Comprehensive aphasia test

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Comprehensive aphasia test

The comprehensive aphasia test (CAT) was created by Kate Swinburn (from Connect: a charity for people with aphasia), Gillian Porter (an NHS therapist from Hertfordshire) and David Howard (a Research Development Professor). The CAT is a new test for people who have acquired aphasia, the impairment of language ability. The comprehensive assessment can be completed over one or two sessions. The test contains a cognitive screening, a language battery and a disability questionnaire. The authors of the comprehensive aphasia test take account of current linguistic and psychological theory and other variable that impact aphasic performance. The CAT was published in 2005 and was the first new aphasia test in English for 20 years. The test is designed to (1) screen for associated cognitive deficits,(2) assess language impairment in people with aphasia, (3) investigate the consequences of the aphasia on the individual's lifestyle and emotional well-being, and (4) monitor changes in the aphasia and its consequences over time. [1] [2] [3] [4] [5] [6]

Parts of the test and subtests

The cognitive section assesses people's abilities across a wide range of tasks that can impact rehabilitation.

Forming the main body of the test, the language battery provides a profile of performance across all modalities of language production and comprehension.

The disability questionnaire explores the practical, psychological, and social impact of impairment from the perspective of the person living with aphasia. The disability questionnaire is optional.

There are 5 receptive subtests (3 auditory comprehension, 2 visual comprehension) and 16 expressive subtest (5 repetition, 3 naming, 4 reading, 4 writing) Neuropsychological deficits that could be associated with aphasia are tested in 6 subtests (line bisection, semantic memory, word fluency, recognition memory, gesture object use, arithmetic).

Related Research Articles

<span class="mw-page-title-main">Aphasia</span> Inability to comprehend or formulate language

In aphasia, a person may be unable to comprehend or unable to formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in the Global North. Aphasia can also be the result of brain tumors, epilepsy, autoimmune neurological diseases, brain infections, or neurodegenerative diseases.

<span class="mw-page-title-main">Expressive aphasia</span> Language disorder involving inability to produce language

Expressive aphasia, also known as Broca's aphasia, is a type of aphasia characterized by partial loss of the ability to produce language, although comprehension generally remains intact. A person with expressive aphasia will exhibit effortful speech. Speech generally includes important content words but leaves out function words that have more grammatical significance than physical meaning, such as prepositions and articles. This is known as "telegraphic speech". The person's intended message may still be understood, but their sentence will not be grammatically correct. In very severe forms of expressive aphasia, a person may only speak using single word utterances. Typically, comprehension is mildly to moderately impaired in expressive aphasia due to difficulty understanding complex grammar.

Aphasiology is the study of language impairment usually resulting from brain damage, due to neurovascular accident—hemorrhage, stroke—or associated with a variety of neurodegenerative diseases, including different types of dementia. These specific language deficits, termed aphasias, may be defined as impairments of language production or comprehension that cannot be attributed to trivial causes such as deafness or oral paralysis. A number of aphasias have been described, but two are best known: expressive aphasia and receptive aphasia.

<span class="mw-page-title-main">Anomic aphasia</span> Medical condition

Anomic aphasia is a mild, fluent type of aphasia where individuals have word retrieval failures and cannot express the words they want to say. By contrast, anomia is a deficit of expressive language, and a symptom of all forms of aphasia, but patients whose primary deficit is word retrieval are diagnosed with anomic aphasia. Individuals with aphasia who display anomia can often describe an object in detail and maybe even use hand gestures to demonstrate how the object is used, but cannot find the appropriate word to name the object. Patients with anomic aphasia have relatively preserved speech fluency, repetition, comprehension, and grammatical speech.

Anosognosia is a condition in which a person with a disability is cognitively unaware of having it due to an underlying physical condition. Anosognosia results from physiological damage to brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere, and is thus a neuropsychiatric disorder. A deficit of self-awareness, it was first named by the neurologist Joseph Babinski in 1914.

<span class="mw-page-title-main">Conduction aphasia</span> Medical condition

Conduction aphasia, also called associative aphasia, is an uncommon form of difficulty in speaking (aphasia). It is caused by damage to the parietal lobe of the brain. An acquired language disorder, it is characterised by intact auditory comprehension, coherent speech production, but poor speech repetition. Affected people are fully capable of understanding what they are hearing, but fail to encode phonological information for production. This deficit is load-sensitive as the person shows significant difficulty repeating phrases, particularly as the phrases increase in length and complexity and as they stumble over words they are attempting to pronounce. People have frequent errors during spontaneous speech, such as substituting or transposing sounds. They are also aware of their errors and will show significant difficulty correcting them.

