Research Article: A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function

Date Published: February 9, 2018

Publisher: Public Library of Science

Author(s): Stephen M. Wilson, Dana K. Eriksson, Sarah M. Schneck, Jillian M. Lucanie, Lutz Jäncke.

http://doi.org/10.1371/journal.pone.0192773

Abstract

This paper describes a quick aphasia battery (QAB) that aims to provide a reliable and multidimensional assessment of language function in about a quarter of an hour, bridging the gap between comprehensive batteries that are time-consuming to administer, and rapid screening instruments that provide limited detail regarding individual profiles of deficits. The QAB is made up of eight subtests, each comprising sets of items that probe different language domains, vary in difficulty, and are scored with a graded system to maximize the informativeness of each item. From the eight subtests, eight summary measures are derived, which constitute a multidimensional profile of language function, quantifying strengths and weaknesses across core language domains. The QAB was administered to 28 individuals with acute stroke and aphasia, 25 individuals with acute stroke but no aphasia, 16 individuals with chronic post-stroke aphasia, and 14 healthy controls. The patients with chronic post-stroke aphasia were tested 3 times each and scored independently by 2 raters to establish test-retest and inter-rater reliability. The Western Aphasia Battery (WAB) was also administered to these patients to assess concurrent validity. We found that all QAB summary measures were sensitive to aphasic deficits in the two groups with aphasia. All measures showed good or excellent test-retest reliability (overall summary measure: intraclass correlation coefficient (ICC) = 0.98), and excellent inter-rater reliability (overall summary measure: ICC = 0.99). Sensitivity and specificity for diagnosis of aphasia (relative to clinical impression) were 0.91 and 0.95 respectively. All QAB measures were highly correlated with corresponding WAB measures where available. Individual patients showed distinct profiles of spared and impaired function across different language domains. In sum, the QAB efficiently and reliably characterized individual profiles of language deficits.

Partial Text

This paper describes a quick aphasia battery (QAB) that was designed to support research into neuroplasticity of language networks after damage to language regions of the brain. There are three crucial features needed in an aphasia battery in this research context.

Transcriptions and scores for each item for each participant are provided in S1 Dataset.

A matrix of correlation coefficients was calculated between the eight QAB summary measures, based on the scores of both groups of individuals with aphasia. The chronic group’s scores were averaged across their three sessions, but only the first rater’s scores were used, because only the first rater had also rated the acute patients. The correlation matrix is shown in Fig 15.

This paper has described the construction and validation of the QAB, a new aphasia battery that can typically be administered in about a quarter of an hour, and yields multidimensional profiles of individual patients quantifying their strengths and weaknesses across core language domains. This efficient language assessment was made possible by careful selection of items, a graded scoring system, and a set of summary measures conceptualized in terms of underlying language functions. The reference data show that the QAB is reliable and valid. Inter-rater reliability was excellent for all summary measures. Test-retest reliability was excellent for six summary measures and good for two (word comprehension and sentence comprehension). All of the QAB summary measures corresponded closely to related measures in the WAB (except for reading, which was not assessed in the core WAB), indicating strong concurrent validity. The profiles of 16 chronic post-stroke patients showed that the QAB can reveal individual patterns of spared and impaired language domains.

 

Source:

http://doi.org/10.1371/journal.pone.0192773

 

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