Bilingual Aphasia Screening Test Template Page 3
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15Part
B
ENGLISH
B ACKGROUND
The following questions are to be read, exactly as given below, to the patient. For multiple
choice items, circle the appropriate alternative. For the other items, put the appropriate
information in the space provided.
In the body of the test, all instructions to the test administrator are preceded by “•••
“ .
T hese
instructions are not to be read aloud to the patient.
••• Give the patient the following introduction and then proceed with the questions.
Now,
I
w ill
a sk
y ou
s ome
q uestions
a bout
y our
E nglish.
R eady?
Have
y ou
e ver
l ived
i n
a /another
c ountry
w here
1
+
–
0
English
w as
s poken?
•••
I f the answer is “no” then go to the question (4)
2
What
w as
t he
n ame
o f
t he
c ountry?
3
How
l ong
d id
y ou
l ive
t here?
•••
I n all the responses which contain a scale show the patient the reference scale (page 2 of
the stimulus book) and mark the answer.
0
Before
y our
i llness,
y our
E nglish
s peaking
w as
:
4
From
n ot
g ood
( 1)
t o
v ery
f luent
( 5)
How
o ld
w ere
y ou
w hen
y ou
l earned
t o
s peak
E nglish?
5
6
Before
y our
i llness,
d id
y ou
s peak
E nglish
a t
h ome?
+
–
0
7
Did
y ou
s peak
E nglish
a t
w ork?
+
–
0
8
Did
y ou
s peak
E nglish
w ith
f riends?
+
–
0
3
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