Monday, March 15, 2010

Testing and aphasia

When you are receiving speech therapy or other therapy services, your therapist will typically do a standardized test (a test that tells how well someone in doing in relation to other people who have the same problem) at the beginning to decide how severe the aphasia is and your strengths and weaknesses with language. Depending upon what kind of test is given, and there are only a few out there, your therapist may set goals based upon your performance on these tests. Typical goals produced in this manner will deal with auditory comprehension or verbal expression. Using the test to target weak areas is one school of thought, whereas the other school of thought is to use the test to show me your strengths. I prefer this approach because, through your strengths, I can help you target your weaknesses in one area while providing success in other areas. I already know that you have aphasia, and that you probably have difficulty with some test items. What I don't know is, what are you good at? For example, if you're good at writing single words, then we may use that in therapy to help you communicate your ideas.

A recent survey by the American Speech-Language and Hearing Association showed that not all outpatient therapists give discharge tests to show your progress. This is most likely to do with insurance reimbursement and lack of available time for the therapist. If you have received post-testing, it's important to keep the scores in perspective. I would caution that put too much emphasis on scores, whether good or bad, is confusing the issue. You could have great final scores and only be able to do the tasks that are on the test, such as being able to point to alphabet letters. You could get poor scores (let's face it, no one likes tests), but now be able to say "hi" to your friends and better follow a conversation. Most aphasia tests only give credit for verbal responses, meaning that if you drew, wrote, or gestured the answers, you don't get credit for it.
As always, demand that your therapist work on things that are important to you! Even I fall asleep doing those silly reading questions about aardvarks and such!