CLQT+ 7/26/17

Im age by Ruben Alvarado

Instructions for submitting forms

for ASHA CEUs
Pearson will submit completed CE forms to ASHA if
you
• Attend the entire 60 minutes of the live session Pearson will not submit completed CE forms to ASHA if
(confirmed by our ReadyTalk verification report)
• The mailed CE forms are postmarked after

• Complete the
• Attendance Sheet (only if more than one
• August 8, 2017
person is at your site) • CE forms are sent via fax or email
• ASHA Participant Form
• CE forms are submitted for “partial credit” [not
• Evaluation Form available]
• CE forms are submitted if you view the webinar
Clinical Application • Please mail the forms postmarked no later
than August 8, 2017 to
recording on PearsonClinical.com or
speechandlanguage.com.
Darlene Davis, Pearson
of the Cognitive 19500 Bulverde Road, Ste. 201

Linguistic Quick San Antonio, TX , 78259

Test+ for SLPs Questions about CEUs?

Contact Darlene Davis at [email protected]
1

Im age by Christof Van Der W alt

Learning Outcomes
Agenda

5 min: Introduction/Background
Participants will learn to:
of CLQT
15 min: Overview of the CLQT+
1. Identify data provided by the CLQT+
15 min: Overview of CLQT+
Interpretation 2. Use referral questions that may prompt
15 min: Clinical Use Cases of the CLQT+ administration
CLQT+
10 min: Questions/Answers
3. Discuss standard administration processes of
the CLQT+

Background: CLQT Overview

The Cognitive Linguistic Quick Test—Plus (CLQT+)

• Author: Dr. Nancy Helm-Estabrooks
is a 2017 update of the original CLQT (2001).
• Age Range: 18:0–89:11
• Publication Date: 2001 (CLQT); 2017 (CLQT+)
The CLQT was designed to quickly assess strengths
and weaknesses in five cognitive domains: • Qualification Level: B

1. Attention • Completion Time: 15–30 minutes

2. Memory • Administration: Paper-and-pencil

3. Executive Functions • Scores/Interpretation: Criterion cut scores with descriptive

severity ratings
4. Language, and
• Other Languages: Spanish (CLQT only)
5. Visuospatial Skills
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Question 1 What’s new in the update?

Traditional Administration Aphasia Administration

• Personal Facts • Personal Facts

• What population would you most often assess • Symbol Cancellation • Symbol Cancellation*

with this test? •

•
Confrontation Naming
Clock Drawing
•
•
Confrontation Naming
Clock Drawing
1. TBI • Story Retelling • Story Retelling
2. Dementia • Symbol Trails • Symbol Trails*
• Generative Naming • Generative Naming
3. left hemisphere stroke • Design Memory • Design Memory
4. right hemisphere stroke • Mazes • Mazes*
• Design Generation • Design Generation
5. other
• Semantic Comprehension
• *Additional points scored for following
auditory directions within this task for the
Aphasia Administration.

Question 2 Question 4

• Does this test provide you with the information

you need for 3rd party payers? • Does the test administration time fit within 3rd
party dictated test-time parameters?
1. Yes
1. Yes
2. No
2. No
3. Comments:

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CLQT+ Benefits and

Special Applications
Who uses the CLQT+?
• Benefits:
• More flexibility in administration
• Clearer interpretation for people with aphasia/language disorders
• Quick, reliable cognitive assessment at table or bedside
• Primarily non-school settings: • Support for English- or Spanish-speaking adults with known or
• Speech-language pathologists (SLPs) suspected neurological impairment as a result of stroke,
traumatic brain injury, or dementia.
• Occupational therapists (OTs)

• Psychologists/Neuropsychologists
• Special Applications:
• Other qualified professionals interested in a quick measure of
• Progress monitoring (especially with Clock Drawing task)
cognitive/linguistic status • Driving assessments
• Competency assessments
• Research
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Picking a tool to help answer…

Driving evaluations
(referral questions)

1. “I need a screening tool for rehab in acute care prior Certified Driver Rehab Specialists and
to Psych evals.” (SLP / OT / PT) generalists, use CLQT:
2. “I need a tool that helps detect early cognitive decline
which may present as other conditions.”
3. “I need a tool that I can use for progress monitoring.” 1. As part of assessment process to indicate
need for on-road assessment
4. “I need something that informs intervention planning.” 2. Support dialogue around driving cessation
5. “I need a tool to help supplement driving evaluations.” decisions

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Question 3

• Do you use the results to make treatment

decisions? Administration
1. Yes
2. No
3. Examples?

