Aphasia Classification and Assessment

Aphasia Classification

• Major syndromes include Fluent Aphasia, Nonfluent Aphasia, Alexia with Agraphia, and Pure Aphasias.

WAB & BDAE Agreement

• Classification agreement between WAB and BDAE occurs approximately 27% of the time.

BDAE Assessment Categories

• Broad categories assessed are Fluent Aphasia, Nonfluent Aphasia, Alexia with Agraphia, and Pure Aphasias.

WAB-R Assessment Categories

• WAB-R assesses Fluent Aphasia and Nonfluent Aphasia.

Nonfluent Aphasias

• Types include Broca's, Transcortical Motor, Global, Mixed Nonfluent (BDAE), and Isolation (WAB-R).

Fluent Aphasias

• Types include Wernicke's, Conduction, Anomic, and Transcortical Sensory (WAB-R).

Pure Alexia

• A reading-only deficit, classified as a pure aphasia.

Pure Agraphia

• A writing-only deficit, classified as a pure aphasia.

Pure Word Deafness

• An auditory comprehension deficit not explained by hearing loss, while reading remains intact.

Optic Aphasia

• Inability to name visually presented objects but can name them when presented tactilely.

Distinguishing Fluent & Nonfluent Aphasia

• Factors include fluency, auditory comprehension, repetition, word finding, and paraphasia; reading and writing skills are not used.

Paraphasia

• Involves the production of unintended syllables, words, or phrases during speaking.

Literal (Phonemic) Paraphasia

• Substitutes one sound for another, e.g., "label" for "table."

Verbal Paraphasia

• Involves substituting one word for another; includes three types.

Semantic Paraphasia

• Most common type, substitutes words semantically related to the target, e.g., "chair" for "table."

Unrelated Verbal Paraphasia

• Substitutes a word unrelated semantically to the target, e.g., "sock" for "table."

Perseverative Paraphasia

• Involves repetition of words from earlier responses.

Neologistic Paraphasia

• Involves the use of a nonsense word.

Circumlocutions

• Refers to talking around the intended word.

Paragrammatism

• Produces running speech that is logically or grammatically incoherent.

BDAE Fluent/Nonfluent Classification

• Fluent: Scores 5.5-7 on "phrase length"; Non-fluent: Scores 1-4.

WAB-R Fluent/Nonfluent Classification

• Nonfluent: Scores 1-4 in key measures; Fluent: Scores 5-10.

Broca's Aphasia Linguistic Features

• Characterized by nonfluent, effortful, slow, and telegraphic speech; high informational content but poor grammatical structure.

Broca's Aphasia Accompanying Deficits

• Often presents with Apraxia of Speech, Hemiplegia, and mild dysarthria.

Broca's Aphasia Site of Lesion

• Involves Broca's area and surrounding areas, with decreased glucose metabolism in both hemispheres.

Transcortical Motor Aphasia Linguistic Features

• May present with mutism; nonfluent speech, echolalia, good repetition ability, and relatively good auditory comprehension.

Transcortical Motor Aphasia Accompanying Deficits

• Includes bilateral ideomotor apraxia, akinesia, and bradykinesia; may also present with upper extremity rigidity and transient urinary incontinence.