measured in the Western Aphasia Battery (WAB)?
Aphasia Quotient
Language Quotient
Cortical Quotient
What is used in the Western Aphasia Battery (WAB) to measure the Aphasia Quotient?
(4)
Speech
Auditory Comprehension
Repetition
Naming
What is used in the Western Aphasia Battery (WAB) to measure the Cortical Quotient?
Entire Test
What is the Western Aphasia Battery (WAB) Aphasia Quotient a functional measure of?
The severity of spoken language deficit in aphasia
What is the range of scores that can be received on the Western Aphasia Battery (WAB) Aphasia Quotient?
What is the cut off score for aphasia?
Score range from 0-100
93.8 cut-off score (must be below this to qualify for aphasia)
What is the Western Aphasia Battery (WAB) Aphasia Quotient used as a classification system for?
Type of aphasia
On the Western Aphasia Battery, what are the scores that would qualify someone for Severe Aphasia?
0 - 39
On the Western Aphasia Battery, what are the scores that would qualify someone for Moderate Aphasia?
40 - 79
On the Western Aphasia Battery, what are the scores that would qualify someone for Mild Aphasia?
80 - 93.7
On the Western Aphasia Battery, what are the scores that would disqualify someone for Aphasia?
93.8 - 100
What picture is this?
What test does it come from?
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Picnic Scene
Western Aphasia Battery (WAB)
What are the different subtests on the Western Aphasia Battery (WAB) used for the Aphasia Quotient?
(4)
Spontaneous Speech
Auditory Verbal Comprehension
Repetition
Naming + Word Finding
What are the three parts of the Auditory Verbal Comprehension subtest in the Western Aphasia Battery (WAB)?
Yes/No Questions
Auditory Word Recognition
Sequential Commands
What are the four parts of the Naming + Word Finding subtest in the Western Aphasia Battery (WAB)?
(4)
Object Naming
Word Fluency
Sentence Completion
Responsive Speech
What is the Boston Naming Test (BNT) part of?
Boston Diagnostic Aphasia Exam 2nd + 3rd editions
How many items are in the Boston Naming Test (BNT)?
What are they?
How does the patient do?
60 items
Line drawings
Confrontational naming
What happens as the patient progresses through the Boston Naming Test (BNT)?
Items increase in difficulty
Is there an alternate version of the Boston Naming Test (BNT)?
What is it?
Which version do most settings use?
Yes
Short version (15 items)
Most settings will use short vision
What does the Reading Comprehension Battery for Aphasia-2 measure?
Severity and quality of reading after aphasia
How many subtests are in the Reading Comprehension Battery for Aphasia-2?
How many items are in each subtest?
10 subtests
10 items in each subtest
What are three Functional Communication Assessments?
Communicative Effectiveness Index
ASHA Functional Assessment for Communication Skills for Adults (ASHA-FACS)
Communicative Abilities in Daily Living (CADL
What does the Communicative Effectiveness Index correlate with?
Western Aphasia Battery
What are the four communication categories in the Communicative Effectiveness Index?
Basic Need
Health Threat
Life Skill
Social Need
What does the ASHA Functional Assessment for Communication Skills for Adults (ASHA-FACS) measure?
Functional communication of adults with speech, language, and cognitive communication disorders (Aphasia, Cognitive- communicative disorders)
How many items are in the ASHA Functional Assessment for Communication Skills for Adults (ASHA-FACS)?
43 items
What four areas of Functional Communication are assessed in the ASHA Functional Assessment for Communication Skills for Adults (ASHA-FACS)?
Social communication
Communication of basic needs
Reading, writing, and number concepts
Daily planning
What is the Communicative Abilities in Daily Living (CADL-2) designed to assess?
Functional communication performance of adults with neurogenic communication disorders
What does the Communicative Abilities in Daily Living (CADL-2) emphasize?
Communication in everyday living situations
How many test items are in the Communicative Abilities in Daily Living (CADL-2)?
50
What 7 areas of communicative function are tested in the Communicative Abilities in Daily Living (CADL-2)?
Reading, writing, + using numbers
Social interaction
Divergent communication
Contextual communication
Non-verbal communication
Sequential relationships
Humor/metaphor/absurdity
What is the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39)?
(2)
Self-report scale
Administered by clinician interview
How many items are in the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39)?
Where do they come from?
49 items
The Stroke-Specific Quality of Life Scale (SS-QOL) (health related quality of life scale)
How many response types are in the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39)?
2 response formats based on 5pt scale
(1) =could not do it at all; definitely yes
(5) =no trouble at all; definitely no
Do all settings use the same tests?
No