Language assessment in older people: the effects of Ageing, Education and English as a second langua

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Language assessment in older people the effects
of Ageing, Education and English as a second
language

• Karen Bryan, Julia Binder, Jane Cockle-Hearne
  Victoria Ramsey and Sue Stevens.

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Barnes Language Assessment

• Developed specifically to assess older people
• To exclude normal age related change from changes
  associated with language pathology and provide a
  basis for informed management
• Successful in identifying older people with
  dementia (Bryan et al Ageing and Mental Health, ,
  5, 371-378).

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Older people with EAL

• Increasing within the population (OPCS 1993)
• Need norms that incorporate error patterns and
  error levels that may be associated with EAL
• Study of 144 older people aged from 50 upwards.
  Stratified by age, education level, occupation
  and EAL.

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Assessment

• Case history
• WRAT spelling test (Wilkinson 1993)
• MMSE (Folstein et al 1975)
• BASDEC (Adshead et al (1992) for depression
• BLA

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Results

• Education and EAL (sig at 0.01 level for all
  tests) were the main influences on performance
• Education more reliable than occupation (and
  easier to code).
• Age and sex less important predictors of
  performance.

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The importance of distinguishing EAL in
evaluating test results

• Two cases, women in good health, of ages 78 and
  80 and both had no educational qualifications and
  had previously worked in administrative
  positions.
• C has English as a first language and has
  tinnitus affecting hearing, D has EAL with her
  first language being Polish. She also D is
  borderline on the MMSE (24) and scores just below
  the threshold on WRAT.
• Depression screen is negative.

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Scoring issues
denotes below the normal range of scores
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Evaluation

• C scores just below norm on following commands
  (hearing)
• D below norm on 7 () using English norms which
  combined with borderline MMSE might be
  interpreted as indicative of dementia. EAL and
  education norms show only 1 test (trail) is below
  the norm (performance is slow but accurate). WRAT
  confirms may not have fully acquired English
  spelling patterns.

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Conclusion

• Norms for EAL and education allow more accurate
  evaluation of language performance by older
  people with EAL
• Particularly beneficial in clinical situations
  where the patient has difficulty giving a history
  or where no family or friends are available.