Adaptation of aphasia tests for neurocognitive screening in South Africa

Abstract

Two aphasia tests — the Cookie Theft Test and the Boston Naming Test — were adapted to help eliminate western cultural, language and education bias in neurocognitive screening in South Africa. These tests were among the commonly used tests initially chosen for inclusion in a larger neurocognitive screening battery currently being developed and translated for use in South Africa — the Groote Schuur Neurocognitive Battery. The adaptations were made employing quantitative and qualitative converging lines of evidence to evaluate their efficacy. This evidence included consultation with clinicians at Groote Schuur Hospital and translators knowledgeable in Afrikaans and isiXhosa language and culture, qualitative feedback from the research participants, and the results on the tests. The adapted tests were piloted by testing 30 neurocognitively intact controls consisting of equal numbers of Afrikaans, English and isiXhosa speakers, comparing their scores to their performances on the original tests. Three aphasic patients were also briefly tested. Results indicate that the adaptations made to the tests improved the performance of controls over the original versions, and tentatively suggest that the adapted tests should be able to screen for aphasia. This pilot study recommends further changes to the Groote Schuur Naming Test before its introduction into the battery ahead of its validation