Aphasia Assessment

Question 1

Assessment of Aphasia involves Evaluation of

Answer 1

Speech, language, reading, writing skills
Related cognitive functions may also be addressed
Dysarthria, dysphagia, &/or voice-related issues might coexist

Question 2

Aphasia Assessment can involve…

Answer 2

Standardized & client-specific procedures

Question 3

Oral Expression in Aphasia Assessment

Answer 3

Expressive output or oral expression
Assessment begins with free conversation as able
Involves 7 characteristics (only 6 listed in ppt)

Question 4

7 Characteristics of Oral Expression in Assessment

Answer 4

Artic agility
Prosody
Grammar
Fluency
Word finding
Paraphasia(s)

Question 5

Articulatory Agility

Answer 5

Speech is abnormal if:
-there is any deviation from normal ease &/or accuracy
-breakdown in automaticity
-output may be labored, awkward, or not at all
-can involve simplifications, omissions, substitutions, distortions
(think about motor speech d/o’s)

Question 6

Prosody

Answer 6

Rate, rhythm, melodic intonation patterns per single words, phrases, sentences, & conversation
Are stress patterns lost?
Is range of intonation compressed?
Is speech monotone?

Question 7

Phonation

Answer 7

Is pt. hypophonic? abnormally weak voice?
Indicative of the extent of the lesion to the deeper subcortical brain areas
Also seen in hypokinetic dysarthria
Referral to ENT; Possible VF pathology

Question 8

Grammar

Answer 8

Examine linguistic level of syntax & morphology
Prime importance as aphasia classification
Paragrammatism? Agrammatism?

Question 9

Fluency

Answer 9

Fundamental & vital in differential diagnosis
Fluent vs. nonfluent
Evaluated in terms of # of words per uninterrupted group that pt may produce

Question 10

Word Retrieval

Answer 10

Based on pt’s level of fluency; is there lack of correctly chosen nouns & verbs
If so, pt’s speech would be classified as anomic

Question 11

Fluent, anomic speech may take many forms:

Answer 11

• May be vague & circumlocutory
• May be marked by overt blocking @ key words w/ self-critical comments
• May be paraphasic so that the key informational words can’t be detected

Question 12

Naming

Answer 12

May reveal anomic tendencies not present in running speech
Modes of Stimulation: naming to visual confrontation, to tactile presentation, to definition or cloze prompt
Probe for clues as to how pt is succeeding @ retrieval
Respond to phonemic cues? Recognize the 1st correct sound of word? Indicate word length?

Question 13

Repetition

Answer 13

Of diagnostic significance
Various forms: Specific preservation & Selective disorder
Assess #s & nouns of varying length
Common for single word #s to be repeated perfectly but multi-digit #s elicit verbal paraphasias; non-# words elicit phonemic paraphasias
Assess ability to repeat multi-syllabic words, nonsensical words, or even foreign language phrases
Parrot-like speech?

Question 14

Specific Preservation in repetition

Answer 14

Ability to repeat is preserved or markedly better from other sx’s of aphasia

Question 15

Selective Disorder in repetition

Answer 15

Repetition vulnerable to words containing a succession of syllables starting w/ plosives (basketball player)
May also have difficulty w/ unusual sentences composed of small grammatical words such as “no ifs, ands, or buts”

Question 16

Automatics

Answer 16

Memorized sequences
May be retained & performance may be essentially intact even w/ severe forms of aphasia
Counting, MOY, DOW, nursery rhymes, alphabet

Question 17

Auditory Comprehension

Answer 17

Free conversation, phonological discrimination, lexical comprehension

Question 18

Free conversation

Answer 18

will pt respond to ?s of personal or timely relevance?

Don’t forget power of y/n ?s in pts with limited speech output

Question 19

Phonological discrimination

Answer 19

discrimination of minimal pairs

Question 20

Lexical comprehension

Answer 20

Examine words out of context; have pt select items from visual multiple choice display
“point to the cup” versus “pour some water into the cup”

Question 21

Reading

Answer 21

Letter & word recognition (multiple choice, matching, oral)
Tasks targeting both oral reading & reading comprehension
Compare site reading for sound & site reading for meaning
Paralexias
Reading w/o knowledge or meaning is possible
Various forms of alexia

Question 22

Paralexias

Answer 22

Disturbance in reading ability marked by the transposition of words or syllables

Question 23

Grapheme Expression

Answer 23

Evaluate letters, short words, written syntax, recall of lexical items
Evaluate channels that go together for writing: sound-to-motor associations, visual imagery of word shapes, orthographical skills, phoneme-to-grapheme conversions
Paragraphia
Does graphemic expression parallel oral expression?

Question 24

Paragraphia

Answer 24

words or letters other than those intended are written (“dead” instead of “kill”)

Question 25

WAB

Answer 25

Western Aphasia Battery

Provides a numerical (quotient) classification of aphasia; often used in research studies

Question 26

Porch Index of Communication Ability

Answer 26

Contains 18 subtests of the four language modalities (audition, reading, speech, writing)
Very complex scoring mechanism (known as a multidimensional scale)

Question 27

Boston Diagnostic Aphasia Examination

Answer 27

Salient features:
Classification of aphasia into syndromes according to symptom patterns
Analysis of spontaneous verbalizations
Short form
Extended testing