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Diminished Language Capacity

Personal Facts
vs. Aphasia Administration

• When administering the CLQT+ to someone 1.This task helps lo assess memory and language abilities.
who has diminished language capability: 2.Examinees with aphasia may respond poorly to the items due to
• Administer the original ten tasks language problems.
• Take note of any modifications indicated in the instruction 1.In such cases, the memory severity rating may not accurately
banner at the beginning of each subtest on the Record recreate memory skills.
Form. 2.Note whether examinees demonstrate better recall of lifelong
• Also… facts (dote and place of birth) vs. newer facts [current age and
address), a pattern seen especially in individuals with
• Complete the examiner-rated items in the Symbol
dementia and dosed head injury.
Cancellation, Symbol Trails and Mazes subtests
3.Delayed and/or self corrected responses may indicate milder
• Administer the Semantic Comprehension task memory problems.
• Calculate the Auditory Comprehension score

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Symbol Cancellation Confrontation Naming

1.Symbol Cancellation is a nonlinguistic task of visual 1.Deficits in confrontation naming are a key symptom of
attention and perception. It also offers information regarding aphasia that can result from various forms of brain
the integrity of the upper and lower quadrants of left and damage (e.g., stroke, head injury, dementia, tumors,
right visual fields. infections).
2.Observe examinees' scanning strategies. 2.Delayed responses suggest mild word-retrieval
1. Are they searching laterally from left to right, down and up, or scanning problems. Note immediate or delayed perseverations,
unsystematically? Notice if examinees Failed to cancel symbols in one or
more of the four quadrants. repeated responses) of all or part of a previous word.
3.Errors of omission (correct symbols not cancelled) and 3.Although no points are deducted, an elaborated
commission (incorrect symbols cancelled) may be response may be symptomatic of verbosity or inability
secondary to: 1. generalized inattention, 2. visual to limit information.
discrimination problems, 3. partial or full hemianopsia, 4.
visual neglect, or 5. inattention to one side or quadrant of 4.Ask the examinee to give a single word response. Use
space. of seldom-used words may be a symptom of word-
finding problems. Request a "common name.” The
4.Observe whether there are similar visual field deficits on types of errors examinees make can guide treatment of
Clock Drawing, Symbol Trails, and Mazes tasks. word-retrieval problems.
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Clock Drawing Story Retelling

1.Story Retelling helps lo assess auditory memory and

1.Clock Drawing serves as a mini-screening tool comprehension, working memory, and language output
skills.
for all cognitive domains.
2.Unrelated responses may indicate loss of topic or memory
2.This task can be re-administered to sample problems.
and monitor examinees' progress, 3.If partially correct information is provided, note whether
recall is better for initial medial, or final parts of the story as
deterioration, or stability across several indications of arousal, attention, and storage capacity.
cognitive domains. 4.Story Retelling is an easy way lo assess narrative skills.
5.Although no points are deducted for retelling the story out of
3.Watch carefully as examinees draw the dock sequence, you can analyze for recall of consecutive events
and note the strategies used. building to the story conclusion by numbering each story
element in the order reported.

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Aphasia Administration of
Symbol Trails (Trial 1) Symbol Trails Item:
Alternating Sizes and Shapes
1.Symbol Trails is a nonlinguistic task used to help
assess planning, self-monitoring, working memory,
and visual attention even in examinees with
compromised language skills.
2.The two trial items introduce the concepts of
graduating size and then alternating shapes.
Examinees are required to manipulate both
concepts in the Scored Item.
3.As you observe examinees perform the task,
check to see whether there is inattention to one
side or quadrant of space and/or impulsivity.
1.Note whether examinees self-monitor and correct errors.

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Generative Naming Design Memory

1.In addition to quantifying word search and retrieval 1.Design Memory is a nonlinguistic task that can
skills by one superordinate semantic category provide information about visual discrimination and
{Animals) and one phonetic category (m Words), analysis, attention, and visual memory even in
the Generative Naming task enables you to examinees with severe aphasia.
qualitatively assess performance. Observe if
examinees subcategorize animals {e.g., farm, zoo, 2.Examinees with brain damage confined to the left
pets) to aid word retrieval. hemisphere may perform normally, whereas those
2.Perseveration Ratio: A ratio of 0.08 or greater with right-hemisphere damage may perform poorly.
indicates notable perseveration, which is indicative 3.This information can guide choice and use of
of brain damage. Example: 3 perseverations treatment stimuli.
divided by: 13 total Animals responses = 0.23
{notable perseveration). Abnormal perseveration 4.In analyzing errors, look for impulsive choices
ratios may have diagnostic value for and/or perseverations (e.g., pointing to designs in
mild/borderline dementia. the same position across trials).
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Mazes Design Generation

1.Satisfactory performance on this task requires

planning, mental flexibility, self-monitoring, and
visual discrimination. 1.This is a nonlinguistic task of creativity and
2.Poor planning and/or impulsivity will be mental flexibility.
reflected in lines going down incorrect paths 2.Look for perseverative responses, failure to
and/or crossing walls. maintain four straight lines connecting four
3.Look for the ability to self-correct errors. Note dots, and/or neglect of stimuli on one side of
neglect or inattention to one side of space. space.
Compare performance on this task with that on
the Symbol Trails task
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General Administration Points:

Completing Scoring Worksheet: 1
Semantic Comprehension
Aphasia Administrations Only!

1. Follow the instructions presented on the CLQT+

Record Form
2. Present the verbal description of each object and
wait up to 10 seconds for the examinee to respond.
3. The examinee must indicate his or her choice by
pointing to the stimulus.
4. If the examinee responds in any way other than
pointing, a prompt should be given to the examinee
to point to the correct stimulus.
5. You may repeat a question one time, as needed.

