Vata-L: Visual-Analogue Test Assessing Anosognosia for Language Impairment

Abstract

Lack of awareness (anosognosia) for one's own language impairments has rarely been investigated, despite hampering language rehabilitation. Assessment of anosognosia by means of self-report is particularly complex, as a patient's language difficulties may seriously prevent or bias the assessment. Other methods, such as measures of self-correction and error detection, have provided valuable information, although they are an indirect form of assessment of anosognosia and are not exempt from methodological criticisms. In this study we report on a new tool, the VATA-L (Visual-Analogue Test for Anosognosia for Language impairment), geared at assessing explicit anosognosia for aphasia. The VATA-L compares the patient's self-evaluation with caregivers’ evaluations of the patient's verbal communication abilities in a series of common situations. By means of non-verbal support and a system of check questions, this test minimizes some of the methodological limitations of existing diagnostic tools (e.g., structured interviews), enhancing reliability, and enabling assessment of patients with aphasia. Finally, normative data provided in the study allow a clearer interpretation of the patient's performance and facilitate assessment of anosognosia.

Keywords:

• Anosognosia
• Unawareness
• Aphasia
• Brain damage
• Assessment

Acknowledgments

This research was supported by the Wellcome Trust (grant n.078580) to GC and SDS. We would like to thank Dr. Lodi, Dr. Pasini, Dr. Galli, and Dr. Zaro for their support in recruiting the patients in Italian wards (Rehabilitation Ward – Gallarate Hospital) and Dr. Papps and Dr. Rado for their support in British wards (Homerton Hospital in London; Blackheath Brain Injury Rehabilitation Centre and Neurodisability Service in London). We would like to thank Ms. Katherine Broomfield and Ms. Annette Cameron for their suggestions on a preliminary version of this test. NB's work is currently supported by a grant from the Compagnia di San Paolo – Programma Neuroscienze.

Notes

¹ Note that in several instances professional caregivers rated more than one patient.