2 hour assessment session for Aphasia (post-stroke)

1. Case Hx
2. Comprehensive Aphasia Battery
a. WAB-R (60 mins) structuralist
i. Language function
ii. Content
iii. Fluency
iv. Auditory comprehension
v. Repetition
vi. Naming
vii. Reading
viii. Writing
ix. calculations
b. CAT (90-120 mins) functionalist
i. Cognitive screener
ii. Language battery
1. Auditory comprehension
2. Visual comprehension
3. Repetition
4. Naming
5. Reding
6. Writing
7. Line bisection
8. Semantic memory
9. Word fluency
10. Recognition memory
11. Gesture object use
12. Arithmetic
iii. Disability questionnaire
c. BDAE (90-120 mins)
i. Fluency
ii. Auditory comprehension
iii. Naming
iv. Oral reading
v. Repetition
vi. Automatic speech
vii. Reading comprehension
viii. Writing
3. Activity/Participation considerations (e.g. observation of everyday activity)
a. Communication Activities of Daily Living (CADL-2) (30mins)
i. Reading, writing, using numbers
ii. Social interactions
iii. Divergent communication
iv. Contextual communication
v. Non-verbal communication
vi. Sequential relationships
vii. Humour/metaphor absurdity, internet basics.
 b. Functional Assessment of Verbal Reasoning (FAVRES) – for people wanting to work
again
4. Environmental considerations (e.g. convo with comm. partner)
a. POWERS
b. Health Professionals and Aphasia Questionnaire (HPAQ)
5. QOL Ax (okay to give some of these to be filled out outside of session)
a. SAQOL
b. Assessment for Living with Aphasia (ALA)
6. Screening for depression, cognition, swallowing, pragmatics
a. Stroke Aphasia Depression Questionnaire (SADQ)
b. SADQ-H10 (for other health professionals to fill out)
c. Cognitive Assessment Scale for Stroke Patients (CASP)
d. Swallow trial
e. Observation of eye contact, turn-taking, other pragmatic skills
7. Establish cueing hierarchy to support naming (for during conversations in between
assessments, not during assessments)
Goal: To understand the relevant social, family, educational, and medical history
Goal: To Determine goals for intervention and readiness
Equipment: Participics-supported Case History, using Haynes & Pindoza’s Table 8.2 (2012) to guide
the conversation (See Appendix A)
Duration: 10-15mins
Type of data collected: Qualitative data about Cooper’s background and personal recovery goals
Strengths: asking Cooper about himself and his goals is a positive way to get the most accurate
information while building rapport with him and his family
Limitations: most written case-histories are not aphasia-friendly and require additional work to
reformat or supplement with images. If Cooper’s brother is not available, then some questions
might be difficult to get a reliable response until his brother is available for a discussion.
Rationale: to build a comprehensive understanding about Cooper’s background and relevant
history to inform future intervention so that it is medically, socially, educationally, and age-
appropriate, and to find potential goals that Cooper would like to achieve.
Goal: To determine the type and severity of aphasia
Equipment: WAB-R (Part 1 subtests: Spontaneous speech, Auditory verbal comprehension,
Repetition, Naming and word finding) to determine the Aphasia Quotient
Duration: 45mins
Type of Data Collected: Standardised, quantitative data about expressive/receptive language
Strengths: how reliable is this assessment?
Limitations: how reliable is this assessment? The WAB-R subtests are not weighted evenly, and
the expressive subtests contribute more to the diagnosis than comprehension does
Rationale: to offer validation for Cooper and receive a more specific indication of his strengths and
weaknesses to inform future therapy
Goal: To determine impact of aphasia on QOL
Equipment: Assessment of Living with Aphasia (ALA)
Duration: ~40minutes
Type of data collected: Non-standardised, Qualitative data about his participation and QOL
Strengths: This assessment is aphasia-friendly and can support someone’s ability to communicate
what’s important to them
Limitations: It’s possible that this assessment may take longer than 40 minutes
Rationale: to assess his mood and motivation and its potential impact on future therapy, as well as
to determine areas of difficulty that may be formulated into a therapy goal to improve his
participation and QOL. An image-based tool can support conversation and provide a personalized
perspective about his own situation.
Goal: Establish comprehensive understanding of functioning
Goal: Determine strengths/weaknesses
Equipment/Method: Profile Of Word Errors and Retrieval in Speech (POWERS) assessment, video
recorder. Ask brother and Cooper to have a 5min conversation about a topic Cooper likes. Film it
to assess outside of the session. If low on time, request that they complete this outside of the
session.
Duration: 5 minutes
Type of data collected: quantitative data about Cooper’s ability to produce words during
spontaneous conversation, as well as his communication partner’s contributions and supports
during conversation
Strengths: doesn’t require much equipment or preparation, and this task can be completed by
Cooper and his brother outside of the session if we run out of time or Cooper is too fatigued by
this point of the assessment.
Limitations: Requires that Cooper understands the reason for recording and to gain both his and
his brother’s consent. Cooper and his brother may feel awkward performing this task while
clinician is present or even while clinician is absent, which may affect their performance.
Rationale: to see how Cooper is using language in a more functional setting (rather than in an
assessment format), and gain insight into how his brother communicates with him. This can inform
future communication partner training to support the family, and can be used again after a period
of intervention to monitor improvement
Goal: Determine oral-motor structure and function and swallowing safety
Equipment: cup of water, tongue depressor, small torch
Duration: 5 minutes (formally) at the end of the session, or throughout the session (informal
observation without tongue depressor/small torch)
Type of data collected: qualitative data about structure, CN function, and swallow safety
Strengths: can be a non-invasive observation or assessment if Cooper is uncomfortable
Limitations: may not have time or be the right time to assess his eating safety
Rationale: To ensure a comprehensive SLP assessment that also takes into account his voice and
swallowing safety
Goal: Determine goals for intervention and readiness
Equipment: Stroke Aphasic Depression Questionnaire -Hospital version 10 (SADQ-H10): have a
nurse fill it out
Duration: 5 mins outside of the session (ask nurse if they can fill it out now or if they need another
week to consciously observe Cooper before filling it out)
Type of data collected: qualitative report
Strengths: it is a short questionnaire so not time-consuming for another professional to fill out.
Offers good insight into behaviours that Cooper might not admit or feel comfortable talking about
himself at this point in time. Is a relevant screener for people with aphasia.
Limitations: Nurses are quite busy and might not be able to observe Cooper as much as would be
preferred before filling this out. Will be more subjective than having Cooper fill out a similar
questionnaire.
Rationale: because Cooper may have difficulties filling out a questionnaire, and we will have
gained insight into his mood during the ALA, it’s good to gain an external perspective on Cooper’s
mood to determine whether he needs further referrals for counselling, and his levels of resilience
in preparation for therapy.