Optimizing Detection of Very Mild Aphasia With Letter Fluency Tests

Area of Science:

• Neurolinguistics
• Clinical Psychology

Background:

• Aphasia diagnosis often misses very mild cases.
• The Western Aphasia Battery-Revised (WAB-R) may not capture subtle language deficits.

Purpose of the Study:

• To identify an efficient clinical measure for diagnosing very mild aphasia.
• To evaluate the diagnostic accuracy of various tests for very mild aphasia.

Main Methods:

• Compared 27 individuals with very mild aphasia to 68 controls on 28 tests.
• Utilized receiver operator characteristic (ROC) curve analysis to find optimal cutoffs.
• Assessed combinations of tests for improved sensitivity and specificity.

Main Results:

• 18 of 28 tests showed significant group differences after Bonferroni correction.
• Letter fluency and a two-letter fluency test achieved sensitivity and specificity ≥ .70.
• A combined letter fluency and two-letter fluency test yielded .89 sensitivity and .81 specificity.

Conclusions:

• Combined letter and two-letter fluency tests effectively detect very mild aphasia.
• This 11-minute assessment is clinically accessible and complements the WAB-R.
• These tests also assess executive control, aiding in treatment target identification.