Seton Hall University

Adler Aphasia Center

Speech/Language Evaluation
Name: K. A.
Date of Birth: November 10, 1957
Diagnosis: Aphasia
Date: April 1, 2015
Onset of Diagnosis: 48 years old
I.
History
A. Medical History and Co-morbidity
Mr. A developed aphasia after a stroke at 48 years old. Mr. As stroke caused a right
hemiparesis and has limited the use of his right arm and hand. Mr. A ambulates
independently with a cane and his vision is corrected by glasses. He receives Speech
Therapy at the Adler Aphasia Center in Maywood, New Jersey four times a week.
B. Background and Social History
Mr. A, a 57 year old male, lives at home alone in Tenafly, New Jersey. An aide visits his
home twice a week for four hours to assist him with cleaning and preparing meals. Prior
to his stroke, Mr. As profession was a lawyer. Mr. A enjoys bowling, scuba diving, and
travelling. At the Adler Aphasia Center he participates in jewelry making, acting, and
communication groups.
C. Primary Presenting Concerns affecting communication
Mr. A often has trouble with word retrieval while speaking. In order to compensate for
his word retrieval difficulties he often writes down words on a piece of paper. He is also
highly dependent on gestures. Mr. A is currently using an iPad app called Lingraphica
in addition, to assist with word retrieval.

II. Behavioral Observation

Mr. A came into the Adler Aphasia Center ready to work with the student clinicians. He
was eager to cooperate and answer questions regarding personal information about
himself pre and post stroke. It was noted that, Mr. A was enthusiastic when talking about
his future travel plans and was able to provide multiple details about his trip (i.e: who is
attending, what the plans for the trip are etc). Mr. A became easily frustrated when he
was unable to recall word. He was conscious of his deficits and would often apologize to
the clinicians. Mr. A also re-auditorized words during conversations as a cue to help
himself better understand the questions. Repetition offered him provided him with the
foundation to comprehend the topics discussed during conversations.
III. Evaluation Results
An assessment was completed using the Western Aphasia Battery (WAB) revised edition,
the ASHA Quality of Communication Life Scale and an informal observation of
communication skills.
Results of Western Aphasia Battery (not all sections Included)
Score
Spontaneous Speech

Severity
Mild- Moderate

Information Content

8/10

Fluency, Grammatical Competence, Paraphasias

5/10

Spontaneous Speech Total

13/20

Auditory Verbal Comprehension

Mild-Moderate

Yes/No Questions

60/60

Auditory Word Recognition

54/60

Sequential Commands

62/80

Auditory Verbal Comprehension Total Score

176/200

Repetition
Repetition Total

Severe
38/100

Naming and Word Finding

Moderate-Severe

Object Naming

46/60

Word Fluency

5/20

Sentence Completion

8/10

Responsive Speech

8/10

Naming and Word Finding Total

67/100

APHASIA QUOTIENT (AQ)

64.6/100

Mr. A received an Aphasia Quotient score of 64.6 out of 100 on the WAB.
INFORMAL OBSERVATION OF COMMUNICATION SKILLS INCLUDING
A. Auditory Comprehension: Functionally, Mr. A demonstrated the ability to
understand single words and simple sentences in given conversations. In addition,
he was able to elaborate on the topic of conversation but at times he displayed
difficulty understanding key details. Mr. A would often ask for clarification or
repetition of a sentence when he had difficulty recalling a word. This repetition
assisted him during the processing of the word presented.
B. Verbal Expression: Mr. A displayed a mild level of difficulty with verbal
expression. When attempting to recall a target word, Mr. A would perform a
gesture indicating he is unable to recall the word. For example, he would tap his
palm on his forehead. Mr. A wrote words down on a piece of paper to assist with
the process of word recall and verbal expression. His iPad was also incorporated
to provide Mr. A with guidance during spontaneous conversations with the student

clinicians. Often times, the iPad created a communication breakdown and he

would revert back to handwriting for word retrieval.
Results of ASHA Quality of Communication Life Scale:
Item # Item Score
1. I like to talk with people. - 3
2. Its easy for me to communicate. - 4.5
3. My role in the family is the same. - 2
4. I like myself. - 4
5. I meet the communication needs of my job or school. - 4
6. I stay in touch with family and friends. - 4
7. People include me in conversations. - 4
8. I follow news, sports and stories on TV/movies. - 5
9. I use the telephone. - 4
10. I see the funny things in life. - 5
11. People understand me when I talk. - 4
12. I keep trying when people dont understand me. - 5
13. I make my own decisions. - 3
14. I am confident that I can communicate. - 5
15. I get out of the house and do things. - 5
16. I have household responsibilities. - 4
17. I speak for myself. - 5
18. In general, my quality of life is good. - 5
OVERALL SCORE AND SHORT ANALYSIS OF QCL
Total: 73
# Items Scored: 18
Mean Score: 4.56
Mr. As overall score is a 4.56 out of 5. After his stroke, he continues to have a positive
outlook on his social communication and ability to interact with others. Areas where his
quality of life scores were lower was his role in the family and his ability to make
decisions for himself.
IV. Summary
Mr. A has a mild-moderate receptive and a moderate-severe non-fluent expressive
aphasia. His Aphasia Quotient classifies him as a patient with conduction aphasia.
V. Prognosis
Prognosis is very good for improving his receptive and expressive language abilities. He
is willing to learn new strategies in order to improve his communication abilities. In
addition, he demonstrates a positive outlook on his current strengths and weaknesses,
which will allow him to succeed in therapy.
VI. Recommendations
Mr. A will benefit from group therapy in order to foster communication with other
individuals. He will also benefit from individual therapy in order to work on his ability
to use his compensatory strategies (gestures, iPad, and writing). It is recommended that

he participates in group therapy twice a week and individual therapy twice a week.
Reevaluation at the end of one year would be warranted to determine if continued
therapy is necessary.
VII. Treatment Goals
A. Long Term Goals (1 year):
1.0 Auditory Comprehension: Within one year, Mr. A will answer 5-7 WHquestions in a simple sentence regarding a given topic with 90% accuracy.
2.0 Verbal Expression: Within one year, Mr. A will label common objects as well
as identify their function in a simple sentence with 90% accuracy.
B. Short Term Goals:
1.1 Auditory Comprehension: Mr. A will answer 3-5 WH- questions in a short
phrase regarding a given topic with 90% accuracy and an immediate verbal
model.
1.2 Auditory Comprehension: Mr. A will answer 3-5 WH- questions in a simple
sentence regarding a topic that is familiar to him with 90% accuracy with a
delayed verbal cue.
2.1 Verbal Expression: Mr. A will label 5-7 common objects as well as identify 2
of the objects functions in a short phrase with 90% accuracy.
2.2 Verbal Expression: Mr. A will label 10-12 common objects as well as identify
their function in a simple sentence with 90% accuracy.
C. Clients Goals: Mr. A would like to be able to make more decisions for himself, as
well as improve his expressive language abilities during social communication.