The Aachen Aphasia Test (AAT) is a diagnostic procedure for the detection and classification of acquired, ie non-congenital speech disorders, so-called aphasias. The test verifies 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?

The Aachen Aphasia Test (AAT) is a diagnostic procedure for the detection and classification of acquired, ie non-congenital speech disorders, so-called aphasias.

Acquired speech disorders are often the result of dominant brain disease, such as injury, tumors, cerebral hemorrhage, inflammation or stroke. Depending on the type of underlying disease, patients show varying degrees of interference in different areas of speech.

Therefore, with the help of the Aachen aphasia test not only the after-speech, the speech comprehension and the naming of things are examined, but also possible abnormalities when reading and writing. It is suitable for one-time use as well as for repeated use to control a disease or therapy course.

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 years and lasts 60-90 minutes. Since the test procedure was designed for the German language, it can only be used in patients with a corresponding linguistic background.

Meanwhile, the AAT has also been translated into Italian and Dutch. Correspondences in English and French are being worked on. The test procedure is always identical and divided into six parts, in which the language skills of the test person in different areas are examined. In the first part of the test, the patient is analyzed during a ten-minute interview with personal questions about family, occupation, interests and health with regard to his spontaneous language, ie his everyday spoken language.

Particular attention is paid here to the communication behavior in conversation with the interviewer as well as to the structure and meaning of the spoken word. But also pronunciation, automatisms, emphasis and speech melody are included in the analysis. In the subsequent token test, the patient is asked to select from several items individually given things. These first two subsections of the AAT relatively reliably detect existing aphasias, but they can not be classified further.

The test sections three to six then allow a more accurate classification of the type of aphasic disorder. The third part of the Aachen Aphasia Test examines the interviewee's ability to repeat individual sounds as well as simple and difficult words and phrases, while the fourth requires the reading and writing of spoken words and phrases. In the fifth section, the subject must correctly name objects, colors, or actions based on drawings. Finally, the sixth part of the test serves to analyze the listening comprehension: the respondent selects from several different pictures the one which in his opinion best suits a sentence or word that has been read.

During the test, the difficulty level of each task increases continuously. Responses are evaluated computer-aided using a set point system. With the help of the test results obtained in this way, reliable statements can be made about the existence of aphasia and its severity. In addition, the present symptoms can be classified according to the four different aphasia forms Global, Broca, Wernicke and Amnestisch. Special forms of aphasia, such as transcortical aphasia and lead phasias, can also be recognized.

It also allows differentiation from other linguistic disorders that have been erroneously classified as aphasia. The Aachen Aphasia Test is a standardized and tested test procedure that can significantly contribute to the diagnosis and often reveals overlooked aphasia in brain tumor patients. The presence of an agraphie or Alexie is also made possible by carrying out the test.

However, without the involvement of further examinations and tests and a thorough history, the results of AAT alone are not suitable for diagnosis. Further testing methods for acute aphasia include, for example, the Aachen Aphasia Bedside Test and the Aphasia Check List.

Risks, side effects & dangers

Since the performance of the Aachen Aphasia Test does not affect the patient on the part of the interviewer, its implementation can generally be classified as non-hazardous.

However, respondents may experience uncertainties about their own cognitive abilities during the course of the test if it is difficult to answer the questions. Recognizing abnormalities in one's own language or perception can greatly distress the patient and requires empathy and experience on the part of the interviewer. The test should therefore only be carried out by psychologically or speech therapist-trained personnel, in order to avoid excessive demands on the patient and to recognize any emotional after-effects.

Likewise, attention must be paid to a suitably equipped test environment. For patients with serious or acute clinical pictures, the performance of the Aachen Aphasia Test can sometimes be very stressful. The interviewer should point this out and make sure that appropriate follow-up care is available. The test results must always be evaluated in conjunction with other suitable diagnostic procedures to assess the presence of speech disorders and to find their causes.

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

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