English adaptation, international harmonisation, and normative validation of the Language Screening Test (LAST)

Abstract

Background: The Language Screening Test (LAST) is a unique bedside tool, designed to rapidly and reliably evaluate aphasia during the acute and chronic phases of stroke. Two equivalent reliable and validated versions of the LAST exist in French. Aims: Our objective was to conduct a linguistic adaptation for English (LASTen) through a process of translation, international harmonisation, and normalisation in multiple English-speaking countries. Methods & Procedures: There were four progressive stages in the adaptation of the LASTen including a series of sequential evaluations to identify problematic items, with selection of alternatives by consensus and in collaboration with the original LAST developers. First, three Canadian translators independently adapted the 29 items of the original LAST into English, resolving discrepancies by consensus to produce adaptation I. Evaluations of adaptation I involved ratings of translation difficulty and multidisciplinary expert panel review to produce adaptation II. Evaluations of adaptation II included ratings of translation quality by three different translators followed by healthy native speaker testing in Canada to produce adaptation III. Evaluations of adaptation III included expert review in Australia, Canada, England, and the USA for cultural acceptability and naturalness, followed by healthy native speaker testing in all the four countries to produce adaptation IV. Adaptation IV constituted a linguistically valid LASTen for four English dialects. We documented consensus decisions to modify or retain problematic items. We evaluated group differences using the Kruskal-Wallis test for continuous variables and chi-squared analyses for frequency variables with statistical significance of alpha ≤.05. Outcomes & Results: During the translation and the evaluations, we reconsidered 22 of the 29 items, revising 20 to produce adaptation IV of the LASTen. Normative testing in the four English-speaking countries involved 109 participants (mean age 60 years, SD ±16.1). Fifty-five percent were women, and 32% lacked postsecondary education. Fourteen participants made errors across nine items. There were no significant differences in errors for age, sex, or country. However, participants with postsecondary education made fewer errors than those without (p = .04). Conclusions: We achieved a linguistically compatible adaptation of the French LAST for English, confirming naturalness and cultural appropriateness in healthy native speakers of four English dialects. Our systematic multistep approach delineates

A Feasibility Study Involving Recruitment and Screening for Aphasia in Acute Stroke: Emerging Viability of the English Adaptation of the Language Screening Test (LASTen)

“… 13 Median scores in patients with and without aphasia were 10 and 15, respectively ( fig 1 ). Patients without aphasia performed comparably to the healthy participants in a previous normalization study, 10 making occasional isolated errors ( table 2 ). The most likely explanations for errors included lower education level, poor hearing with background noise despite corrective aids, or fatigue on the second version.…”

“… 10 Testing demonstrated equivalent performance across dialects and comparable results on the LASTen-A and LASTen-B. 10 Nevertheless, participants with high school education (or less) made more errors than those who had completed community college or university programs. 10 …”

“…We recently adapted and harmonized the LAST for multiple English dialects (LASTen) 10 by conducting normative testing in 109 healthy adults in 4 countries: Australia, Canada, England, and the United States. 10 Testing demonstrated equivalent performance across dialects and comparable results on the LASTen-A and LASTen-B. 10 Nevertheless, participants with high school education (or less) made more errors than those who had completed community college or university programs.…”

“… 10 Nevertheless, participants with high school education (or less) made more errors than those who had completed community college or university programs. 10 …”

Assessment Of Afasia in Stroke Patients: Case Study

“…LAST can assess as a whole because it has 5 clinical indicators namely naming images, syllable repetition, sub spontaneous speaking tests, understanding images and verbal commands, without writing subtes. Previous measuring instruments are very time-consuming, existing instruments are also still very high from the risk of bias because they involve writing subtests and are difficult to interpret by nurses while a brief, low-bias and easily interpretable assessment is needed (Flamand-Roze et al, 2011) LAST is the only fastest tool in detecting aphasia with only 2-3 minutes, low bias and simple and easy to interpret (Flamand-Roze et al, 2011;Flowers, Flamand-roze, Denier, & Roze, 2015;Koenig-Bruhin et al, 2016) LAST has also been validated in stroke patients. LAST has a good rating for knowing patients with aphasia.…”