Clinical and prognostic properties of standardized and functional aphasia assessments

Laska, Ann‐Charlotte; Bartfai, Aniko; Hellblom, A.; Murray, Veronica; Kahan, Thomas

doi:10.2340/16501977-0070

Cited by 22 publications

(20 citation statements)

References 17 publications

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“…[5][6][7] Tools capable of detecting aphasia and evaluating its severity during the acute phase of stroke might help to improve early rehabilitation and to predict outcome. 8 Standard aphasia rating scales such as the Western Aphasia Battery, the Boston Diagnostic Aphasia Evaluation (BDAE), and the Boston Naming Test are not appropriate for use during the acute phase of stroke. 7,9 -11 In particular, these scales take too long to complete and must be administered by speech and language therapists.…”

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confidence: 99%

“…9 -11 Global stroke rating scales such as the National Institutes of Health Stroke Scale and the Scandinavian Stroke Scale include language items and have been developed for use in acute settings, 12-17 but they do not reliably detect aphasia. 8 Several attempts have been made to develop and validate brief aphasia screening scales suitable for patients with acute stroke, 5,18 -25 but all have inherent structural limitations, including 7 (1) inclusion of written language subtests, the results of which are influenced by hemiplegia and illiteracy 5,19 -23,25 ; (2) use of complex visual material inappropriate for patients with stroke with neurovisual deficits 19,20 ; (3) inclusion of subtests the results of which are markedly influenced by attention/executive dysfunction 19,20 ; (4) excessively lengthy administra-tion 22 ; (5) difficulties with administration or scoring 5,18,23,25 ; and (6) IQ dependency. 21 Some of these scales also have poor sensitivity for the detection of language disorders and a paucity of information on their validity and reliability.…”

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confidence: 99%

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Validation of a New Language Screening Tool for Patients With Acute Stroke

Flamand-Roze

Falissard

Roze

et al. 2011

Stroke

117

122

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Background and Purpose-Standard aphasia scales such as the Boston Diagnosis Aphasia Evaluation are inappropriate for use in acute stroke. Likewise, global stroke scales do not reliably detect aphasia, and existing brief aphasia screening scales suitable for patients with stroke have several limitations. The objective of this study was to generate and validate a bedside language screening tool, the Language Screening Test, suitable for use in the emergency setting. Methods-The Language Screening Test comprises 5 subtests and a total of 15 items. To avoid retest bias, we created 2 parallel versions of the scale. We report the equivalence of the 2 versions, their internal and external validity, and their interrater reliability. We validated the scale by administering it to 300 consecutive patients within 24 hours after admission to our stroke unit and to 104 stabilized patients with and without aphasia using the Boston Diagnosis Aphasia Evaluation as a reference. Results-The 2 versions of the Language Screening Test were equivalent with an intraclass correlation coefficient of 0.96.Internal validity was good; none of the items showed a floor or ceiling effect with no redundancy and good internal consistency (Cronbach ␣ 0.88). External validation against the Boston Diagnosis Aphasia Evaluation showed a sensitivity of 0.98 and a specificity of 1. Interrater agreement was near perfect (intraclass correlation coefficient, 0.998).The median time to complete the Language Screening Test was approximately 2 minutes. Importantly, the Language Screening Test does not need to be administered by a speech and language therapist. Conclusions-This comprehensively validated language rating scale is simple and rapid, making it a useful tool for bedside evaluation of patients with acute stroke in routine clinical practice. (Stroke. 2011;42:1224-1229.)

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confidence: 99%

mentioning

confidence: 99%

Validation of a New Language Screening Tool for Patients With Acute Stroke

Flamand-Roze

Falissard

Roze

et al. 2011

Stroke

117

122

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“…Quality-of-life scales for stroke patients often include aphasia as a measure of neurological compromise in the long term 20 . This is important if we take into consideration that even patients who go on without visual or motor deficits can be severely impaired for their regular activities if aphasia is present, and the length of their hospital stays is usually longer [21][22][23] .…”

Section: Resultsmentioning

confidence: 99%

“…Considering that comatose patients were not included, 100% of the approached subjects were tested in the end. We also avoided functional communication assessments in our evaluation because they are less reliable for acute stroke patients 20 .…”

Section: Resultsmentioning

confidence: 99%

Global aphasia as a predictor of mortality in the acute phase of a first stroke

Oliveira

Damasceno

2011

Arq. Neuro-Psiquiatr.

