Formal language assessment in low-educated persons with aphasia: can the lesion effect be distinguished from the education effect?

MEDEIROS, Natalia Malagueta de; ORTIZ, Karin Zazo

doi:10.1590/0004-282X-ANP-2020-0475

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ARTICLE • Arq. Neuro-Psiquiatr. 80 (02) • Feb 2022 • https://doi.org/10.1590/0004-282X-ANP-2020-0475 copy

Formal language assessment in low-educated persons with aphasia: can the lesion effect be distinguished from the education effect?

Avaliação da linguagem em pacientes afásicos com baixa escolaridade: o impacto da lesão neurológica pode ser discriminado da baixa escolaridade?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background: Language tests are important in the assessment and follow up of people with aphasia (PWA). However, language assessment in the low literacy population is still a challenge. Objective: To investigate whether a formal evaluation of aphasia is able to distinguish the neurological effect from the effect of low educational level in people with post-stroke aphasia. Methods: The sample consisted of a group of 30 aphasic subjects (AG) and a control group (CG) of 36 individuals, both with an educational level of 1-4 years. The Brazilian Montreal-Toulouse Language Assessment battery was applied to all subjects. Results: There were statistically significant differences between the groups in 19 out of the 20 tasks analyzed. Conclusions: These results suggest that formal evaluation procedures are able to detect language disorders resulting from stroke, even in subjects with low educational level.

Keywords:
Aphasia; Language; Education

MTL-BR Task¹	Group	Mean	SD	Median	ANCOVA adjusted p-value
Structured interview	CG	25.11	1.33	25.50	<0.001*
Structured interview	AG	14.50	8.90	16.00	<0.001*
Automatic speech - form	CG	5.81	0.52	6.00	<0.001*
Automatic speech - form	AG	3.27	2.41	4.00	<0.001*
Automatic speech - content	CG	5.75	0.55	6.00	<0.001*
Automatic speech - content	AG	3.13	2.43	3.50	<0.001*
Oral comprehension - words	CG	4.94	0.23	5.00	<0.001*
Oral comprehension - words	AG	3.43	1.63	4.00	<0.001*
Oral comprehension - sentences	CG	11.61	1.54	11.50	<0.001*
Oral comprehension - sentences	AG	6.30	3.31	6.00	<0.001*
Written comprehension - words	CG	4.39	1.61	5.00	0.002*
Written comprehension - words	AG	2.43	1.91	3.00	0.002*
Written comprehension - sentences	CG	6.33	1.49	6.00	<0.001*
Written comprehension - sentences	AG	2.53	2.50	2.00	<0.001*
Copying	CG	7.44	1.38	8.00	<0.001*
Copying	AG	2.00	2.95	0.00	<0.001*
Dictation	CG	14.22	5.19	14.50	<0.001*
Dictation	AG	3.30	5.31	0.00	<0.001*
Repetition - words	CG	10.67	0.83	11.00	<0.001*
Repetition - words	AG	5.57	4.44	7.00	<0.001*
Repetition - sentences	CG	21.78	0.87	22.00	<0.001*
Repetition - sentences	AG	7.40	8.58	3.00	<0.001*
Reading aloud - words	CG	9.06	2.37	9.00	<0.001*
Reading aloud - words	AG	2.97	3.95	1.00	<0.001*
Reading aloud - sentences	CG	19.58	3.76	21.00	<0.001*
Reading aloud - sentences	AG	6.03	7.95	0.00	<0.001*
Semantic verbal fluency	CG	16.31	4.60	15.50	<0.001*
Semantic verbal fluency	AG	3.60	3.40	3.00	<0.001*
Non-verbal praxis	CG	23.47	1.06	24.00	0.001*
Non-verbal praxis	AG	16.00	8.55	19.00	0.001*
Naming - nouns	CG	21.42	2.67	22.00	<0.001*
Naming - nouns	AG	10.03	8.99	11.50	<0.001*
Naming - verbs	CG	5.28	1.49	6.00	<0.001*
Naming - verbs	AG	2.73	2.38	3.00	<0.001*
Object manipulation by verbal command	CG	12.97	5.26	16.00	0.098
Object manipulation by verbal command	AG	10.10	5.63	12.00	0.098
Phonological verbal fluency	CG	7.53	5.06	7.00	<0.001*
Phonological verbal fluency	AG	2.10	3.58	0.00	<0.001*
Left-right orientation	CG	3.89	0.67	4.00	0.002*
Left-right orientation	AG	2.63	1.43	3.00	0.002*
Body part recognition	GC	7.39	1.05	8.00	0.037*
Body part recognition	GA	5.83	2.57	6.50	0.037*
Written naming - words	CG	12.14	7.80	14.00	<0.001*
Written naming - words	AG	3.67	6.90	0.00	<0.001*
Written naming - verbs	CG	2.89	2.07	3.00	0.001*
Written naming - verbs	AG	0.80	1.75	0.00	0.001*
Oral text comprehension	CG	5.69	2.54	6.00	<0.001*
Oral text comprehension	AG	2.00	2.38	1.50	<0.001*
Number dictation	CG	4.97	1.30	5.00	<0.001*
Number dictation	AG	1.90	2.23	0.50	<0.001*
Reading of numbers	CG	5.22	0.64	5.00	<0.001*
Reading of numbers	AG	2.43	2.11	2.50	<0.001*
Written text comprehension	CG	6.28	2.54	7.00	<0.001*
Written text comprehension	AG	1.30	2.83	0.00	<0.001*
Numerical mental calculation	CG	3.03	1.46	3.00	<0.001*
Numerical mental calculation	AG	0.83	1.12	0.00	<0.001*
Numerical written calculation	CG	2.83	1.95	3.00	<0.001*
Numerical written calculation	AG	0.33	0.84	0.00	<0.001*

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[1] Correspondence: Karin Zazo Ortiz; Email: karin.ortiz@unifesp.br.