Western Aphasia Battery

WAB was developed in Canada at the University of Western Ontario by Kertesz and
Poole in 1974. Norms were reported by Kertesz and Poole in 1974 and Kertesz, 1979.
WAB has good reliance on subtest scores for the classification of aphasic patients. WAB
provides a single overall score which is called as aphasia quotient. The AQ reflects
performance of aphasics in auditory and speech modalities.

The basic battery for deriving AQ consists of four sections.

1. Spontaneous Speech:
It includes questions to answer and a picture to describe. The fluency of language
and content of information is looked. A maximum score of ten is assigned to each
section.

a. Fluency : 10
b. Information content: 10
Total: 20.

2. Auditory comprehension:
It includes the following subsections.
a. Yes/No questions: there are 20 yes/no questions which are graded difficulty. A
maximum score of 60 is assigned to these tasks. A patient can give response
either verbally, gesturally or by eye blinking. Each question is given a score of 3.
b. Auditory word recognition: there are total 10 sections in auditory word
recognition which are again of graded difficulty namely. Real object, drawn
object, forms, letters, numbers, colors, furniture, body parts, fingers and left-
right. Each section has six items thus a total of 60 items. The patient’s task is to
point to the named lexical item. A total of 60 score i.e, each correct lexical item is
given a score of 1.
c. Sequential commands: the tasks are of graded difficulty and here patient has to
carry out the command by acting viz, raise your hand, etc… as the complexity
increases the scoring is rated high. A maximum score of 80 will be given in this
section.

1) Yes/No questions : 60
2) Auditory word recognition: 60
3) Sequential commands : 80
Total : 200
 This score is divided by 20 to get AQ. i.e, 200/20 = 10. and this should be divided by
10 to get CQ. i.e, 200/10 = 20.

3. Repetition : A total of 15 linguistic stimuli, which patient has to repeat which are
graded difficulty. A maximum score is 100. This score is divided by 10.

i.e, 100/10 = 10.

4. Naming:

There are four subsections in the naming aspect. These are

a. Object naming: a total of 20 stimuli and each correct named object is given a
score of 3. if tactile and phonemic cue can be given but the scoring is less i.e, 2 or
1. Total score is 60.
b. Word fluency: here the patient is asked to name as many animals as he can in one
minute. Score 1 point for each animal named correctly. Maximum score is 20.
c. Sentence completion: a total of 5 questions which are mainly by fill in the blanks.
Each correct score is given score of 2. Maximum score is 10. Ex: the grass is
_____.
d. Responsive speech: there are five questions, and each correct response is given a
score of 2. Maximum score is 10.

Naming:

a. object naming : 60
b. Word fluency : 20
c. Sentence completion: 10
d. Response speech : 10.
Total : 100.

This will be divided by 10. i.e, 100/10 = 10.

To calculate AQ = (spontaneous speech + Auditory word recognition + Repetition +

Naming) x 2 = (20+10+10+10) x 2 = 100.

Kertesz (1979), described additional tests for reading, writing and nonverbal functions,
from which he derived the performance quotient (PQ). The score is derived from all
subtests is the cortical quotient (CQ).

5. Reading:
This task includes subtests like reading comprehension of sentences, reading command,
written word stimulus – object choice matching, written word stimulus – picture choice
matching, picture stimulus – written word choice matching, spoken words – written word
choice matching, letter discrimination, spelled word recognition, and spelling. A
maximum score of 100 is given to the patient.
For PQ, this should be divided by 10. i.e, 100/10 = 10.
6. Writing: This includes writing on request, written output, writing to dictation, writing
of dictated or visually presented words, alphabets and numbers, dictated numbers and
letters, copying of words of a sentence. A maximum score of 100 will be given.
This score is divided by 10 to get PQ.

7. Apraxia: The maximum score of 100 will be given to this section.

8. Constructional, Visuospatial and calculation tasks: A maximum score of 100 will

be given to this section.

PQ = 20 + 10 + 10 = 40.

Cortical quotient: Spentaneous speech (20) + Auditory verbal comprehension (20) +

Repetition (10) + Naming (10) + PQ = 100.

Kertesz reported that an AQ below 93.8 is indicative of aphasia. A score that is above the
level of this score is most likely to be made by patients with diffuse or subcortical lesions
and by non brain damaged persons.