<span class="mw-page-title-main">Global aphasia</span> Medical condition

Global aphasia is a severe form of nonfluent aphasia, caused by damage to the left side of the brain, that affects receptive and expressive language skills as well as auditory and visual comprehension. Acquired impairments of communicative abilities are present across all language modalities, impacting language production, comprehension, and repetition. Patients with global aphasia may be able to verbalize a few short utterances and use non-word neologisms, but their overall production ability is limited. Their ability to repeat words, utterances, or phrases is also affected. Due to the preservation of the right hemisphere, an individual with global aphasia may still be able to express themselves through facial expressions, gestures, and intonation. This type of aphasia often results from a large lesion of the left perisylvian cortex. The lesion is caused by an occlusion of the left middle cerebral artery and is associated with damage to Broca's area, Wernicke's area, and insular regions which are associated with aspects of language.

Specific language impairment (SLI) is diagnosed when a child's language does not develop normally and the difficulties cannot be accounted for by generally slow development, physical abnormality of the speech apparatus, autism spectrum disorder, apraxia, acquired brain damage or hearing loss. Twin studies have shown that it is under genetic influence. Although language impairment can result from a single-gene mutation, this is unusual. More commonly SLI results from the combined influence of multiple genetic variants, each of which is found in the general population, as well as environmental influences.

Transcortical motor aphasia (TMoA), also known as commissural dysphasia or white matter dysphasia, results from damage in the anterior superior frontal lobe of the language-dominant hemisphere. This damage is typically due to cerebrovascular accident (CVA). TMoA is generally characterized by reduced speech output, which is a result of dysfunction of the affected region of the brain. The left hemisphere is usually responsible for performing language functions, although left-handed individuals have been shown to perform language functions using either their left or right hemisphere depending on the individual. The anterior frontal lobes of the language-dominant hemisphere are essential for initiating and maintaining speech. Because of this, individuals with TMoA often present with difficulty in speech maintenance and initiation.

<span class="mw-page-title-main">Mixed transcortical aphasia</span>

Mixed transcortical aphasia is the least common of the three transcortical aphasias. This type of aphasia can also be referred to as "Isolation Aphasia". This type of aphasia is a result of damage that isolates the language areas from other brain regions. Broca's, Wernicke's, and the arcuate fasiculus are left intact; however, they are isolated from other brain regions.

The Wechsler Intelligence Scale for Children (WISC) is an individually administered intelligence test for children between the ages of 6 and 16. The Fifth Edition is the most recent version.

<span class="mw-page-title-main">Primary progressive aphasia</span> Medical condition

Primary progressive aphasia (PPA) is a type of neurological syndrome in which language capabilities slowly and progressively become impaired. As with other types of aphasia, the symptoms that accompany PPA depend on what parts of the left hemisphere are significantly damaged. However, unlike most other aphasias, PPA results from continuous deterioration in brain tissue, which leads to early symptoms being far less detrimental than later symptoms.

Auditory verbal agnosia (AVA), also known as pure word deafness, is the inability to comprehend speech. Individuals with this disorder lose the ability to understand language, repeat words, and write from dictation. Some patients with AVA describe hearing spoken language as meaningless noise, often as though the person speaking was doing so in a foreign language. However, spontaneous speaking, reading, and writing are preserved. The maintenance of the ability to process non-speech auditory information, including music, also remains relatively more intact than spoken language comprehension. Individuals who exhibit pure word deafness are also still able to recognize non-verbal sounds. The ability to interpret language via lip reading, hand gestures, and context clues is preserved as well. Sometimes, this agnosia is preceded by cortical deafness; however, this is not always the case. Researchers have documented that in most patients exhibiting auditory verbal agnosia, the discrimination of consonants is more difficult than that of vowels, but as with most neurological disorders, there is variation among patients.

Western Aphasia Battery (WAB) is an instrument for assessing the language function of adults with suspected neurological disorders as a result of a stroke, head injury, or dementia. There is an updated version, the Western Aphasia Battery-Revised (WAB-R). 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. Another such test is the Boston Diagnostic Aphasia Examination. The WAB targets English speaking adults and teens with a neurological disorder between the ages of 18 and 89 years old. The WAB tests both linguistic and non linguistic skills. The linguistic skills assessed include, speech, fluency, auditory comprehension, reading and writing. The non-linguistic skills tested include drawing, calculation, block design and apraxia.

