Impairment-Focused Standardized Assessments of Apraxia
Apraxia Screen of TULIA (AST)
- Authors: Vanbellingen T, Kersten B, Van de Winckel A, Bellion M, Baronti F, Müri R, and Bohlhalter S (2011)
- Description: A bedside screening test for apraxia that includes 12 items, based on the comprehensive standardised Test for Upper-Limb Apraxia (TULIA). According to Dovern, Fink, & Weiss, the AST takes approximately 6 minutes to administer, has high specificity (93%), high sensitivity (88%), good validity (due to high correlation between TULIA and AST scores), and good test-retest reliability (2012). Norms: 12 is the maximum score, a score below 9 indicating apraxia, and a score below 5 indicating severe apraxia (Vanbellingen et al., 2011). Weakness of test: lacks validation from an external source (Dovern, Fink, & Weiss, 2012).
PDF of the Assessment: Apraxia Screen of TULIA (AST):
PDF of the original research paper:
- Vanbellingen, T., Kersten, B., Van de Winckel, A., Bellion, M., Baronti, F., Müri, R., & Bohlhalter, S. (2011). A new bedside test of gestures in stroke: The apraxia screen of TULIA (AST). Journal of Neurology, Neurosurgery, and Psychiatry, 82(4), 389-392.
Assessment of Apraxia
- Authors: van Heugten & Geusgens
- Description: The purpose of this screening test is to measure the presence and severity of apraxia (ideational, ideomotor). The test consists of 2 subtests: demonstration of object use and imitation of gestures. Demonstration of object use is directed at ideational apraxia (3 sets of objects presented under 3 different conditions), while imitation of gestures is directed at assessing ideomotor apraxia (6 gestures to be imitated). The performance of the patient is scored on a scale ranging from 0 to 90.
- According to Quintana (2008): Validity is not established, reliability is good (good internal consistency and inter-rated reliability), and sensitivity was 91% at cut-off score of 86 (Total score below 86 is considered to identify apraxia). A strength of the assessment is that it uses common gestures and objects (Quintana, 2008).
- According to Dovern, Fink, & Weiss, the Assessment of Apraxia takes approximately 10 minutes to administer.
- Zwinkels, Geusgens, van de Sande, & Van Heugten suggest it is a short, simple, and reliable bed side test, however, "test scores should be combined with behaviouralobservations for a proper evaluation of apraxia and its consequences in daily life" (2004, p.825).
PDF of the Assessment: Assessment of Apraxia
Original research paper reference:
- van Heugten, C. M., Dekker, J., Deelman, B. G., Stehmann-Saris, F. C., & Kinebanian, A. (1999). A diagnostic test for apraxia in stroke patients: Internal consistency and diagnostic value. The Clinical Neuropsychologist, 13(2), 182-192.
Another relevant research paper that uses the assessment:
- Zwinkels, A., Geusgens, C., van de Sande, P., & Van Heugten, C. (2004). Assessment of apraxia: Inter-rater reliability of a new apraxia test, association between apraxia and other cognitive deficits and prevalence of apraxia in a rehabilitation setting. Clinical Rehabilitation, 18(7), 819-827.
The Ontario Society of Occupational Therapists (OSOT) Perceptual Evaluation
- Description: Assessment tool to measure perceptual impairment (Sensation, Scanning, Apraxia, Body awareness, Spatial relations, Visual agnosia) in adults who have experienced brain damage caused by traumatic brain injury or stroke (Boys, Fisher, Holzberg, & Reid, 1988).
- According to the authors, the test is valid to differentiate between the neurological normal and those diagnosed with a neurological damage (Boys, Fisher, Holzberg, & Reid, 1988). However, Boys et al. states "it is notable that the two tests lowest in discriminating between the two subject groups were Ideomotor and Ideational Apraxia, the same tests that demonstrated poor item-total correlation" (1988, p.97). Further investigation into the reliability and validity is necessary.
- Information on the measurement properties can be found at this link: http://strokengine.ca/assess/module_osot_quick-en.html
Relevant Research Article:
- Boys, M., Fisher, P., Holzberg, C., & Reid, D. (1988). The OSOT Perceptual Evaluation: A research perspective. American Journal of Occupational Therapy. 42, 92-98.