Aachen aphasia test

Of the Aachen aphasia test (AAT) is a diagnostic method for the detection and classification of acquired, i.e. non-congenital language disorders, so-called aphasia. The test checks the language ability of a patient in several areas and thus enables a reliable description of the type of aphasic disorder.

What is the Aachen aphasia test?

Acquired language disorders are often the result of a disease of the dominant hemisphere of the brain, for example from injuries, tumors, cerebral haemorrhage, inflammation or a stroke. Depending on the type of underlying disease, the patients show different degrees of disorders in different areas of language.

Therefore, with the help of the Aachen aphasia test, not only the repeating, the understanding of language and the naming of things are examined, but also possible abnormalities in reading and writing. It is suitable both for a one-time implementation and for repeated use to control the course of a disease or therapy.

Function, effect & goals

The Aachen aphasia test is not only used in medical practice, but also in clinical psychology, clinical linguistics and speech therapy. It is suitable for patients from the age of 14 and lasts 60-90 minutes. Since the test procedure was designed for the German language, it can only be used for patients with a corresponding linguistic background.

In the meantime, however, the AAT has also been translated into Italian and Dutch. Correspondence in English and French is in progress. The test procedure is always identical and divided into six parts in which the test person's language skills are examined in different areas. In the first part of the test, the patient is analyzed during a ten-minute interview with personal questions about family, work, interests and health with regard to his spontaneous speech, i.e. his everyday language.

Particular attention is paid to the communication behavior in conversation with the interviewer as well as to the structure and the meaning of what is said. But pronunciation, automatisms, intonation and speech melody also flow into the analysis. In the token test that follows, the patient is asked to select individual items from several items. With these first two sections of the AAT, existing aphasias can be determined relatively reliably, but these cannot be classified in any more detail.

The test sections three to six then enable a more precise classification of the type of aphasic disorder. The third part of the Aachen aphasia test examines the respondent's ability to repeat individual sounds as well as simple and difficult words and sentences, while the fourth requires the reading and writing of spoken words and parts of words. In the fifth section, the test person must correctly name objects, colors or actions using drawings. Finally, the sixth part of the test is used to analyze listening comprehension: the respondent selects from several different images the one that, in his opinion, best fits a sentence or word read aloud.

In the course of the test, the level of difficulty of the individual tasks increases continuously. The answers are evaluated using a computer-based system of points. With the help of the test results obtained in this way, reliable statements can be made about the presence of a possible aphasia and its severity can be determined. In addition, the symptoms can be classified according to the four different forms of aphasia Global, Broca, Wernicke and Amnestisch. Special forms of aphasia such as transcortical aphasia and conduction aphasia can also be recognized in this way.

It is also possible to distinguish it from other linguistic disorders that were erroneously classified as aphasia. The Aachen aphasia test is a standardized and tested test method that can make a significant contribution to the diagnosis and reveals aphasia that is often overlooked in brain tumor patients. The presence of agraphia or alexia is also made possible by performing the test.

However, without the involvement of further examinations and test procedures as well as a thorough medical history, the results of the AAT alone are not suitable for a diagnosis. Further test procedures for acute aphasia are, for example, the Aachen aphasia bedside test and the aphasia check list.

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Risks, side effects & dangers

Since the interviewer does not influence the patient when carrying out the Aachen aphasia test, it can generally be classified as harmless.

In the course of the test, however, the respondent may become uncertain about their own cognitive abilities if answering the questions is difficult. Recognizing deviations from the norm in one's own language or perception can be very worrying for the patient and requires empathy and experience on the part of the interviewer. The test should therefore only be carried out by personnel trained in psychology or speech therapy in order to avoid excessive demands on the patient and to identify possible emotional after-effects.

It is also important to ensure that the test environment is set up accordingly. For patients with serious or acute clinical pictures, performing the Aachen aphasia test can sometimes be very exhausting. The interviewer should point this out and make sure that appropriate aftercare is available. The test results must always be evaluated in conjunction with other suitable diagnostic methods in order to be able to assess existing speech disorders and to find their causes.

Only then can appropriate therapy be initiated. The test structure follows a standardized procedure and must not be changed either in the order of the questions or in the overall scope, as this can lead to falsified results and thus to overlook or incorrect classification of aphasia. The implementation of sections of the AAT is possible for speech therapy-therapeutic purposes.