The Boston Diagnostic Aphasia Examination is a neuropsychological battery used to evaluate adults suspected of having aphasia, and is currently in its third edition. It was created by Harold Goodglass and Edith Kaplan. The exam evaluates language skills based on perceptual modalities, processing functions, and response modalities. Administration time ranges from 20 to 45 minutes for the shortened version but it can last up to 120 minutes for the extended version of the assessment. There are five subtests which include: conversational & expository speech, auditory comprehension, oral expression, reading, and writing. In the extended version all questions are asked while in the shortened version only a few questions are asked within each subtest. Many other tests are sometimes used by neurologists and speech language pathologists on a case-by-case basis, and other comprehensive tests exist like the Western Aphasia Battery.

Aprosodia is a neurological condition characterized by the inability of a person to properly convey or interpret emotional prosody. Prosody in language refers to the ranges of rhythm, pitch, stress, intonation, etc. These neurological deficits can be the result of damage of some form to the non-dominant hemisphere areas of language production. The prevalence of aprosodias in individuals is currently unknown, as testing for aprosodia secondary to other brain injury is only a recent occurrence.

Jargon aphasia is a type of fluent aphasia in which an individual's speech is incomprehensible, but appears to make sense to the individual. Persons experiencing this condition will either replace a desired word with another that sounds or looks like the original one, or has some other connection to it, or they will replace it with random sounds. Accordingly, persons with jargon aphasia often use neologisms, and may perseverate if they try to replace the words they can not find with sounds.

<span class="mw-page-title-main">Right hemisphere brain damage</span> Medical condition

Right hemisphere brain damage (RHD) is the result of injury to the right cerebral hemisphere. The right hemisphere of the brain coordinates tasks for functional communication, which include problem solving, memory, and reasoning. Deficits caused by right hemisphere brain damage vary depending on the location of the damage.

The Boston Naming Test (BNT), introduced in 1983 by Edith Kaplan, Harold Goodglass and Sandra Weintraub, is a widely used neuropsychological assessment tool to measure confrontational word retrieval in individuals with aphasia or other language disturbance caused by stroke, Alzheimer's disease, or other dementing disorder. A common and debilitating feature is anomic aphasia, an impairment in the ability to name objects. The BNT contains 60 line drawings graded in difficulty. Patients with anomia often have greater difficulties with the naming of not only difficult and low frequency objects but also easy and high frequency objects. Naming difficulties may be rank ordered along a continuum. Items are rank ordered in terms of their ability to be named, which is correlated with their frequency. This type of picture-naming test is also useful in the examination of children with learning disabilities and the evaluation of brain-injured adults.

Phonological dyslexia is a reading disability that is a form of alexia, resulting from brain injury, stroke, or progressive illness and that affects previously acquired reading abilities. The major distinguishing symptom of acquired phonological dyslexia is that a selective impairment of the ability to read pronounceable non-words occurs although the ability to read familiar words is not affected. It has also been found that the ability to read non-words can be improved if the non-words belong to a family of pseudohomophones.

References

  1. Bruce, C.; Edmundson, A. (2010). ""Letting the CAT out of the bag: A review of the Comprehensive Aphasia Test. Commentary on Howard, Swinburn, and Porter, "Putting the CAT out: What the Comprehensive Aphasia Test has to offer". Aphasiology . 24 (1): 79–93. doi:10.1080/02687030802453335. S2CID   144065963.
  2. Howard, D.; Swinburn, K.; Porter, G (2004). Comprehensive Aphasia Test. Routledge.Psychology Press. ISBN   978-1-84169-379-8.
  3. "Sorry! That Page Cannot be Found". Archived from the original on 2010-01-19.
  4. Bruce, C.; Edmundson, A. (2010). "Letting the CAT out of the bag: A review of the Comprehensive Aphasia Test. Commentary on Howard, Swinburn, and Porter, oPutting the CAT out: What the Comprehensive Aphasia Test has to offero". Aphasiology . 24: 79–93. doi:10.1080/02687030802453335. S2CID   144065963.
  5. Springer, L.; Mantey, S. (2010). ""The Comprehensive Aphasia Test: A review. Commentary on Howard, Swinburn, and Porter, "Putting the CAT out: What the Comprehensive Aphasia Test has to offer". Aphasiology . 24 (1): 75–78. doi:10.1080/02687030802453301. S2CID   143406740.
  6. c. Transforming clinical practice in aphasia: The Comprehensive Aphasia Test (CAT). (n.d.). Retrieved November 11, 2017, from http://impact.ref.ac.uk/CaseStudies/CaseStudy.aspx?Id=21714