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!


  1. I started a blog....Goddess Aphasiadite

    And, would like if you could comment on my blog sometimes....and I could comment on your blog.

  2. I like the blog, but do have one suggestion. This suggestion is especially true because your communicating with folks with aphasia.

    There are calculators to determine the difficulty of a piece of prose. The first sentence in this blog entry (Testing and aphasia) requires a postgraduate+ educational level. This is determined by the SMOG Calculator.

    Making things understandable, and scientifically accurate is incredibly hard to do. Good luck!

  3. And speaking of tests.....My husband here in Australia has primary progressive aphasia. I can't tell you the number of times he has had to sit through the Boston Naming Test in the six or so years since he was diagnosed. His results fluctuate a fair bit, depending on a variety of factors (some to do with the degenerative nature of PPA, and others to do with contextual factors). This doesn't worry us too much because it's only one of several tools his therapists have use over the years.

    Even so, I cringe whenever I witness my husband struggling to find the word 'beaver' or 'acorn' in response to drawings of those things -- neither of which appears naturally in the Australian 'bush'. (Would you recognise that 'bush' used in that sentence means 'countryside'?)

    No therapist has been able to tell me why someone doesn't adapt that standard test to be more relevant to the countries in which it is administered. We have 'possums' here (not beavers) and gum nuts (not acorns) and most Australians would recognise drawings of those.

    'Tables' and other such generic items are fine in any English-speaking country, but North American native fauna and flora really don't register with Australians, no matter whether or not they have aphasia. And as you know, every item not named or named incorrectly can contribute to a person's anxiety level and render the instrument less reliable.

    I wonder: Whose job would it be to develop culturally specific equivalants to standardised American tests????