Background:We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia. Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia. Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no studymandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months. Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.

The Boston Naming Test (BNT) is the most widely used naming test worldwide in research and clinical settings. This study aimed to develop a method for adapting the BNT to suit different linguistic and cultural characteristics using the example of Maltese in a bilingual context. In addition, it investigated the effects in Malta of age and level of education on naming performance. The words of the BNT were first translated into Maltese. The test was then piloted to establish target and alternative responses. Naming performance data were later collected from individuals of different ages and levels of education. Only 38 BNT items had at least 70% name agreement. Main effects of age and education were found. A Maltese adaptation was proposed using 38 items and lenient scoring. Similar procedures may be used in other bilingual populations.

Background: Word-retrieval difficulties are commonly experienced by people with aphasia (PwA) and also by typically ageing persons. Differentiation between true naming impairments and naming difficulties found in healthy persons may, therefore, be challenging. Aims: To investigate the extent to which the Maltese adaptation of the Boston Naming Test (BNT) can identify people with lexical retrieval difficulties and to differentiate them from people with unimpaired word finding. Methods & Procedures:Naming performance of a group of PwA was compared with the performance of a control group. Performance on the Maltese adaptation of the BNT was investigated in terms of scores, range of scores and error profiles of the two groups. Outcomes & Results: All PwA scored below the mean score of the controls, indicating that persons who scored above the mean score may be considered as unimpaired. However, a number of the controls obtained very low scores that overlapped with the scores obtained by the PwA. This indicated that scores alone cannot be used to differentiate between impaired and unimpaired people. Some types of errors were only produced by people with impaired naming, and did not appear at all in error profiles of unimpaired individuals. Conclusions & Implications:Mild-moderate anomic impairments may be missed if naming impairment is assessed and diagnosed using a cut-off score. In order to differentiate between people with impaired and unimpaired naming, it is necessary to look at error profiles, apart from the number of errors, as the presence of atypical errors may be an important indicator of naming impairments.