Boston Diagnostic Aphasia Examination (BDAE)

Overview

We conducted a literature search to identify all relevant publications on the
psychometric properties of the Boston Diagnostic Aphasia Examination (BDAE) in individuals
with stroke. We identified 5 studies.

Floor/Ceiling Effects

No studies have examined the ceiling effects of the BDAE in clients with stroke.

Reliability

No studies have examined the reliability of the BDAE in clients with stroke.

Validity

Content

No studies have examined the content validity of the BDAE in clients with stroke.

Criterion

Concurrent.
No studies have examined the concurrent validity of the BDAE in
clients with stroke.

Predictive.
No studies have examined the predictive validity of the BDAE in
clients with stroke.

Construct

Convergent/Discriminant.
Larson, Kirschner, Bode, Heinemann and Goodman
(2005) analyzed the construct validity of the BDAE by comparing it to the Repeatable
Battery for the Assessment of Neuropsychological Status (RBANS) (Randolph, 1998) in 88
clients with stroke. Correlations between the Repetition subscale of the BDAE and the
Attention, Language, Immediate Memory, and Delayed Memory Indexes of the RBANS were
adequate (r = 0.45; 0.42; 0.40; 0.38, respectively), while correlations between the
Repetition subscale of the BDAE and the Visuospatial Index of the RBANS were
poor (r = 0.25). Correlations between the Commands subscale of the BDAE and the Language and
Immediate Memory Indexes of the RBANS were adequate (r = 0.38; 0.37, respectively) while
between the Commands subscale of the BDAE and the Delayed Memory, Attention and
Visuospatial Indexes of the RBANS correlations were poor (r = 0.30; 0.24; 0.14,
respectively).

Wilde, (2006) examined the construct validity of the BDAE by comparing it to the
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (Randolph,
1998) in 22 clients with stroke. The BDAE showed an adequate correlation with the Language
Index of the RBANS (r = 0.40) and a poor correlation with the Visuospastial Index of the
RBANS (r = 0.19).

Tucker et al. (2012) developed modified versions of the Stroke Impact Scale (SIS), Medical Outcomes Study Short Form-36 (SF-36), Activity Card Sort (ACS) and the Reintegration to Normal Living Scale to improve the use of the measures with patients with aphasia. The authors examined the relationship between patients’ performance on these modified measures and the severity of aphasia as measured using the BDAE-3 Short Form, in a sample of 29 community-dwelling people with subacute or chronic stroke and aphasia. The BDAE Expressive component demonstrated excellent correlations with the SIS Communication, Participation and Stroke Recovery domains (r=0.72, 0.66, 0.60 respectively), and adequate correlations with the SIS Physical domain (r=0.46) and the ACS total, Instrumental and Low Demand Leisure scores (r=0.55, 0.53, 0.57 respectively). The BDAE Auditory Comprehension component demonstrated adequate correlations with the SIS Communication, Participation and Stroke Recovery domains (r=0.57, 0.50, 0.45 respectively) and the ACS total, Instrumental and Low Demand Leisure scores (r=0.51, 0.48, 0.47 respectively). The BDAE Language Competency Index (LCI) demonstrated excellent correlations with the SIS Communication and Participation domains (r=0.67, 0.61 respectively) and adequate correlations with the SIS Stroke Recovery domain (r=0.56) and the ACS total, Instrumental and Low Demand Leisure scores (r=0.55, 0.53, 0.55 respectively). Correlations with other SIS domains, ACS scores and the SF-36 and Reintegration to Normal Living Scale were not significant.

Peristeri and Tsapkini (2011) examined correlations between similar subtests of the BDAE-3 Short Form (Greek version) and the Bilingual Aphasia Test (BAT) (Greek version) in 9 patients with agrammatic aphasia, including 7 with chronic stroke. Correlations between tests of automated sequences, listening comprehension (BDAE complex ideational material subtest) and reading were excellent (r=0.75; 0.75; 0.88, respectively). Correlations between tests of fluency, commands, verbal auditory discrimination, word repetition, sentence repetition and naming were not significant.

