Language assessment in adults with Aphasia

OBJECTIVES Following the completion of this chapter, the reader will be able to identify the features of global aphasia, its etiology, the patterns of evolution and outcome in global aphasia, and some factors that are related to recovery from this syndrome. The reader also will be able to provide a rationale for early intervention with these patients, describe contemporary goals for assessment, and develop treatment plans that exploit the residual language capacity and/or other functional abilities of patients with global aphasia. Finally, the reader will be able to identify current testing measures and both impairment-based and socially oriented treatment programs that emphasize improved language and functional communication and are appropriate for assessing and treating patients with global aphasia.

Boston yang asal tetapi mempunyai isi kandungan yang berbeza. Sebanyak 29 item daripada ujian asal dikekalkan, kerana didapati sahih dari segi budaya dan bahasa populasi Melayu di Malaysia. Sebanyak 41 item baru disertakan agar sejumlah 70 item digunakan dalam ujian rintis. Pada awalnya, item ujian disemak oleh sekumpulan panel pakar, dan selepas itu, ujian dilakukan ke atas 40 orang Melayu dewasa normal. Berdasarkan analisis item daripada kajian rintis tersebut, M-BNT versi terakhir dibentuk dan terdiri daripada ujian sejumlah Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 27-36 28 50 item. Ujian ini kemudian dilakukan ke atas 230 subjek Melayu normal dalam lima kumpulan umur (20 -29 tahun, 30 -39 tahun, 40 -49 tahun, 50 -59 tahun, dan 60 -69 tahun), yang dibahagi kepada dua tahap pendidikan (iaitu < 12 tahun pendidikan, dan 12 tahun atau lebih) dan jantina berbeza.

Current findings from intervention in bilingual aphasia are inconclusive regarding the extent to which levels of language proficiency and degree of linguistic distance between treated and non-treated languages influence cross-language generalisation and changes in levels of language activation and inhibition following treatment. In this study, we enrolled a 65-year-old multilingual speaker with aphasia and administered treatment in his L1, Dutch. We assessed pre- and post-treatment performance for seven of his languages, five of high proficiency and two of lower proficiency. We asked whether treatment in L1 would generalise to his other languages or increase interference among them. Forty hours of treatment were completed over the course of five weeks. Each language was tested three times at pretreatment and at post-treatment. Testing included measures of narrative production, answering questions, picture description and question generation. Dependent measures examined language efficiency, defined as Correct Information Units (CIUs)/min, as well as language mixing, defined as proportion of code-mixed whole words. We found that our participant’s improved efficiency in Dutch was mirrored by parallel improvement in the four languages of high proficiency: English, German, Italian and French. In contrast, in his languages of lower proficiency, Norwegian and Spanish, improved efficiency was limited. An increase in code-mixing was noted in Spanish, but not in Norwegian. We interpret the increased code-mixing in Spanish as indication of heightened inhibition following improvement in a language of close linguistic proximity, Italian. We conclude that an interaction of language proficiency and linguistic similarity affects cross-language generalisation following intervention in multilingual aphasia.

Boston yang asal tetapi mempunyai isi kandungan yang berbeza. Sebanyak 29 item daripada ujian asal dikekalkan, kerana didapati sahih dari segi budaya dan bahasa populasi Melayu di Malaysia. Sebanyak 41 item baru disertakan agar sejumlah 70 item digunakan dalam ujian rintis. Pada awalnya, item ujian disemak oleh sekumpulan panel pakar, dan selepas itu, ujian dilakukan ke atas 40 orang Melayu dewasa normal. Berdasarkan analisis item daripada kajian rintis tersebut, M-BNT versi terakhir dibentuk dan terdiri daripada ujian sejumlah Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 27-36 28 50 item. Ujian ini kemudian dilakukan ke atas 230 subjek Melayu normal dalam lima kumpulan umur (20 -29 tahun, 30 -39 tahun, 40 -49 tahun, 50 -59 tahun, dan 60 -69 tahun), yang dibahagi kepada dua tahap pendidikan (iaitu < 12 tahun pendidikan, dan 12 tahun atau lebih) dan jantina berbeza.