BSL Aphasia Assessment Battery

What is it?

The BSL Adult Language Impairment Battery (ALIM) is a clinical battery for profiling British Sign Language and gesture ability in deaf adults. It is intended for use with adult British sign language users to assess suspected language impairment. These may be either developmental or acquired language impairments, including; those with developmental language disorder; learning disabilities; and language aphasia after a stroke or another brain condition.

Tests from this battery may also be used to assess knowledge of BSL by home-signers or those arriving from other countries. In particular the Noun Comprehension Test can be used to assess whether a deaf person has full knowledge of BSL or whether they are relying mainly on gesture to communicate.

Tests in this battery may also be useful for teaching purposes, related to learning BSL or BSL linguistics. For example, asking deaf children/ BSL students/ university students to complete the BSL negation, BSL Questions or BSL phonology tests may give them a better understanding of these concepts. Likewise, the BSL Noun Comprehension Test could be used to explore the concept of iconicity. BSL

What is involved?

This is a battery of tests of varying length from 10 – 30 minutes. The tests are video-based task with BSL instructions. Responses can be entered either by the participant or the clinician by selecting the correct picture from an array.

The tests are designed to screen for aphasia and language difficulties in deaf adults. The pattern of errors they make on the tests provide detailed diagnostic information about the likelihood of aphasia or language impairment. All the tasks in the ALIM are easy and healthy deaf adult signers, who know BSL, will make very few errors.

These tests can be administered by clinicians without a good level fluency in BSL because the respondent can enter their own responses or point to the correct picture on the screen. Clinicians without BSL skills are advised to use the services of a BSL interpreter to ensure good clinical rapport.

Who is it suitable for?

  • Deaf adults where there is concern about language impairment.
  • Deaf adults who have had a stroke, or have a neurological condition such as dementia or a brain injury. PLEASE NOTE: care will need to be taken if administering to person with visual neglect, hemianopia or other visual or attention impairment, as the layout and size of pictures may require modification.
  • Deaf adults with suspected developmental language disorder.
  • Assessment of knowledge of BSL by adult home-signers or those arriving from other countries.
  • Educational assessment and BSL teaching purposes – these tests are good tools for demonstrating specific aspects of BSL to students or children e.g. negation or phonological awareness.
  • Some of these tests can be used with deaf children and young adults for explorative assessment, but some test items on some tests may be unfamiliar to younger people, and there are no norms for these age groups.

List of tests in the battery

  • BSL Noun Comprehension
  • BSL Verb and Sentence Comprehension
  • BSL Prepositions
  • BSL Classifiers
  • Gesture Comprehension
  • BSL Phonology Handshape Judgement
  • BSL Phonology Location Judgement
  • BSL Negatives
  • BSL Question Judgement

What normative data is available?

Small group data for older deaf adults. Cut offs for each test are provided.

Who should use this test?

  • This test should be used by clinicians or educators who are fluent in BSL, or by non-signing practitioners with the assistance of a BSL interpreter.
  • Use of this test for identification of aphasia and language impairment should be done in the context of full developmental and medical history.
  • Educators may wish to use these tests for teaching and demonstration.

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Test citation

Marshall, J., Atkinson, J., Woll, B., & Thacker, A. (2005). Aphasia in a bilingual user of British sign language and english: Effects of cross-linguistic cues. Cognitive Neuropsychology, 22(6), 719-736.

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Atkinson, J., Marshall, J., Woll, B., & Thacker, A. (2005). Testing comprehension abilities in users of British Sign Language following CVA. Brain and language, 94(2), 233-248.

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Atkinson, J., Campbell, R., Marshall, J., Thacker, A., & Woll, B. (2004). Understanding ‘not’: neuropsychological dissociations between hand and head markers of negation in BSL. Neuropsychologia, 42(2), 214-229.

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Marshall, J., Atkinson, J., Smulovitch, E., Thacker, A., & Woll, B. (2004). Aphasia in a user of British Sign Language: Dissociation between sign and gesture. Cognitive neuropsychology, 21(5), 537-554

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Marshall, J., Atkinson, J., Thacker, A., & Woll, B. (2003). Investigating comprehension impairments in users of British sign language following CVA. Brain and Language, 87(1), 129-130.

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Marshall, J., Atkinson, J., Thacker, A., & Woll, B. (2003). Is speech and language therapy meeting the needs of language minorities? The case of deaf people with neurological impairments. International Journal of Language and Communication Disorders, 38(1), 85-94.

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Use Side or Front facing videos for Task 5


Data is generated in CSV format for easy import into your preferred data management software

Task data

A separate CSV file is generated for each participant. Each contains the raw data including the order in which the items were presented and the score for each item.

For questions related to this test, please contact the task owner, Jo Atkinson.