Aphasia

Examinations to determine Aphasia

Boston Diagnostic Aphasia Examination (BDAE)
The BDAE is designed to diagnose aphasia and related disorders. This test evaluates various perceptual modalities
(auditory, visual, and gestural) processing functions (comprehension, analysis, problem-solving) and response modalities
(writing, articulation, and manipulation). BDAE can be used by neurologists, psychologists, speech language pathologists
and occupational therapists.

It was developed by by Harold Goodglass and Edith Kaplan in 1972

Subscales:

The BDAE is comprised of 8 subscales:

Fluency
Auditory comprehension
Naming
Oral reading
Repetition
Automatic speech
Reading comprehension
Writing
1. Fluency: In this section the client should be encouraged to engage in a free narrative and an open-ended conversation.

2. Auditory Comprehension

Word discrimination

Body part identification

Commands

3. Naming

Visual confrontation

Animal naming

Body part naming

4. Oral reading

5.Repetition
6. Automatic speech

Reciting

7. Reading comprehension

*Symbol discrimination

*Word-picture matching

*Sentences and paragraphs

8. Writing

*Serial writing

*Sentences to dictation

*Narrative writing
Western Aphasia Battery - WAB
The Western Aphasia Battery (WAB) was developed by Kertesz in 1979 based on the format of the Boston Diagnostic
Aphasia Examination

Western Aphasia Battery (WAB) is used for assessing the language function of adults with suspected neurological
disorders as a result of a stroke, head injury, or dementia. It helps discern the presence, degree, and type of aphasia. It
also measures how the patient performed on the test to provide a baseline so they can detect changes throughout their
time in therapy. This also allows to see the patient's language strengths and weaknesses so that they can figure out what
to treat, and lastly, it can infer the location of the lesion that caused aphasia.

Purpose:

It was designed as an assessment tool to examine linguistic skills (information content, fluency, auditory comprehension,
repetition, naming and word finding, reading, and writing) and main nonlinguistic skills (drawing, block design,
calculation, and praxis) of adults with aphasia. The observed language behaviours facilitate diagnosis by classifying the
patient as having 1 of 8 types of aphasia .

This provides information regarding the type and severity of aphasia and lesion location.

Patients between the ages of 18 and 89 with acquired neurological disorders due to stroke, a head injury, or dementia.
Versions:

The WAB was originally developed by Kertesz in 1979. It was revised in 1982 and then again in 2006, and was published as
the Western Aphasia Battery-Revised (WAB-R). The WAB-R has a number of improvements including supplemental
tasks, revision of the items, more modern equipment as well as revised directions and scoring guidelines for clarity.

Subscales

The WAB is comprised of 8 subscales.

1. Spontaneous speech
2. Auditory verbal comprehension
3. Repetition
4. Naming and word finding
5. Reading
6. Writing
7. Apraxia
8. Constructional, visuospatial, and calculation tasks
9. Supplemental writing and reading tasks (WAB-R only)
The WAB consists of two parts. Each part has different subsets to it which would be discussed below:

Part 1:

Subtest 1: spontaneous speech

Conversational question-In this task the person is asked to verbally respond to 6 personal questions.

Personal description-He/she describes a picture in the stimulus book.

Subtest 2: Auditory verbal comprehension Auditory word recognition-The person is shown objects, cards,
letters,numbers etc., then the perso

n should point to what the examiner says.

Sequential commands-He/she is asked to execute 11 commands that increase in difficulty and length.
Subtest 3; Repetition

He/she must repeat words, phrases and sentences

Subtest 4: Naming and word forming

This includes showing various objects from different categories and ask them to
name one at a time.

Sentence completion-the person must complete the sentences that are read to
them.

Word fluency-the person is asked to name as many animals as they can in one
minute.
Part 2: Reading

It includes reading comprehension of sentences.

Written word stimulus-object choice matching, Written word stimulus-picture choice matching,
Picture stimulus-written word choice matching, Spoken word-written word choice matching, Spelled
word recognition.

Subtest : Writing

Writing on request, writing to dictation, alphabets and numbers etc.,

Subtest: Apraxia

-20 actions are to be performed.

Subtest : Constructional, visuospatial and calculation tasks

Drawing, Block design and calculations.

The WAB has high validity and reliability.

The WAB has been used to detect change in communication or severity of aphasia over time or in
response to intervention.

Shewan (1986) examined change in WAB scores over time in a sample of 50 adults with aphasia
secondary to acute stroke, who received treatment (n=42) or no treatment (n=8). Participants were
assessed at baseline (2-4 weeks post-onset of aphasia), 3 months, and at least 6 months post-baseline.
There was a significant main effect for time analysis by Newman-Keuls shortest significant range test
revealed significant differences in the mean scores for the three tests .

These significant increases in WAB scores with recovery supports its validity as a measure of severity.