Aphasia: definition
Aphasia designates a very complex and heterogeneous symptomatological framework, so much so that it is sometimes difficult to distinguish between one form and another. As analyzed in the previous articles, aphasia identifies an alteration of language on the level of both word comprehension and word processing.
The aphasic disorders take on different connotations depending on the severity of the pathology. In some subjects suffering from aphasia, the words spoken are not understandable, because they are crippled or even invented (indecipherable neologisms); in other patients, words are difficult not only to pronounce, but also to process. Still, other aphasics are not able to combine more words, although these are pronounced grammatically correct [//www.aitafederazione.it/].
Key points for diagnosis
In order to draw up a correct diagnosis, it is first of all necessary to distinguish a hypothetical aphasia from a possible dysarthria: if in aphasia patients are not able to enunciate words and / or understand them, in dysarthria the patients present difficulties only in the articulation of the words.
After having ascertained that it is an aphasia, it is the duty of the specialist to identify the exact type of disease; strictly speaking, some parameters must be considered, summarized below:
- Ability to understand words;
- Degree of fluidity of language;
- Faculty to name / identify objects;
- Competence to repeat some words;
- Recognition ability for slowly spelled words;
- Writing skills and methods;
- Search for any neologisms
- Ability to repeat / imitate sounds.
Aachen test for aphasia
In order to ascertain the disease and to identify exactly the type of aphasia, the differential diagnosis involves the Aachen test . The objective of this diagnostic investigation is to catalog and classify affected patients within a standard and precise syndrome; furthermore, the Aachen test is useful for assessing the severity of aphasia and, possibly, the degree of degeneration of the same. The test first of all recognizes the most common standard aphasic syndromes: Broca, Werniche, global, amnestic, trans cortical and conduction (the aforementioned aphasias were analyzed in the article concerning the classification of language disorders).
The test mainly involves spontaneous language evaluation tests, word repetition, object or color naming, word repetition, oral / written comprehension of words or phrases, and writing and written language evaluations.
The Aachen test proves to be very advantageous, since it is rather simple in application and of a standard and / or objective assessment of the disorder; unfortunately, this diagnostic test needs a fairly long time for data transcription, correction and evaluation.
Token test for aphasia
The Token test, better known as a token test, gives an idea of the ability to understand oral language: the aphasic patient faces 36 tokens, distinguished by color, shape and size. Based on the indications provided by the specialist (eg touching the yellow round buttons) and the way the patient responds, the various levels of severity of the disorder can be highlighted, discriminating aphasic patients from healthy (or non-aphasic ). This diagnostic test does not provide information on the fluent and non-fluent form of aphasia, but only on the degree of speech impairment.
Other diagnostic tests
To verify and confirm the hypothesis of aphasia, the specialist can recommend other diagnostic tests to the patient:
- Fluence test : evaluate the ability to quickly search for words, focusing on the patient's vocabulary.
- Language tests : evaluation of word production, denomination (written and oral), and comprehension. Useful for differential diagnosis, as it frames the patient in a precise aphasic syndrome.
- Evaluation of the cortical quotient, a very useful classification tool in order to evaluate both the typology of aphasia and its degree of severity.
- Benton test : includes tests of spontaneous language, repetition of figures, comprehension, association of words and writing.
In conclusion, some fundamental parameters must be considered in all aphasic diagnostic tests: comprehension, repetition, production, reading, writing and denomination. Depending on the results obtained, the doctor must be able to profile the patient in a precise diagnostic picture, in order to direct him towards the most suitable therapy.
