assessment and neuroplasticity

assessment procedures

• case history including psychosocial factors

• assessment

• neurological exam

case history form includes:

• Lesion/imaging information

• Pt/Family interview

• Intake form

assessment includes:

• Informal (observations, error analysis)

• Formal

which type of assessment is “gold” in assessment?

informal

formal type tools

• Aphasia/cognitive- linguistic diagnostic

• Cognition

• Bilingual assessment

• Language sample

neurological exam

motor speech screen

qualitative interview differs by _______

setting

what questions may be included in a qualitative interview

• Does the person know what is wrong? Do they understand what aphasia is? (they may not know what aphasia is)

• What helps and what hinders communication with others?

• Can they perform specific tasks relevant to the setting (such as contacting the RN or caregiver)?

functional assessment tool

Inpatient Functional Communication Interview

• designed for acute care setting

• goal-focused, functional

• we accomodate for the patient-adjust speech rate, clarity, speech style

standardized gold standard of aphasia

Western Aphasia Battery

Western Aphasia Battery 4 areas of assessment

1. Speech production score:

2. Auditory comprehension:

3. Repetition

4. Word-retrieval (versus naming)

• Content: 0-10 severely nonfluent (or lack of comprehension) to normal

• Fluency: 0-4 nonfluent aphasias, 5 is borderline (often milder Broca’s or mod-severe anomia), 6-10 fluent aphasia

speech production in Western Aphasia Battery

• yes/no questions: personal information to comparisons

• categories of single-word comprehension

• commands from 1 to 3 steps

auditory comprehension in Western Aphasia Battery

repetition in Western Aphasia Battery

from 1 syllable to sentence level

word retrieval in Western Aphasia Battery

• Confrontation naming

• Generative naming

• Sentence (phrase) completion

• Responsive naming

“what’s this?”

• track errors/paraphasias

• different point values for errorful productions

• effect of hierarchical cueing: tactile, phonemic, semantic

confrontation naming

“Name as many ___ as you can in 1 minute.”

generative naming

Salt and ___”

sentence completion

What do you do with a spoon?”

responsive naming

includes rating scale profile of speech characteristics, reading and writing

Boston Diagnostic Assessment Exam (BDAE) short form

pick and choose subtests to more closely assess specific skills

Boston Diagnostic Assessment Exam (BDAE) long form

Results demonstrate criterion (concurrent) validity with WAB

Quick Aphasia Test (free online)

Quick Aphasia Test (free online) includes what 3 things?

Includes alertness and orientation (AAOx#) and motor speech screening

• assesses types of cues provided

• identifies types of paraphasia

  • phonological

  • verbal (semantic)

  • multi-word

  • perceptual

Boston naming test (BNT)

Boston naming test (BNT) assesses types of cues provided

• latency (word-retrieval delay)

• stimulus cues (semantic cue)

• phonemic cues

• multiple choice (written)

Boston naming test (BNT) identifies types of paraphasia

• phonological

• verbal (semantic)

• multi-word

• perceptual (visual, auditory, sensory)

Correlates to aphasia severity level on the Western Aphasia Battery-Revised

Severity Calibrated Aphasia Naming Test (SCANT)

Severity Calibrated Aphasia Naming Test (SCANT) can be used to assess _____

cueing

• Similar to BNT, but assesses 30 actions

• Helpful for assessing individuals with __________ aphasia or for comparing objects vs. action naming

Hopkins Action Naming Assessment

agrammatic

• Micro- and macro-structure measures

• Picture description

  • Cookie theft, Cat rescue

• Prompts

  • Tell me about an important event in your life

  • Tell me what you remember about when you had your stroke OR what led to a diagnosis of aphasia

Language sample analysis

Assesses underlying semantic knowledge via various associations of nouns

Pyramids and Palm Trees Test

Assesses underlying semantic knowledge via various associations for actions

Kissing and Dancing Test

• Non-linguistic: cognition

• Linguistic: aphasia

• Cognitive domains

  • attention

  • language

  • memory

  • visuospatial skills

  • EFs

  • clock drawing

Cognitive Linguistic Quick Test (CLQT)

Assesses communicative ability in daily functions via scenarios and role play. Discrete language skills are not assessed; performance is cumulative.

Communication Activities of Daily Living (CADL-3)

_________ assessment is almost superior to _________

qualitative; quantitative

For all diagnostic activities, look at:

• Effective cues (cues that work most consistently and cues that DON’T work)

• Error and response analysis (can this information be used as a strength?)

• Intentionality and self-awareness

• Use of alternate modalities

• Extra-performance factors (fatigue, motivation, response to environmental variables)

recommendations for cognitive involvement in assessment

• Include informal or qualitative observations when considering performance

• Adaptation of standardized tests

Adaptation of standardized tests

• Consider noise vs. quiet

• Increase the number of prompts (within test instructions)

• Decrease memory demands through pauses

• Only vary conditions, not stimuli