Criteria for classifying aphasias based on scores from WAB.

S. No. Type of Fluency Comprehension NRepetition aming

Aphasia
1 Global 0-4 0-3.9 0-4.9 0-6
2 Broca’s 0-4 4-10 0-7.9 0-8
3 Isolation 0-4 0-3.9 5-10 0-6
4 Trascortical 0-4 4-10 5-10 0-8
Motor
5 Wernicke’s 5-10 0-6.9 0-7.9 0-9
6 Transcortical 5-10 0-6.9 8-10 0-9
sensory
7 Conduction 5-10 7-10 0-6.9 0-9
8 Anomic 5-10 7-10 7-10 0-9
LINGUISTIC PROFILE TEST

The test was designed by Karanth (1980) with the objective of evaluating the linguistic
samples at the phonemic, syntactic and semantic levels both in reception and expression. It is
more of a descriptive tool than a diagnostic one. LPT was originally called the test of
psycholinguistic abilities in Kananda (Karanth, 1980, 1981). A parallel version in Hindi was
developed (Karanth, Ahuja, Nagaraja, Pandit, & Shivashankar, 1986) at that time, the name of
the test was changed to Linguistic Profile Test, in order to make it language free.

LPT has three major sections, which include phonology, syntax and semantics
respectively, with discourse forming the tail end of the third section. The choice of methods
within these sections caters a wide range of tasks such as pointing, repetitions, naming,
indication of grammatical and semantic acceptability, testing of lexical categories, sentence
completion, and matching synonyms and antonyms (Karanth, 1980).

1. Phonology: There are two sub-sections in the phonology section.

i) Phonemic discrimination in which there are 48 items.
ii) Phonemic expression in which there are 52 items.

Of the two sub-sections in phonology section of LPT, the scores of only the phonetic
discrimination section were considered as this section assesses the comprehension abilities.

2. Syntax: There are 10 subsections in the syntax section.

a) Morphophonemic structures
b) Plurals
c) Tenses
 d) PNG markers
e) Case markers
f) Transitive, intransitive and causative
g) Sentence types
h) Conjunctions, quotatives and comparatives
i) Conditional clauses
j) Participle construction

In this section, there are 130 items. This section assesses the metalinguistic abilities of
the client. Metalinguistic ability refers to one’s ability to reflect on one’s language, appreciate it
and even talk about it. In making acceptability judgements the individual not only checks for
proper grammatical formulation of sentences, but also the semantic coherence of the same.
Hence it means that making language judgements – retrieving and making use of one’s intentions
is relatively hard, when compared to talking and understanding.

3. Semantics: There are two major subsections in this section.

a) Semantic discrimination
b) Semantic expression

Semantic discrimination subsection includes colours, furniture and body parts. Semantic
expression subsection consists of the following tasks.
1. Naming
2. Lexical category
3. Synonymy
4. Antonymy
5. Homonymy
6. Polar questions
7. Semantic anomaly
8. Paradigmatic relations
9. Syntagmatic relations
10. Semantic continuity
 11. Semantic similarity
This test is clinically useful for evaluation and as a basis for rehabilitation and linguistic
retraining of communicatively disabled (Karanth, 1988).

It provides a useful means to tap the impaired and spared linguistic skills and structures at
different linguistic levels which can serve as a rehabilitative baseline for language intervention.
REVISED TOKEN TEST (RTT)

Token test was first developed by DeRenzi and Vignolo (1962). The materials used were
the tokens of two shapes (circle and rectangles), two sizes (large and small) and five colours (red,
blue, green, yellow and white). While describing the test DeRenzi and Vignolo (1962) stated
that “the peculiar characteristic of the material is that, when all the tokens are present, it is not
enough to use a single word in order to identify a particular token, but on the contrary, at least
three specific words are required, namely a noun and two adjectives, for e.g., the large red
rectangle. Moreover, if only two out of three elements of connotation are understood, they do
not give any clue concerning the third element e.g., if it is told to take the large rectangle, still
there is no clue whatsoever as to which of the large rectangles the red, blue etc.

The test consists of five parts and the order of difficulty increases from I to V. DeRenzi
and Vignolo (1962) stated, “In the first four parts, commands are expressed in an elementary
grammatical and syntactic form – verb, objective. In the first part, the test is made more difficult
by introducing grammatical particles and other more complex syntactic structures, the exact
understanding of which is always necessary to a correct performance”. They caution examiners
who like to use this to make sure that the patient has no agnostic disability to recognize form and
colours and is capable of understanding the word ‘circle’ and ‘rectangle’.

