Western Aphasia Battery - Revised (WAB-R)

WAB-R Overview

- receptive and expressive test for Aphasia

- 2 versions: standard and bedside

- includes Raven's Coloured Progressive Matrices test

age range for WAB-R

adult (including teenager)

subdivisions in Standard WAB-R

9 main areas

4 in part 1 (oral / verbal)

5 in part 2 (graphic / visual / apraxia)

subdivisions in bedside WAB-R

10 areas

administration times for WAB-R

standard: 1-2 hours

bedside: 15 minutes

standardization sample for WAB-R

- 365 aphasia patients total

- 165 non aphasia controls total (some with other brain injury)

- done in 4 stages over time (varied dates and item administered) included original and revised versions of the test

standardization data (1st standardization)

- reported for subtest groupings (fluency, comprehension, repetition, naming, info)

- mean scores

- standard deviation

- aphasia quotient (selected score sums) (control, mean scores: 93.8-98.4) (aphasia patients, mean scores: 10.5-83.3)

- criterion validity

- attempts to differentiate aphasia types by score patterns and clustering (numerical taxonomy)

- attempts to standardize with patients with Alzheimer's Disease

criterion validity with WAB-R

- ability to discriminate between aphasia and non

- aphasia to quotient significant for discrimination ability

- normal = mean 93.8

- anomic aphasia (mild) = mean 83.3

- difference significant p<0.0005

- recovered aphasia patients = mean 97.47

- fluency rating (all normal achieved subtest score = 10

reliability data (1st standardization)

- intra rater - done on videotaped performances with long time frames between repeat scorings. correlations: 0.79 - 0.99

- inter rater: correlations: 0.98 - 0.99

- test retest: correlations: 0.45 - 0.97

WAB-R materials

- stimulus materials: stimulus book, test objectives (common items, Koh's blocks (4))

- response forms: record form part 1, record form part 2, bedside record form

- examiners manual

WAB-R Organization (part 1)

- spontaneous speech: conversational speech, picture descriptions

- auditory visual comprehension: yes/no questions, auditory word recognition, sequential commands

- repetition

- naming and word finding: object naming, word fluency, sentence completion, response speech (answer questions)

WAB-R organization (part 2)

- reading: comprehension of sentences, reading commands, written word - object matching, written word - picture choice matching, picture written word choice matching, spoken word written word choice matching, letter discrimination, spelled word recognition, spelling

- writing: writing upon request, writing output, writing to dictation, writing dictated words, alphabet and numbers, dictated letters and numbers, copying a sentence

- apraxia: upper limb, facial, instrumental (objects), complex

- construction, visuospatial, and calculation: drawing, block design (Koh's Blocks), calculation, raven's Coloured Progressive Matrices

- supplemental writing and reading: writing irregular words to dictation, writing non words to dictation, reading irregular words, reading non words

WAB-R organization bedside

- spontaneous speech: content

- spontaneous speech: fluency

- auditory verbal comprehension: yes / no questions

- sequential commands

- repetition

- object naming

- reading

- writing

- apraxia (optional)

WAB-R administration

method varies by item

- verbal stimuli (questions, requests, etc.)

- pictures, written item in stimulus booklets

- manipulatives

all items in subtest administered (not basal ceiling) but parts can be done separately (part 1, part 2, bedside)

WAB-R scoring raw scores

- spontaneous speech: (A) conversational questions and (B) picture descriptions

- information content of spontaneous speech (0-10 pt scale)

- fluency, grammatical competence and paraphasias (0-10 pt scale)

- repetition subtest: verbal apraxia rating (absent - mild - moderate - severe

- apraxia scoring (part 2): 0-3 based on specific criteria

- other tests: points as specified for correct / incorrect (some items can be >1 point for correct)

WAB-R scoring: score summary worksheet part 1

- spontaneous speech score (subtest sum)

- auditory verbal comprehension score (subtest sum)

- repetition score

naming and word finding score (subtest sum)

- AQ (Aphasia Quotient): sum of above 4 scores x 2, indicates severity

- aphasia classification criteria: fluency, auditory verbal comprehension, repetition, naming and word finding scores compared to criteria

WAB-R scoring: score summary worksheet part 2

- reading score

- writing score

- LQ (language quotient) indicator of severity but not normed as well as aphasia quotient: sums 2 + selected scores from part 1

- CQ (cortical quotient) indicator of severity: apraxia score + writing score + reading score + selected items from part 1

- supplemental writing and reading scores

WAB-R scoring: bedside

- bedside aphasia score: average of selected raw scores x 10

- bedside language score: average of selected raw scores x 10

- bedside aphasia classification criteria: fluency, auditory verbal comprehension, repetition scores vs cutoffs to determine aphasia type