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Completing Scoring Worksheet:

Completing Scoring Worksheet: 3
2 (Optional)

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Front of Record Form Development of new tasks

1. Picture stimuli for the Semantic Comprehension task

were taken from the Confrontation Naming task
• Verbal stimuli were developed to elicit nonverbal responses so
that examinees can demonstrate their knowledge free from
the requirements of expressive language.
2. CLQT users participated in a study to collect
responses on the Semantic Comprehension task, as
well as the other CLQT+ tasks.
• Clinicians were asked to target people diagnosed with only a
left hemisphere stroke and probable aphasia.
3. A split-half reliability estimate was calculated for the
Auditory Comprehension task using the Spearman-
Brown formula (r = .91).

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Task Means and Standard Deviations of the Task Means and Standard Deviations of the
CLQT Aphasia Sample and Nonclinical Research CLQT Aphasia Sample and Nonclinical Research
Sample (18-69) Sample (70-89)
Aphasia Non-clinical

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Clinical Sample of Individuals With

Aphasia Compared to Matched Control
Question 5

• Do the test results point you to more

comprehensive assessments? If so, give
examples.
1. Yes
2. No
3. Examples:

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Interpreting CLQT+ Index Scores for

Aphasia Administration

• Semantic Comprehension task & Auditory

Comprehension
1. Developed to enhance the assessment of individuals
with diminished language capabilities/aphasia.
Interpretation 2. No cut score (because the development of the task
occurred after the initial release of the CLQT).
3. However, expect results cut scores at or near perfect
performance on the task (e.g., 8 out of 8 for Personal
Facts, 10 out of 10 for Confrontation Naming).
4. Auditory Comprehension task score much lower than
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• Individual likely experiencing difficulty understanding what
they hear, and further evaluation might be warranted.

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Non-Linguistic Cognition
Linguistic/Aphasia Index (L/AI)
Index (NLCI)
• Provides an estimate of cognitive functioning that is free of • L/AI includes scores from Personal Facts, Confrontation
language demands when responding to task items. Naming, Story Retelling, Generative Naming, and Semantic
• Intended to provide a more appropriate estimate of cognitive Comprehension.
ability for those individuals with diminished language skills. • The Auditory Comprehension score plays a primary role in
• The severity ratings (i.e., Within Normal Limits, Mild, the L/AI score;
Moderate, Severe) for this domain are based on the same • it contributes up to approximately one-third of the score’s total
representative population used to evaluate the other CLQT raw score points (i.e., up to 19 of 56 total points).
domain scores (i.e., Attention, Memory, Executive • The L/AI includes expressive and receptive language
Functions, Language, Visuospatial Skills). components, both of which are important when working with
• The tasks included in the NLCI are the same as the individuals who have diminished language capacity.
Visuospatial Skills domain score (i.e., Symbol • Severity Rating cut scores for this index score are based on
Cancellation, Symbol Trails, Design Memory, Mazes, a population of individuals with aphasia.
Design Generation).
• Contribution of each task score to the overall NLCI varies
• Lower L/AI scores (i.e., more severe scores) indicate more
somewhat (compared to Visuospatial Skills), and are based on significant problems with language comprehension and
the author’s clinical experience. language expression.

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Question 6

• Do you incorporate academic focused tests

into your assessment process for older adults? Q &A
If yes, which test do you use?
1. Yes
2. No
3. Examples

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Q&A Q&A

Q. I already have the CLQT kit. What do I need to purchase to use

Q. Why are some items listed as “CLQT” and some as
the CLQT+?
“CLQT+?”
A. You can purchase the following individual components:
A. Those items that are listed as “CLQT” are • Record Forms (25)
• CLQT+ Response Booklets English/Spanish & English
components that did not change between the original • CLQT+ Stimulus Manual
CLQT release and the release of the CLQT+. • CLQT+ Manual Supplement

45

Instructions for submitting forms

for ASHA CEUs
Pearson will submit completed CE forms to ASHA if
you
• Attend the entire 60 minutes of the live session Pearson will not submit completed CE forms to ASHA if
(confirmed by our ReadyTalk verification report)
• The mailed CE forms are postmarked after

• Complete the •
Do you have any
August 8, 2017
• Attendance Sheet (only if more than one
person is at your site) • CE forms are sent via fax or email
• ASHA Participant Form
questions? • Evaluation Form
• CE forms are submitted for “partial credit” [not
available]
• CE forms are submitted if you view the webinar
• Please mail the forms postmarked no later recording on PearsonClinical.com or
than August 8, 2017 to speechandlanguage.com.
Darlene Davis, Pearson
19500 Bulverde Road, Ste. 201
San Antonio, TX , 78259

Questions about CEUs?

Contact Darlene Davis at [email protected]
47

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 CLQT+ 7/26/17

Thank you for watching! For more

information about the CLQT+ and to
order, please visit:

Customers in the USA:

www.PearsonClinical.com

Customers in Canada:
www.PearsonClinical.ca

© Pearson 2017 9