McNeil and Prescott (1976) designed a sensitive test battery for the assessment of
auditory inefficiencies associated with brain damage, aphasia and learning disabilities. It is a
reconstruction of the original token test (DeRenzi and Vignolo, 1962) in accordance with
accepted standards of the test construction and standardization. The RTT includes a
multidimensional system for describing the nature and qualifying the degree of deficits.
 A Kannada adoption of the RTT incorporating principles of the RTT (Mc Neil and
Prescott, 1978) and “concrete object form of token test” (Martino, Pizzamiglio, and Razzana
1978) was designed to assess the comprehension ability in normal and disordered adults and
children (Veena, 1982). Normative data on 52 children (5-9 years), 37 adults (20-60 years) and
11 brain-damaged subjects have been compiled (Veena, 1982).

The procedure that was followed for the administration of the Revised Token Test (RTT)
was as follows.

The subjects were seated comfortably in front of a table where tokens were placed. The
materials were presented within the visual field of the subjects.

Instructions: The subjects were instructed to point out to the appropriate items, when named by
the examiners. E.g. they were asked to point to a big yellow tumblers, a small red flower etc
(refer appendix 3).
Prior to the actual test the subjects were given pre-test instructions. This was done to
make sure that the subjects were familiar to the items, colours and sizes. If any part of the test
trial was not performed correctly, the instructions were repeated.

Scoring: The scoring pattern was as detailed below

Score: Each item received a score between 1 to 15 depending on the response.

15. Complete

When the subject responded in a normal manner without needing extra information to
perform the task.

14. Vocal/sub vocal rehearsal

If the subject repeated the command loudly or by whispering while performing the task or
before performing, (if any unit in the command received a score of 14, no other unit in the
command could receive a score of 14).
13. Delay

If the subject responded with a delay i.e., (a) the subject took more time (approximately
the time required to repeat the command silently) to respond after the command has been given
or (b) if he started responding but in course changes his direction or halted (when commands
with two parts are given, the delay might occur before the scored part. Then the first part of the
command received a score of 15 and the second part 13).

12. Immediate

When the subject started responding even before the command is completely given (if
any unit in the command received a score of 12, no other unit in the command can receive a
score higher than 12).

11. Self- correction

When the subject makes a physical contact with the object specified in the command, it
was considered as self-correction otherwise it was considered as delay (if any unit in the
command received a score of 11, no other unit in the command can receive a score higher than
13).

10. Reversal

This applies only for sub-tests consisting of two part commands (i.e. sub-test 3, 4, 5, 6, 7
& 8) when any set of unit in the two part command is reversed from the order in which they are
presented, score 10 was given.

9. Repeat

The command was repeated (a) if the subject asked for a repeat (b) if the subject did
nothing for 30 seconds, (c) if the patient did the task incorrectly such as picking up when asked
to touch (this was always judged by the verb and not any other unit in the command). When a
repeat was given no other unit in the command received a score higher than 9.
8. Cue

The cue was given when the subject (a) did the wrong tasks, (b) did nothing for 30
seconds, and (c) requested for a repeat. Cue was given only after repeat. Cue was similar to
repeat, but a specific gesture was given accompanying it.

7. Error

Even after repeat or cue when a response to an entire command or a unit within the
command other than the verb received a score of 7, no repeat or cue being specified, the
particular unit was scored as an error.

6. Perseveration

When a command or any unit within a command other than the verb is incorrectly
performed but was a preservation of response to a unit preceding the command.
5. Intelligible/rejection

When a subject responded to the command but the response was not a clearly definable
attempt at doing the task, although it was an intelligible response like moving an object towards
another object. This score is also given if the subject reflects to do the task.

4. Unintelligible/differentiated

When the response cannot necessarily be judged as an attempt at the task but was clearly
different from other unintelligible response (picking up the object, chalking it and keeping.

3. Unintelligible (perseveration)

The same type of response as performed with a score of 4, but was undifferentiated from
previous unintelligible tasks.

2. Omission

When one part of a two part command or any particular unit in the command was
omitted.

1. No response
When there is no response.