The Brief Executive Language Scale (BELS): A Novel Measure of Propositional Language

Aphasia assessment tools have primarily focused on classical aphasia type and severity, with minimal incorporation of recent findings that suggest a significant role of executive control operations in language generation. Assessment of the interface between language and executive functions is needed to improve diagnostic sensitivity and specificity. This study aims to ascertain the psychometric properties and diagnostic utility of a new assessment of aphasia, the Brief Executive Language Scale (BELS). The BELS was developed as a brief bedside screening tool specifically designed to assess core language and executive functions involved in spontaneous generation of language. Similar to other measures of aphasia, the BELS assesses core language skills: articulation, reading, repetition, naming, and comprehension. Unique additions to the BELS include assessments of: spontaneous speech, word fluency (phonemic/semantic), sentence completion, and sentence generation. Data from one-hundred and thirty-six acute stroke patients, collected from local metropolitan hospitals were analysed. Confirmatory factor analysis, and logistic regression were employed to determine the construct validity, and discriminant validity of the new scale. The BELS provided a new measure that is easily administered to acute stroke patients at the bedside. The results showed that the BELS is sensitive for nominal language deficits (e.g., naming), and it measures executive aspects such as spontaneous language generation, which is a hallmark of frontal dynamic aphasia. The results have encouraging theoretical and practical implications