Aachen Language Analysis (ASPA): Evaluation in Patients with Chronic Aphasia

Background: The proof of the effectiveness of aphasia therapy gains more and more in importance in light of the present financial situation of the public health system and the increasing demand for evidence based medicine. In this context it is expected that improvements are evaluated not only by means of standardised tests or questionnaires but also in communicational situations similar to those in everyday life. The aim of this study was the evaluation of the Aachen Language Analysis (Aachener Sprachanalyse, ASPA). This new analysis system covers many parameters and was evaluated with regard to its objectivity, reliability and validity. Methods: The interraterreliability and the intraraterreliability for the transcript and the division into phrases were evaluated. A comparison of the two pre-therapy measurements was conducted in order to test the reliability of the results. The validity of ASPA was tested by evaluating its ability to differentiate between patients with aphasia and a healthy control group and the sensitivity when evaluating therapy effects. Results: Interraterreliability and intraraterreliability of ASPA were >93%. High correlations between the two pre-tests were obtained in the patient group. The syntax parameters and word retrieval parameters differed significantly between patients with aphasia and the healthy controls, whereas no differences were found in the prosodic parameters. Significant improvements after therapy were obtained in the parameters complete phrases%, complex sentences% and complete sentences%. These results were correlated with results of the sentence production tasks of the Aachen Aphasia Test before and after therapy. Conclusions: The results provide evidence for high objectivity and reliability. In terms of the evaluation of therapy effects, the syntactical parameters demonstrated the highest sensitivity.