Known groups.
Tsapkini, Vlahou and Potagas (2009/2010) examined the discriminative (known group) validity of the BDAE-SF (Greek version) by comparing the performance of healthy community-dwelling adults and patients with aphasia secondary to stroke, using Wilcoxon’s rank sum test (W). Participants were matched according to education, age and gender. Significant differences between healthy adults and individuals with aphasia were seen in subgroups of middle-aged individuals (40-59 years) of middle education and higher education on subtests of auditory comprehension (W=32, p=0.005; W=20, p=0.015 respectively), oral expression (W=32, p=0.005; W=20, p=0.015 respectively) and reading (W=24, p=0.003; W=10, p=0.035 respectively), and in a subgroup of older individuals (60 years+) with low education on subtests of auditory comprehension (W=56.5, p=0.009) and oral expression (W=51, p=0.005).

Responsiveness

No studies have examined the responsiveness of the BDAE in clients with stroke.

References
  • Borod, J.C., Goodglass, H., & Kaplan, E. (1980). Normative data on the
    Boston Diagnostic Aphasia Examination, Parietal Lobe Battery, and the Boston Naming
    Test. Journal of Clinical Neuropsychology, 3, 209-215.
  • Enderby, P.M., Wood, V.A., Wade, D.T., & Hewer, L.R. (1987). The Frenchay
    Aphasia Screening Test: A short, simple test for aphasia appropriate for nonspecialists.
    International Journal of Rehabilitation Medicine, 8, 166-170.
  • Goodglass, H. & Kaplan, E. (1972). The assessment of aphasia and related
    disorders
    . Philadelphia, Boston: Lea & Febiger.
  • Larson, E.B., Kirschner, K., Bode, R., Heinemann, A., & Goodman, R. (2003).
    Construct and predictive validity of the repeatable battery for the assessment of
    neuropsychological status in the evaluation of stroke patients. Journal of clinical and
    experimental neuropsychology
    , 27, 16-32.
  • Peristeri, E., & Tsapkini, K. (2011). A comparison of the BAT and BDAE-SF batteries in determining the linguistic ability in Greek-speaking patients with Broca’s aphasia. Clinical Linguistics & Phonetics, 25 (6-7): 464-479.
  • Radanovic, M. & Scaff, M. (2003). Speech and language disturbances due to
    subcortical lesions. Brain and language, 84, 337-352.
  • Randolph, C. (1998). The Repeatable Battery for the Assessment of Neuropsychological
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    . San Antonio, TX: The Psychological Corporation.
  • Rosselli, M., Ardila, A., Florez, A., & Castro, C. (1990). Normative data on
    the Boston Diagnostic Aphasia Examination in a Spanish-speaking population. Journal of
    Clinical and Experimental Neuropsychology
    , 12, 313-322.
  • Sbordone, R.J., Saul, R.E., & Purisch, A.D. Neuropsychology for Psychologists, Health Care Professionals, and Attorneys. Boca Raton, FL: Taylor and Francis Group.
    Tucker, F.M., Edwards, D.F., Mathews, L.K., Baum, C.M., & Connor, L.T. (2012). Modifying Health Outcome Measures for People With Aphasia. American Journal of Occupational Therapy, 66, 42-50.
  • Tsapkini, K., Vlahou, C.H., & Potagas, C. (2009/2010). Adaptation and validation of standardized aphasia tests in different languages- Lessons from the Boston Diagnostic Aphasia Examination – Short Form in Greek. Behavioural Neurology, 22, 111-119.
  • Tucker, F.M., Edwards, D.F., Mathews, L.K., Baum, C.M., & Connor, L.T. (2012). Modifying Health Outcome Measures for People With Aphasia. American Journal of Occupational Therapy, 66, 42-50.
  • Wilde, M.C. (2006). The validity of the repeatable battery of neuropsychological
    status in acute stroke. The clinical neuropsychologist, 20, 702-715.