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What is it?

The BSL Adult Language Impairment and Aphasia Battery (ALIAB) 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.

What is involved?

This is a battery of tests of varying length from 10–30 minutes. The tests are video-based tasks 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 provides detailed diagnostic information about the likelihood of aphasia or language impairment. All the tasks in the ALIAB 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 of 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. Note: care will need to be taken if administering to a 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 Locatives: Prepositions and Classifiers
• 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 battery?

• This battery 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.

More information about tests

BSL Noun Comprehension

A single sign must be matched to one of five pictures, including the target and visual, semantic, phonological, and unrelated distractors.

• Visual distractors look like the form of the sign (e.g. cutlery for DOG).
• Semantic distractors are related in meaning (e.g. cat for DOG).
• Phonological distractors differ from the target in terms of one phonological feature, handshape, movement or location (e.g. shop for DOG; same movement and location but a different handshape).
• Unrelated distractors are included to balance the test and to reduce chance guessing.

20 high iconic and 20 low iconic signs are tested. Iconicity is how closely a sign visually relates to its meaning.

BSL Verb and Sentence Comprehension

A single signed verb or sentence must be matched to one of four pictures. It is a BSL test that is similar in format to the spoken English Test for Reception of Grammar (TROG).

It includes:

• 15 single verbs (9 uninflected, 6 inflected)
• 25 sentences of varying complexity
• 6 have one argument
• 9 have two arguments
• 4 have three arguments
• 19 sentences are reversible
• Distractors show: the reversal of the action (the cat biting the dog), a verb distractor (the dog chases the cat), and a noun distractor (the dog biting the man).

BSL Locatives

This involves matching 30 signed locative sentences to one of four pictures. Half the items are reversible, so the pictures include the target (e.g. a cup on a box) and its reversal (a box on a cup).

There are two versions of this test:

1. Preposition version – a lexical sign for the spatial relationship (ON, UNDER, BEHIND)
2. Classifier version – classifiers are used to show the spatial relationship between objects.

BSL Classifiers

This test explores a signer’s understanding of classifiers and their use in space, including placement, orientation, and rotation. A single classifier sign must be matched to one of four pictures. To succeed, the person must know the class of object shown by the classifier and process an additional spatial element (e.g. orientation).

Gesture Comprehension

Respondents must match a gesture to one of four pictures with semantic distractors (e.g. a gesture for a chainsaw has distractors showing a hand saw, an electric drill, and a hand drill).

BSL Phonology Handshape and Location Judgement Tasks

The handshape and location judgement tasks explore awareness of sign phonology. For example, the respondent must reflect on the signed name of a picture and associate it with one of three pictured sign handshapes or sign locations.

These tests are useful in determining whether a person with aphasia has lost knowledge of sign phonology or is just unable to retrieve it. There are no norms for this test; it is designed for deductive assessment when there is a clinical question about BSL phonological skills. It is also a useful test for teaching BSL students or deaf children about sign phonology or metalinguistic skills.

BSL Negatives

Statements must be matched to one of two pictures showing positive or negative scenarios (e.g. a dog with and without a bone).

• 16 positive statements (e.g. BONE)
• 16 negative statements that provide a negative lexical sign with negative face and head shake markers (e.g. BONE NOTHING + negative face)
• 16 negative statements with only negative face and head shake markers (e.g. BONE + negative face)

This tests whether the signer can understand negatives without a lexical negation sign.

BSL Question Judgement

This is a metalinguistic task that is sensitive to face processing ability. Statements must be matched according to whether a statement makes a command or a question. Respondents select pictures for “ask” or “tell.”

• 17 command statements (WINDOW CLOSE, “Close the window”)
• 19 questions conveyed via a question facial expression without a lexical question sign (WINDOW CLOSE + question face, “Is the window closed?”)
• 14 questions conveyed with a lexical question sign (e.g. WHAT/WHEN/WHERE?)

Some signers find this a hard task as it requires metalinguistic skills and good understanding of instructions. There are no norms and this test is designed only to be used for deductive assessment or research.