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Objective: To establish whether vascular aphasic syndromes can predict stroke outcomes. Method: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. Results: Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (nine mute; five deceased), consisting on a risk factor for death in the acute stroke phase (ρ=0.022). Age (z=1.65; ρ>0.09), thrombolysis (ρ=0.591), infarct size (ρ=0.076) and side (ρ=0.649) did not significantly influence survival. Absence of aphasia did not predict a better evolution, regardless of the affected hemisphere. Prevalence of cardiovascular risk factors was similar for all patient groups. Conclusion: Global aphasia in acute stroke can adversely affect prognosis, translated into impairment of dominant perisylvian vascular territories, with mutism as an important semiological element. Key words: linguistics, aphasia, stroke, brain infarction, language, speech, disability evaluation, prognosis.Afasia global prediz mortalidade na fase aguda de um primeiro acidente vascular cerebral isquêmico RESUMO Objetivo: Determinar se síndromes afásicas na fase aguda do infarto cerebral influenciam o prognóstico. Método: Avaliação para fala e linguagem de 37 adultos dentro de 72 horas após um primeiro infarto cerebral, em associação topográfica cega com TC e/ou RM. Resultados: Detectaram-se afasias ou disartria em 7 (87,5%) dos 8 pacientes falecidos, e em 26 (89,7%) dos 29 sobreviventes. Afasia global foi identificada em 11 pacientes, todos com lesões no hemisfério esquerdo (cinco óbitos; mutismo em nove), consistindo em fator de risco para mortalidade na fase aguda do acidente vascular cerebral isquêmico (ρ=0,022). Idade (z=1,65; ρ>0,09), trombólise (ρ=0,591), dimensões da lesão (ρ=0,076) e lado (ρ=0,649) não afetaram significativamente a sobrevivência. Ausência de afasia não prenunciou melhor evolução. Fatores de risco cardiovascular tiveram similar prevalência para todos os grupos de pacientes. Conclusão: Afasia global na fase aguda do infarto cerebral pode aumentar mortalidade, demonstrando envolvimento de território vascular perisylviano dominante, tomando-se mutismo como importante elemento semiológico. Palavras-chave: linguística, afasia, acidente cerebral vascular, infarto encefálico, linguagem, fala, avaliação da deficiência, prognóstico.

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“…Tools capable of detecting aphasia and evaluating its severity during the acute phase of stroke might help to improve early rehabilitation and to predict outcome [23]. Standard aphasia rating scales such as the Western Aphasia Battery, the BDAE (Boston Diagnostic Aphasia Evaluation), and the Boston Naming Test are not appropriate for use during the acute phase of stroke [22,[24][25][26].…”

Section: Tools For Language Assessmentmentioning

confidence: 99%

Tools and Early Management of Language and Swallowing Disorders in Acute Stroke Patients

Flamand-Roze

Cauquil-Michon

Denier

2011

Curr Neurol Neurosci Rep

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The role of the stroke units in improving morbidity, mortality, and recovery from stroke is clearly demonstrated. However, acute management of language disorders in these specialized units remains controversial, and management of swallowing disorders is usually nonstandardized. The recent validation of a scale for rapid screening of language disorders (LAST [Language Screening Test]) in acute stroke patients should allow optimization of their detection and early management. Swallowing disorders should be screened and managed using a standardized protocol. Following early initial evaluation repeated on a daily basis, they justify tailored rehabilitation sessions, adaptation of food textures, team formation, and families' information. The use of these protocols implies the cooperation and coordination of the medical and paramedical teams and the daily presence of speech therapists. These aspects are crucial for patients in the stroke units to achieve full benefits from the management proposed in this paper, leading to diminution of complications and better long-term functional prognosis.

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Clinical and prognostic properties of standardized and functional aphasia assessments

Cited by 22 publications

References 17 publications

Validation of a New Language Screening Tool for Patients With Acute Stroke

Validation of a New Language Screening Tool for Patients With Acute Stroke

Global aphasia as a predictor of mortality in the acute phase of a first stroke

Tools and Early Management of Language and Swallowing Disorders in Acute Stroke Patients

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