Post-stroke aphasia: Limitations of the Boston diagnostic aphasia examination

Objectives: Stroke is a major international public health issue and is the leading cause of aphasia. The Boston diagnostic aphasia examination (BDAE) is one of the most widely used tools for assessing aphasia by speech and language therapists (SLTs). The general aim of this study was to describe the limitations of using the BDAE by SLTs in Togo, with a view to making suggestions for adaptation. Materials and Methods: This was a cross-sectional descriptive and analytical study of (SLTs) practicing in Lomé, Togo, who had followed aphasic stroke patients from June to July 2022. The target population of our study is all SLTs practicing in Togo, and the source population, SLTs practicing in Lomé. We surveyed a total of 35 SLTs in Lomé. We used an interview guide to gather information from them. Free and informed consent was obtained from them and limitations in adapting the BDAE were raised and noted. All the data were entered in the Excel file and transposed into the STATA software to facilitate the statistical processing of the results. The results were presented in the form of averages with standard deviations for quantitative variables and proportions for qualitative variables. Chi-square and Student’s t -tests are used for the different variables. Results: We surveyed 35 SLTs out of 38 present in Lomé, that is, 92.11% of cases. We noted a male predominance with a sex ratio (M/F) of 3.38. The study showed that the BDAE was the tool most frequently used by SLTs to assess aphasic patients, in 91% of cases. On the other hand, almost half (48.57%) of professionals use it only infrequently but the use they make of it is also heterogeneous. SLTs face a number of obstacles in using the BDAE, including language barriers (46.87%), patients’ general condition (80%), patients’ low level of education (68.75%), and the unsuitability of certain items (43.75%). In addition to the reasons given above, there were personal choices, the patient’s failures on simple items, and the long test-taking time. Conclusion: The majority of SLTs use the BDAE to assess aphasic patients. Several limitations of the BDAE tests were revealed by SLTs practicing in Lomé, Togo’s cosmopolitan capital, with a view to making suggestions for adaptation.