Accuracy of prediction of language abilities by relatives of long‐term aphasic patients

Abstract

ABSTRACT British and American research has demonstrated that relatives of cerebrovascular accident (CVA) patients underestimate the linguistic impairments in their aphasic relative. It is important that the reasons for this inaccuracy, with its effects, are ascertained so the management of these patients and their relatives can be handled more sensitively. None of these studies researched the effect of the linguistic misperceptions of the carers on the patient. It is possible that the misperceptions lead carers to use and expect language that is too complex for the patient. This may lead the patient to become frustrated and, possibly, depressed. This study aims to confirm whether carers of long‐term patients aphasia are similarly inaccurate at estimating language problems in their relatives. It also studies the modd of the patient. Twenty‐nine carers of long‐term aphasic patients (from 11 months to eight years (mean 31.9 months)) were asked by speech and language therapists to predict how their relative would perform on the verbal sections of the Western Aphasia Battery (WAB) (Kertesz, 1982) and of the Functional Communication Profile (FCP). At the same time, the patients were tested on the same tests by final‐year student speech and language therapists who also tested the patients on the Raven's Coloured Progressive Matrices and on a visual analogue scale of mood (scale of 0–100, with 100 being ‘very happy’). Results showed that the relatives of long‐term patients with aphasia were accurate at predicting both comprehension and expressive problems on the WAB (Wilcoxon matched‐pairs Signed‐ranks Test: z = 1.0812, p = 0.28; z = −1.7838, p = 0.07; z = 0.8994, p = 0.37; z = 0.4318, p = 0.67), but not on the FCP' (z = −2.9516, p = 0.00). Overall, the patient sample was not found to be depressed (mean = 72.6, range 38–100). Furthermore, there was no correlation between the patient's mood and the discrepancies between relatives' and patients' scores, but mood was related to the age of the patient (r = 0.48, p = 0.01). Living with the aphasia helps carers to have a realistic idea of their aphasic relative's linguistic abilities. Speech and language therapists should continue to endeavour to find ways to help carers obtain a realistic picture earlier on in the illness.