Boston Diagnostic Aphasia Examination (BDAE)

Purpose of the measure

The BDAE is designed to diagnose aphasia and related disorders. This test evaluates
various perceptual modalities (auditory, visual, and gestural), processing functions
(comprehension, analysis, problem-solving) and response modalities (writing, articulation,
and manipulation). The BDAE can be used by neurologists, psychologists, speech language
pathologists and occupational therapists (Goodglass & Kaplan, 1972).

Available versions

The BDAE was developed in 1972 by Goodglass and Kaplan. A second edition was published
in 1983 by the same authors. The most recent edition was published in 2001 by Goodglass,
Kaplan, and Barresi and contains both a shortened and extended version of the BDAE.

Features of the measure

Items and scoring:
Items and scoring on the BDAE is as follows (Goodglass & Kaplan, 1972):

1. Fluency: In this section the client should be encouraged to engage in a free narrative and an open-ended conversation. The following features are then assessed:

Melodic line: The examiner should observe the intonational pattern in the entire sentence.

Phrase length: The examiner should observe the length of uninterrupted runs of words.

Articulatory agility: The examiner should observe how the client articulates phonemic sequences.

Grammatical form: The examiner should observe the variety of grammatical construction.

Paraphasia in running speech: The examiner should observe substitutions or insertions of semantically erroneous words in running conversation.

Word-finding: The examiner should observe the client’s capacity to evoke needed concept names and informational content in the sentences.

All features are scored on a 7-point scale where 1 is the maximum abnormality and 7 the minimum abnormality.

2. Auditory Comprehension
Word discrimination: Consists of a multiple choice task and samples six categories of words: objects, geometric forms, letters, actions, numbers and colors. Five words are written on cards and the client is asked to identify among them the word requested by the examiner. Clients are given 2 points for correctly identifying the word within 5 seconds, 1 point for correct identification taking longer than 5 seconds, half a point for localizing the right category. The maximum score is 72. The examiner should record in writing all incorrect choices by the client.

Body-part identification: Includes 24 items, the first 18 are related to body part names, and the remaining 8 with right-left comprehension. The client is asked to identify on his own body the body part named by the examiner. One point is given for correctly identifying the body within 5 seconds. When more time is required on identifying the body parts only a half point is scored. For right-left comprehension, the examiner requires the client to identify the right forearm, for example. One point is given for correctly identifying the side within 5 seconds. When more time is required on identifying the side of the body only one point is scored.

Commands: The client is requested to carry out commands. The score in this subscale ranges from 0 to 15.

Complex ideational material: In this section the examiner asks general questions such as “will a stone sink in water?” and the client is required to understand and express agreement or disagreement. Each item consists of two questions, one having yes and the other no as response options. One point is scored for each item with both questions correctly answered. Score ranges from 0 to 10.

3. Naming
Responsive naming: The examiner asks the client a question containing a key word associated with the expected answer. Then the client should answer the question using the following words: nouns (watch, scissors, match, drugstore); colors (green, black), verbs (shave, wash, write) and a number (twelve). Three points are given when the response is provided within 3 seconds, 2 points within 3 to 10 seconds, 1 point within 10 to 30 seconds, and 0 if the client provides an improper answer. Maximum score is 30.

Visual Confrontation: The client should name the images presented by the examiner. The visual stimulus items are from cards 2 and 3 and represent objects, geometric forms, letters, actions, numbers, colors and body parts. Three points are given when the response is given within 3 seconds, 2 points within 3 to 10 seconds, 1 point within 10 to 30 seconds, and 0 if the client is unable to provide the correct answer. Maximum score is 105.

Animal naming: The first word “dog” is provided by the examiner to stimulate the client. Then the client should provide all animals name that he/she knows within 60 seconds. The score consists of counting the number of different animals named by the client.

Body part naming: The examiner points to 10 body parts to be named on him/her. Three points are given when the response is given within 3 seconds, 2 points within 3 to 10 seconds, 1 point within 10 to 30 seconds, and 0 if the client if the client provides the wrong answer. Maximum score is 30.

4. Oral Reading
Word reading: The examiner indicates a word from card 5 that should be read by the client. Three points are given when the word is read within 3 seconds, 2 points within 3 to 10 seconds, 1 point within 10 to 30 seconds, and 0 if the client provides the wrong answer. Maximum score is 30.

Oral sentence: Ten sentences should be read from cards 6 and 7. The sentences are scored as pass (score of 1) or fail (score of 0).

