Bilingual Aphasia Test (BAT)

The Bilingual Aphasia Test (BAT) was designed to assess each of the languages of a bilingual or multilingual individual with aphasia in an equivalent way. The various versions of the BAT are not mere translations of each other, but culturally and linguistically equivalent tests. The criteria of cross-language equivalence vary with each task.

A version of the BAT is an adaptation of the battery to the structure and culture of a particular language — not carved in stone. It can be adapted to a particular dialect, a given population, or a specific patient. The implementation manual is:

Michel Paradis and Gary Libben (1987) The Assessment of Bilingual Aphasia, Mahwah, NJ: LEA — also available in Spanish, Italian, and Chinese. This manual should be consulted before administering the test.

Data on psychometric properties (construct validity: factorial analysis, discriminant function analysis; and reliability) may be found in Gómez Ruiz (2008: 421–490).

Important note: A sentence in the instructions before stimulus 48 (verbal auditory discrimination) was omitted in the original French version and is missing in several derived versions. The last sentence before « Are you ready? » should be: « If I say ‘bird’ you touch this X because there is no picture of a bird on that page. » Please add its equivalent if missing in the version you use.

The stimulus book is prepared to be printed back to back so that, once bound, each set of stimulus pictures faces an X in the verbal auditory discrimination section (example + 48–65), and each word or sentence faces its stimulus picture in the reading comprehension section (408–427). Some blank pages are inserted in strategic positions — make sure to print back to back from first to last page.

The book may be bound or stapled on the left or right depending on the reading direction of the language. Bind on the right-hand side for: Arabic, Azari, Farsi, Hebrew, Kurdish, Urdu, and Yiddish. Stimulus books are re-usable.

Since each language test serves as a score sheet, a new copy must be downloaded or photocopied for each patient, or for each assessment at different time intervals (e.g., pre- and post-therapy).

Short version

When time is limited, the following items have been selected across all languages for the short version (see Muñoz & Marquardt (2008) and Ivanova & Hallowell (2009) for comments on use):

• Spontaneous speech (514–539)
• Pointing (23–32)
• Simple and semi-complex commands (33–42)
• Verbal auditory discrimination (48–65)
• Syntactic comprehension (66–70; 81–96; 121–124; 129–132; 137–144 only)
• Synonyms (158–162)
• Antonyms (163–167)
• Word repetition (odd numbers only: 193–251; 566–573)
• Sentence repetition (253–259; 574–622)
• Series (260–262)
• Naming (269–288)
• Sentence construction (289–313)
• Semantic opposites (314–323)
• Listening comprehension (362–366)

For literate patients only

• Reading of words (367–376; 623–628)
• Reading of sentences (377–386; 629–708)
• Reading of paragraph (387–392)
• Copying (393–397; 709–743)
• Dictation of words (398–402; 744–783)
• Dictation of sentences (403–407; 784–812)
• Reading comprehension for words (408–417)
• Reading comprehension for sentences (418–427)

See The Assessment of Bilingual Aphasia (pp. 191–200) for criteria for posttest scoring (514–812).

The stimuli for items 428–437 appear at the end of the test and should be detached before administering. Present them to the patient while reading the stimuli out loud, as per the instructions in the test.

There is only one Part C for any given language pair. For convenience, it appears alongside each language of a pair (e.g., English-French in the English list and French-English in the French list), so you can quickly identify which languages are paired with any language the patient speaks.

Instructions for constructing a new language-pair specific test (Part C) are found in The Assessment of Bilingual Aphasia (pp. 167–173). Tips on finding reversible contrastive features are provided in Chapter 3 of Paradis (2004).

For results to be comparable across institutions, the instructions in Paradis & Libben (1987, pp. 152–167) regarding stimulus construction must be scrupulously followed. A particular stimulus number must correspond to a stimulus with the same structural properties in all versions — any discrepancy results in a lack of comparability.

Full guidelines are found in The Assessment of Bilingual Aphasia (Paradis & Libben, 1987). Instructions for constructing a language-pair specific test (Part C) are on pp. 167–173.

The outline below may be used to construct a screening test in any language. Ready-made versions are available for: Arabic, Castilian, English, French (Européen, Québécois), German, Italian, Korean, Portuguese, Russian, Turkish.

Subtests and items

• Spontaneous Speech (18–22 + 1 new item: Borrowing or code-switching: from very frequent (1) to absent (5))
• Naming: select six among the best-suited stimuli (e.g. English: 269–271, 282, 286, 288)
• Pointing: select five items other than those chosen for naming (e.g. English: 23–26, 31)
• Simple and semi-complex commands: select three simple and three semi-complex (e.g. English: 34–36, 39, 41, 42)
• Complex commands: select one (e.g. English: 43)
• Verbal auditory discrimination: select six stimuli and one with X as answer (e.g. English: 48, 53, 55, 57, 60, 62, 65)
• Syntactic comprehension: select ten stimuli —
  • one standard sentence S (e.g. English: 66)
  • one pronominal reference sentence P (e.g. English: 69)
  • one nonstandard NS1 (e.g. English: 84)
  • two NS2 — one subject-topicalized, one object-topicalized (e.g. English: 87 and 94)
  • one standard negative sentence (e.g. English: 121)
  • three reversible noun-phrase constructions (e.g. English: 140, 143, 150)
• Word and nonsense-word repetition: five nonsense words + seven words of increasing phonological complexity (e.g. English: nonsense: 199, 209, 219, 231, 247; words: 193, 207, 237, 243, 245, 249, 251)
• Sentence repetition: three sentences — one S, one P, one standard negation (e.g. English: 253, 254, 259)
• Series (260 and 261, from 1 to 15)
• Verbal fluency (« animals » if culturally appropriate: 263, 264)
• Semantic opposites: five stimuli (e.g. English: 314, 317, 320–322)

For literate patients only

• Reading: 5 word stimuli + 4 sentences (one S, one P, one NS1, one NS2 subject-topicalized) (e.g. English: 367–371; 377–380)
• Copying: two items (e.g. English: 393, 397)
• Dictation: three word stimuli + one standard negation sentence (e.g. English: 399, 402, 406)
• Reading comprehension for words: four items (e.g. English: 410, 413, 414, 417)
• Reading comprehension for sentences: four items among the more complex — P (419), NS2S (421), SN (422), passive negation (427)

Gómez Ruiz, I. (2008). Aplicabilidad del Test de la Afasia para Bilingües de Michel Paradis a la población catalano/castillano parlante. Tesis doctoral, Universidad de Barcelona.

Hambleton, R.K. (1994). Guidelines for adapting educational and psychological tests: A progress report. European Journal of Psychological Assessment, 10, 229–240.

Ivanova, M.V. & Hallowell, B. (2009). Short form of the Bilingual Aphasia Test in Russian: Psychometric data of persons with aphasia. Aphasiology, 23(5), 544–556.

Muñoz, M.L., & Marquardt, T.P. (2008). The performance of neurologically normal bilingual speakers of Spanish and English on the short version of the Bilingual Aphasia Test. Aphasiology, 22, 3–19.

Paradis, M. (2004). A neurolinguistic theory of bilingualism. Amsterdam: John Benjamins.

Paradis, M. & Libben, G. (1987). The Assessment of Bilingual Aphasia. Mahwah, NJ: LEA. (Also available in Spanish, Italian, and Chinese.)