The assessment of aphasia: a review of aphasia assessments, batteries, evaluations and procedures 1886–1996

Abstract

ABSTRACT Over 50 aphasia test batteries have been published since 1886. A review of these tests provides interesting insights into the changing theoretical issues concerning the investigation of aphasia, as well as the indications of change in the management of patients with aphasia. The study demonstrates several important landmarks in both theory and practice. Assessment of the patient with aphasia make be conducted by the speech and language therapist, clinical psychologist, clinical linguist, neurologist or physician. Approaches differ according to the purpose of the assessment. Methods of assessment have ranged from the original neurological ‘checklist’ to the more recent detailed investigations of linguistic processes by sophisticated hypothesis testing systems. Although the advantages and disadvantages of the division of aphasia into modality‐based syndromes has been argued for a century, most published test batteries for the diagnosis of aphasia are based on the modality skills framework, i.e. oral and written speech/language production and auditory and reading comprehension. The notable exceptions to this pattern demonstrate dissatisfaction by clinicians with the traditional approach. These divergences have resulted in new and innovative techniques of investigation. Unresolved conflicts in clinical practice remain. The clinical dilemma, in 1996, is the same as it was in 1886. The question that needs to be addressed is ‘Can the clinician justify extensive and time‐consuming, but illuminating investigations of each patient, or shall we implement a short “screen” functional treatment plan and prognostic indicators in less than 30 minutes as our NHS auditors demand?’ Although this paper intends to raise the issues it may not solve the problems. The presentation will be accompanied by a detailed reference list of published aphasia test batteries.