Aphasia Assessment Related Disorders

General Overview

• Importance of proper assessment in identifying and treating aphasia and related disorders.

• Consideration of barriers and facilitators in the communication process.

• Necessity of documenting assessment results for ongoing interventions and prognosis.

Assessment of Individuals with Dementia

General Assessment Tools

• Mini-Mental State Examination (MMSE): A common tool for dementia assessment.

• Dementia Scales:

  • Blessed Dementia Scale

  • Global Deterioration Scale (GDS)

  • Clinical Dementia Rating Scale (CDR)

  • Instrumental Activities of Daily Living Scale (IADLS)

• Formal Speech/Language Testing:

  • Boston Naming Test: Particularly sensitive to early-stage word retrieval deficits.

  • Aphasia Batteries: Tailored assessments for aphasia in dementia.

Arizona Battery for Communication Disorders of Dementia (Second Edition)

• Standardized on normal adults and those with dementia.

• Comprises 14 subtests and four screening tests.

• Available Cognitive Tool Kit: Cognitive Assessment Toolkit

Global Deterioration Scale (B. Reisberg)

• Levels and Clinical Characteristics:

  • Level 1: No memory deficits evident.

  • Level 2: Subjective complaints of memory deficits, no objective evidence.

  • Level 3: Mild cognitive decline, early clear-cut deficits.

  • Level 4: Moderate cognitive decline, difficulty with complex tasks.

  • Level 5: Moderate dementia, assistance needed for daily tasks.

  • Level 6: Moderately severe dementia, requires assistance for basic needs.

  • Level 7: Severe dementia, loss of verbal abilities, requires total assistance.

Right Hemisphere Impairment

Formal Assessment Tools

• Mini Inventory of Right Brain Injury (2nd Edition): For identification and severity classification.

• Domains Covered:

  • Visuoperceptual/Visuospatial Processing

  • Lexical Knowledge Processing

  • Affective Processing

  • General Behavioral Processing

• Additional Assessments:

  • Burns Brief Inventory of Communication and Cognition

  • Rehab Institute of Chicago Clinical Management

  • Right Hemisphere Language Battery

General Assessment Needs

• Comprehensive speech/language assessment focusing on high-level language and pragmatic appropriateness.

Traumatic Brain Injury (TBI)

Assessment Procedures

• Assessment varies based on presentation; covers both cognition and language.

• Key Assessment Tools:

  • Ranchos Los Amigos Scale

  • Glasgow Coma Scale

  • Ross Information Processing Assessment-2nd Edition

Compensatory Strategies for Communication

• Use of visual aids like communication boards and pictures.

• Auditory scanning and cueing techniques.

• Writing/drawing, gestures, and AAC devices/apps when available.

• written choice cues- writing is this your daughter or niece for person who comes with them. giving them written choices

Identifying Barriers and Facilitators of Communication

Facilitators

• Support from family, availability of communication partners, personal motivation, and the ability to utilize strategies.

• supportive family members are always a plus

Barriers

• Lack of communication partners, cognitive deficits, visual/motor impairments, and other health conditions.

Outcomes of Assessment

• Diagnosis of a language disorder with detailed characteristics and severity.

• Prognosis for change and recommendations for interventions.

• Referrals for other assessments and services.

Considering Severity Level

• Scope and degree of communication deficits.

• Impact on communication and participation; consistency in performance varies across skills.

Best Practices in Sharing Assessment Results

• Tailor expressions to meet communication needs of individuals and families.

• Involve individuals with communication disorders actively in the process.

• Utilize visual aids and avoid overwhelming individuals with information.

• Address limitations of findings due to confounding factors.

Sharing Prognosis Information

• Consider factors affecting recovery patterns and provide clear, specific aspects of the prognosis.

• Ongoing considerations during interventions. No definitive guarantees of recovery.

Reporting Assessment Results in Writing

• Clarity, non-bias, and usefulness of the written content is paramount.

Typical Report Content

• Background description, summary of communication strengths and weaknesses, recommendations, and coding schemes for documentation.

Common Abbreviations in Clinical Reporting

• ADL, CABG, CAD, HTN, CHI, CXR, DNR, DOI, GSW.

Useful Resources for Reports

• Examples and templates available online for reference:

  • Diagnostic Report Example

  • AAC-RERC Archive Samples

  • Sample SLP Reports