Clinical and Research Tools

Clinical Tests for Aphasia

Clinical and Research Tools

The Northwestern Naming Battery (NNB)

The NNB was designed to examine comprehension and production of several categories of objects and actions, while ruling out other deficits that could be related to naming or word comprehension impairments. Therefore, it provides a comprehensive assessment of production and comprehension of nouns and verbs as well as assessments of peripheral auditory processing and object recognition ability. Subtests also are included to evaluate the integrity of semantic and word form access/selection systems.

The NNB consists of seven subtests: (1) Auditory Discrimination, (2) Auditory Lexical Decision, (3) Confrontation Naming, (4) Auditory Comprehension, (5) Semantic Associates, (6) Non-word Repetition, and (7) Word Repetition. The first two subtests, Auditory Discrimination and Auditory Lexical Decision, examine auditory processing ability for words and non-words. In the Confrontation Naming and Auditory Comprehension subtests, noun category effects are testing using items from two non-living things (artifacts) (i.e., tools and clothing) and two categoriesof living things (i.e., animals and fruits/vegetables). A fifth set of object nouns includes only low frequency items from several semantic categories. In addition, naming of body parts and colors are tested in both the Confrontation Naming and Auditory Comprehension subtests. The action verbs tested consist of both transitive and intransitive forms. The Semantic Associates subtest examines semantic processing by asking participants to select pairs of pictured objects according to how related they are in meaning. Finally, the Word and Non-word Repetition subtests examine the ability to repeat both real and non-words.

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The Northwestern Assessment of Verbs and Sentences (NAVS)

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The NAVS was designed to examine comprehension and production of action verbs, production of verb argument structure in sentence contexts, and comprehension and production of canonical and non-canonical sentences in individuals with language disorders resulting from neurological disease. Results of testing provide a comprehensive profile of these abilities.

The NAVS consists of five subtests: the Verb Naming Test (VNT), the Verb Comprehension Test (VCT), the Argument Structure Production Test (ASPT), the Sentence Production Priming Test (SPPT), and the Sentence Comprehension Test (SCT). The VNT and VCT examine action production (picture naming) and comprehension of verbs that differ with respect to argument structure properties – the number and optionality of arguments. The ASPT evaluates production of these verbs together with their arguments in a sentence production task. Production and comprehension of sentences by canonicity and sentence type are examined in the SPPT and SCT, respectively, using six sentence types – three canonical forms (actives, subject extracted wh-questions, and subject relative clause structures) and three non-canonical forms (passives, object extracted wh-questions, and object relative clause structures).

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The Northwestern Anagram Test (NAT)

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The NAT was developed to examine non-verbal production of canonical and non-canonical sentences, using a set of word cards and action pictures. It is particularly useful for testing individuals with motor speech, cognitive (e.g., attention, memory), or other impairments that preclude ability to perform spoken sentence production tasks, such as those included on the Northwestern Assessment of Verbs and Sentences (NAVS).

The NAT consists of two versions: a Long and Short Version.The Long Version examines production of the same sentence types examined with the NAVS, including active sentences, passive sentences, subject extracted wh-questions, object extracted wh-questions, subject relatives, and object relatives. The Short Version examines production of subject and object extracted wh-questions only. Scores derived from the two versions are highly correlated with one another. In addition, scores on the NAT correlate highly with those derived from the Sentence Production Priming Test (SPPT) on the NAVS.

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The Northwestern Assessment of Verb Inflection (NAVI).

The NAVI was designed to examine production of verb inflection forms in individuals with language disorders resulting from neurological disease. The NAVI is used to assess one’s ability to produce finite (present singular, present plural, past regular and irregular forms) and nonfinite (infinitive, present progressive) verb inflection forms in English, using a sentence completion task. The NAVI can be used in both research and clinical settings in order to test for the presence of verb inflection difficulties and the nature of such difficulties in adults with language disorders.

Many individuals with neurogenic language disorders experience difficulty producing correct verb infection forms. In addition, different inflection forms can be affected differently. For example, an individual with aphasia may show greater difficulty with the past tense verb as in yesterday he danced, compared to the present progressive form as in now he is dancing. The NAVI was designed as a clinical and research tool to systematically examine the presence and nature of verb inflection difficulties in individuals with aphasia and related neurogenic language disorders.

The NAVI consists of 10 verbs, tested in five different verb inflection forms: two nonfinite forms (infinitive and present progressive) and three finite inflection forms (3rd person present singular, present plural, and past tense). Both regular and irregular verbs are tested, allowing comparison of production of regular (e.g., poured) and irregular (wrote) past tense forms. Inclusion of both the 3rdperson present singular and plural forms allows assessment of the ability to produce inflectional marking for number agreement (e.g., the man eats vs. the men eat). The target verb inflection form is elicited using a sentence completion task (Now the man is _____ the hamburger). The NAVI also includes two supplementary tests, including the Phonological Screening Test and the Grammaticality Judgment Test of verb inflection to assist in better determining the nature of verb inflection deficits. Administration of the NAVI is relatively quick (approximately 15-30 minutes). The NAVI can be used as a stand-alone test for evaluating verb inflection morphology or as a supplementary assessment to complement more general language assessment tools such as the Northwestern Assessment of Verbs and Sentences (Thompson, 2011).

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The Northwestern Narrative Analysis (NNLA)

The NNLA was developed to examine patterns of recovery, as well as the effects of treatment, for individuals with agrammatic, Broca’s aphasia. The present version of the NNLA is intended to be of use to both clinicians and researchers interested in documenting the narrative ability of patients with aphasia. We have used the method with both fluent and nonfluent aphasic individuals and have found it to be equally useful for both types of aphasia. We also suggest that it can be used for children or adolescents with specific language impairments and other language disorders.

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Treatment of Underlying Forms (TUF)


TUF was developed for use with individuals with agrammatic aphasia, a type of aphasia characterized by production of short, grammatically impoverished utterances, with frequent word-finding pauses. TUF focuses on non-canonical sentence structures and incorporates training for both sentence production and comprehension. Importantly, treatment is based on the premise that training underlying, abstract properties of language facilitates generalization to untrained structures with similar linguistic properties, especially those of lesser linguistic complexity.

The TUF treatment materials consist of three treatment protocols for the training of: (1) Passive Sentences, (2) Object Cleft Sentences, and (3) Wh-questions. Within each structure are materials for training 20 reversible sentences with the use of reversible picture pairs and word cards needed to construct target sentences, as shown above. The supplemental package includes materials for an additional 29 reversible sentences and 65 non-reversible sentences, as shown above. In conjunction with treatment, instructions for behavioral probes are included for tracking treatment progress and checking for generalization.

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