5. Repetition
Words: A wide sampling of word types is presented, including a grammatical function word, objects, colors, a letter, numbers, an abstract verb of three syllables and a tongue twister. An item is scored correct if all phonemes are in correct order and recognizable. One point is allowed per item for a total of 10.

High and low probability sentences: The sentences should be repeated by the client, alternating between a high- and a low-probability item. One point is given for each sentence correctly repeated and high- and low- probability sections are scored separately from 0 to 8.

6. Automatic speech
Automatized sequences: Four sequences are tested: days of the week, months of the year, number from one to twenty-one and the alphabet. Two points maximum are given for complete recitation of any series and 1 point is given for unaided runs of 4 consecutive words when reciting days, 5 consecutive words when reciting months, 8 consecutive words when reciting numbers and 7 consecutive words when reciting the alphabet.

Reciting: Several nursery rhymes are suggested to elicit completion responses. A score of 0 is given if the client is unable to recite, 1 for impaired recitation and 2 for good recitation.

7. Reading Comprehension
Symbol discrimination: Cards 8 and 9 contain 10 items each. The examiner shows the word or letter centered above the five multiple-choice responses and asks the client to select the equivalent. One point is given to each correct item.

Word recognition: Using cards 10 and 11 the client is requested to identify the one word, out of 5, which matches the word said previously by the examiner. This task is repeated another 7 times and a score of 1 point is given to each correct answer.

Oral spelling: The client should recognize 8 words spelled by the examiner. One point is given for each correct recognition.

Word-picture matching: Ten words are selected from card 5 to be identified on cards 2 and 3. One point is given for each correct recognition.

Sentences and paragraphs: The examiner reads 10 sentences from cards 12 to 16. The client is requested to complete the ending of a sentence with a four multiple choice options. One point is given for each correct sentence.

8. Writing
Mechanics: The client is requested to write his/her name and address with the stronger hand. In case he/she is not able to do so, then the examiner can write the sentence and the client should then transcribe it. Score ranges from 0 to 3 according to performance level.

Serial writing: The client should write the alphabet and numbers from 1 to 21. The score is the total number of different, correct letters and numbers, combined for a maximum score of 47.

Primer-level dictation: The client should write the letters, numbers and primer words that are dictated by the examiner. A score is given by adding the number of correct words.

Spelling to dictation: The client should write the words dictated by the examiner. Score is based on the amount of correct words written by the client.

Written confrontation naming: The patient should write the name of the figure that is shown from cards 2 and 3 by the examiner. The examiner should show 10 figures. One point is given for each correctly spelled response.

Sentences to dictation: The client should write the three sentences dictated by the examiner. Scores for each sentence range from 0 to 4.

Narrative writing: Card 1 has a picture of a cookie theft which is shown to the client who must then write as much as he/she can about what he/she sees in the picture. The client should be encouraged to keep writing for 2 minutes. Scores for this section range from 0 (no relevant writing) to 4 (full description in grammatical sentences).

16 stimulus cards are enclosed with the BDAE. These cards include a range of images, words and sentence that are shown to the client during the assessment.

Detailed administration guidelines are in the test manual that should be purchased.

Time:
The BDAE takes 90 to 120 minutes to administer. The extended format of the BDAE may take up to 2 1/2 hours (Sbordone, Saul & Purisch, 2007). The shortened version takes 30 to 45 minutes (Goodglass & Kaplan, 2001).

Subscales:

The BDAE is comprised of 8 subscales:

  • Fluency
  • Auditory comprehension
  • Naming
  • Oral reading
  • Repetition
  • Automatic speech
  • Reading comprehension
  • Writing

Equipment:
The BDAE requires specialized equipment that should be purchased in specialized stores or online.

Training:
The test costs approximately US$450.00 and includes the full test battery, manual and instructional video.

Alternative forms of the BDAE

Shortened version: described as “a brief, no frills assessment.”

Extended version: includes an assessment of praxis in addition to the standard assessment.

Client suitability

Can be used with:

  • Adults with stroke
  • Adults with communication and language impairments

Should not be used with:

  • Not reported
In what languages is the measure available?

English, Spanish, Portuguese, French, Hindi, Finnish, and Greek (Radanovic & Scaff, 2002; Rosselli, Ardila, Florez & Castro, 1990; Tsapkini, Vlahou & Potagas, 2009/2010).