Comprehensive Aphasia Test (CAT)

The Comprehensive Aphasia Test (CAT) is a test for use with people who have acquired aphasia, that can be completed over one or two assessment sessions. The test includes a user manual, a ring-bound cognitive screen and language battery, a pack of 10 scoring booklets, which are all unchanged since the previous edition, and - new to this release - a concise Aphasia Impact Questionnaire (AIQ) which replaces the Disability Questionnaire.

• The Cognitive Screen assesses people's abilities across a range of tasks that can affect rehabilitation.
• The Language Battery forms the main body of the test; it provides a profile of performance across all modalities of language production and comprehension.
• The Aphasia Impact Questionnaire (AIQ) is a pictorial Patient Reported Outcome Measure, which produces both qualitative and quantitative information. It was co-produced with people with aphasia. It supports the person with aphasia to give a subjective rating of how language difficulties identified in the Language Battery affect their daily life, enabling first steps towards goal setting.

By capturing this information, the CAT helps the therapist track changes over the course of recovery and provides a guide to likely outcomes on the basis of an early assessment. The first two sections of the CAT are supported by normative data on people both with and without aphasia, and extensive data on reliability and clinical validity. The CAT allows users to:

• Identify underlying impairments
• Find where to focus assessments using PALPA and other batteries
• Ascertain the practical, psychological, and social impact of aphasia, from the perceptive of the person with aphasia
• Create a profile of strengths and weaknesses to guide therapy.

Structured around fully up-to-date models of language assessment, from cognitive neuropsychology to patient reported outcome measures, test is an indispensable resource for speech and language therapists and researchers. It provides as much information about people's language ability as possible in a relatively brief test designed to be completed in 90-120 minutes.

Key features of the CAT:

• It is comprehensive: it tests a wide range of language functions as well as related neuropsychological deficits.
• The AIQ allows clinicians to begin to examine the effect of impairment on the patients’ lives to guide focused interventions, and to involve the patient in the process of goal setting
• Clinically useful: it is relatively brief but maximally informative and can typically be completed in 1-2 assessment sessions.
• It assesses the severity of aphasia over time so clinicians can use the information from the initial tests alone to predict the recovery of their patients.

Table of Contents

Acknowledgements

1. Introduction
• Aphasia tests
• The need for the CAT
• The advantages of the CAT
• Structure of the CAT
2. Directions for Administration and Rationale
• General introduction to administration of the test battery
• Detailed guide to rationale and administration of subtests

THE COGNITIVE SCREEN

1. Line bisection

2. Semantic memory

3. Word fluency
4. Recognition memory
5. Gesture object use
6. Arithmetic

THE LANGUAGE BATTERY

Part 1: Language comprehension

7. Comprehension of spoken words

8. Comprehension of written words

9. Comprehension of spoken sentences

10. Comprehension of written sentences

11. Comprehension of spoken paragraphs

Part 2: Expressive language

Repetition

12. Repetition of words

13. Repetition of complex words

14. Repetition of nonwords

15. Repetition of digit strings

16. Repetition of sentences

Spoken language production

17. Naming objects

18. Naming actions

19. Spoken picture description

Reading aloud

20. Reading words

21. Reading complex words

22. Reading function words

23. Reading nonwords

Writing

24. Writing: Copying

25. Writing picture names

26. Writing to dictation

27. Written picture description

THE APHASIA IMPACT QUESTIONNAIRE

• General introduction to the rationale and administration of the AIQ
• Detailed guide to rationale and administration of subtests

28. Communication

29. Participation

30. Emotional Well-Being

Modality summary scores

• The cognitive screen
• The language battery
• The aphasia impact questionnaire
• T-score transformation

3. Interpretation of Results

THE COGNITIVE SCREEN

1. Line bisection
2. Semantic memory
3. Word fluency
4. Recognition memory
5. Gesture object use
6. Arithmetic

THE LANGUAGE BATTERY

Part 1: Language comprehension

7. Comprehension of spoken words

8. Comprehension of written words

9. Comprehension of spoken sentences

10. Comprehension of written sentences

11. Comprehension of spoken paragraphs

Part 2: Expressive language

Repetition

12. Repetition of words

13. Repetition of complex words

14. Repetition of nonwords

15. Repetition of digit strings

16. Repetition of sentences

Spoken language production

17. Naming objects

18. Naming actions

19. Spoken picture description

Reading aloud

20. Reading words

21. Reading complex words

22. Reading function words

23. Reading nonwords

Writing

24. Writing: Copying

25. Writing picture names

26. Writing to dictation

27. Written picture description

THE APHASIA IMPACT QUESTIONNAIRE

28. Communication

29. Participation

30. Emotional well being

THE T-SCORE PROFILE

• Example 1: Patient RP
• Example 2: Patient UA
• Example 3: Patient AC

4. Reliability and Validity

• Standardisation samples
• T-score transformation
• Reliability
• Test–retest reliability
• Inter-rater reliability
• Comparing modality summary scores
• Construct validity
• The cognitive screen
• The language battery
• Predictive validity
• Concurrent validity

5. Predicting Aphasia Recovery

• Introduction
• Study design
• Subjects
• Assessment
• Data management
• Results
• Patterns of recovery
• Predicting performance at 12 months
• Discussion
• Effects of therapy
• Comment
• References

Appendices

1. Worked examples (subtest 19)
2. Derivation of T-scores from raw scores for cognitive subtests
3. Derivation of T-scores from raw scores for language comprehension subtests
4. Derivation of T-scores from raw scores for repetition and naming subtests
5. Derivation of T-scores from raw scores for reading and writing subtests
6. Derivation of T-scores from raw scores for spoken and written description subtests
7. Derivation of 'frontal' T-scores from the relationship between the scores in word fluency and naming objects