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Poster A32, Wednesday, November 8, 10:30 – 11:45 am, Harborview and Loch Raven Ballrooms

A quick bedside language assessment

Sarah M. Schneck1, Dana K. Eriksson2, Jillian Lucanie1, Stephen M. Wilson1;1Vanderbilt University Medical Center, 2University of Arizona

In this presentation, we describe a new aphasia battery: the Quick Bedside Language Assessment (QBLA), which aims to evaluate language function in adults with acquired aphasia as comprehensively as possible in about a quarter of an hour. The QBLA is intended to fill a gap between existing comprehensive batteries and rapid screening instruments, and to optimize assessment of aphasia in the many clinical and research contexts in which time is limited for one reason or another. Moreover, it has multiple forms for repeated administrations, requires no props, and is freely available to clinicians and researchers. The battery is comprised of eight subtests: Level of consciousness, Connected speech, Word comprehension, Sentence comprehension, Picture naming, Repetition, Reading aloud, and Motor speech. Each subtest contains between 5 and 12 items. To maximize the informativeness of each item, items were carefully chosen to span a wide difficulty range, so that mild as well as severe deficits can be quantified effectively, and a graded scoring system and set of error codes were developed so that information can be gleaned from responses that are neither completely correct nor completely incorrect. After completion of the eight subtests, nine summary measures are derived: Word comprehension, Sentence comprehension, Word finding, Grammatical construction, Selection and encoding, Speech motor programming, Repetition, Reading, and Overall. Together these yield a multidimensional profile of an individual’s strengths and weaknesses across core language domains. To obtain reference data, the QBLA was administered to 28 individuals with acute stroke and aphasia, 25 individuals with acute stroke but no aphasia, 16 individuals with chronic post-stroke aphasia, and 14 healthy controls. The 16 individuals with chronic post-stroke aphasia were tested 3 times each and scored independently by 2 raters to establish inter-rater reliability and test-retest reliability. The Western Aphasia Battery (WAB) was also administered to these patients to assess concurrent validity. The inter-rater reliability of all nine summary measures was excellent, with intraclass correlation coefficients (ICC) ranging from 0.81 to 0.99 (0.99 for the Overall summary measure). Test-retest reliability was good to excellent over the nine measures (0.72 to 0.98; 0.97 for the Overall summary measure), and can be increased by stacking multiple forms for individual subsections when needed. With respect to clinical impression of aphasia, the sensitivity of the QBLA was 0.91 and the specificity was 0.95. Seven of the nine summary measures have related measures on the WAB, and correlations between QBLA and WAB measures ranged from 0.79 to 0.95, demonstrating strong concurrent validity. The specific profiles of summary measures were studied in the 16 individuals with chronic aphasia and were found to effectively capture clinical impressions. In sum, despite taking less than a quarter of an hour to administer to the majority of patients, the QBLA is a reliable and valid aphasia battery that is capable of characterizing spared and impaired language functions across multiple domains. It promises to be a useful tool for clinical and research applications.

Topic Area: Language Disorders

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