Development and application of a Chinese Version of the Language Screening Test (CLAST) in post-stroke patients

Abstract

Aphasia shows high incidence in stroke patients and seriously impairs language comprehension, verbal communication, and social activities. Therefore, screening aphasic patients during the acute phase of stroke is crucial for language recovery and rehabilitation. The present study developed a Chinese version of the Language Screening Test (CLAST) and validated it in post-stroke patients. The CLAST was adapted from the Language Screening Test developed by Constance et al to incorporate Chinese cultural and linguistic specificities, and administered to 207 acute stroke patients and 89 stabilized aphasic or non-aphasic patients. Based on the Western Aphasia Battery (WAB) test, its reliability and validity were assessed. A cut-off for the CLAST in Chinese patients was determined by ROC curve analysis. The CLAST comprised 5 subtests and 15 items, including 2 subscores, namely expression (8 points, assessing naming, repetition, and automatic speech) and receptive (7 points maximum, evaluating picture recognition, and verbal instructions) indexes. Analysis of the alternate-form reliability of the questionnaire showed a retest correlation coefficient of 0.945 ( P < .001). Intraclass correlation coefficients of three rating teams were >0.98 ( P < .001). Internal consistency analysis showed a Cronbach's alpha coefficient of 0.909 ( P < .001). The non-aphasia group showed higher scores than the aphasia group (14.2 ± 1.3 vs 10.6 ± 3.8) ( P < .01). The questionnaire showed good construct validity by factor analysis. ROC curve analysis showed high sensitivity and specificity for the CLAST, with a cut-off of 13.5. The CLAST is suitable for Chinese post-stroke patients during the acute phase, with high reliability, validity, sensitivity, and specificity.

Clinical assessment and screening of stroke patients with aphasia: a best practice implementation project

“…The higher the score, the lighter the degree of aphasia; if the opposite is true, the degree of aphasia is more severe. A score lower than 13 indicates patients at risk of aphasia 19 …”

“…Barrier 1: The absence of a poststroke aphasia screening tool Through a literature review and interdisciplinary conversations, the Chinese version of the Language and Speech Test 19 (CLAST) scale was determined as the instrument appropriate for poststroke aphasia clinical screening. There was a total of 15 items on the CLAST scale and the total score was the sum of each item score; the time of screening using the CLAST was 24 h when the patient regained consciousness and was in a stable situation.…”

“…A score lower than 13 indicates patients at risk of aphasia. 19 Barrier 2: The absence of a poststroke aphasia depression assessment tool A poststroke aphasia depression assessment tool should be used with patients for whom it is impossible to conduct a lengthy interview or fill out a self-report form, as aphasia may impact listening, speaking, reading, and writing. After careful consideration, the Stroke Aphasia Depression Questionnaire-H10 20 (SADQ-H10) was used to assess depression in post-stroke aphasia patients; the time of assessment involved patients diagnosed with aphasia 1 week later.…”

The clinical and neurocognitive functional changes with awake brain mapping for gliomas invading eloquent areas: Institutional experience and the utility of The Montreal Cognitive Assessment

“…Language Screening Test (LAST) was another important screening tool (48), and recently its Chinese version, CLAST, has been developed and reported as an efficient and timesaving bedside aphasia screening tool for stroke patients in the acute phase (49). New evidence also implied that CLAST is suitable for Chinese post-stroke patients with high reliability, validity, sensitivity, and specificity (50). Meanwhile, in the background of Covid-19, TeleLanguage test has drawn special attention.…”

Emerging Validation for the Adapted Chinese Version of Quick Aphasia Battery

“…While it is almost impossible for a weak patient who just underwent a stroke to spend such a long time and energy to complete all tasks. On the other side, some other quick screening tests, like Language Screening Test (LAST), 16 which takes 5–10min, but can only distinguish whether aphasia happened or not simply, cannot give a further diagnosis to guide rehab, so that not really be used since adapted.…”