CLQT+

CLQT or the Cognitive Linguistic Quick Test Plus is used to evaluate a variety of cognitive and linguistic skills, including attention, memory, executive functions, language, and visuospatial skills. 

The CLQT is an effective tool for assessing individuals with neurological impairments, which may be due to a known diagnosis such as stroke, TBI, or dementia. Speech pathologists working with clients who are 18 or older and have cognitive or communication deficits should be familiar with this helpful assessment tool.

SLPs can administer the CLQT as part of a comprehensive evaluation of an individual’s cognitive-linguistic skills.  The results of this assessment can be used to identify an individual’s areas of difficulty, which can assist with making a diagnosis. This, and information about the client’s areas of strengths, can facilitate a tailored intervention plan for the client.

Follow along as we unfold the components of the CLQT, procedures for administering and scoring the test, and tips for interpretation. We’ll also discuss how SLPs can use the results of the CLQT to develop an effective, comprehensive treatment plan for clients with cognitive and linguistic deficits.

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What does the CLQT assess?

A thorough understanding of the components and subtests of the CLQT+ is crucial for SLPs. This can help clinicians confidently and competently determine when and how to administer the assessment.

The CLQT offers two paths for standard administration: Traditional Administration and Aphasia Administration in the CLQT+.

The subtests of the Traditional Administration include:

1. Personal facts/orientation
2. Symbol cancellation*
3. Confrontation naming
4. Clock drawing
5. Story retelling
6. Symbol trails*
7. Generative naming
8. Design memory
9. Mazes*
10. Design generation

What is the difference between CLQT and CLQT Plus?

The subtests of the Aphasia Administration in the CLQT+ include all of the above subtests (with additional points scored for following auditory directions within the tasks marked by an *). A Semantic Comprehension subtest is also included in the Aphasia Administration. 

Scoring and interpretation

Familiarity with scoring and interpretation procedures for the CLQT can help speech-language pathologists effectively utilize the information they obtain from the test.

Each subtest on the CLQT yields a raw score, which is transformed into a scaled score for comparison with a normative sample. Using the scoring manual, SLPs can also convert scores to age equivalents. This indicates the client’s performance relative to their chronological age.

When interpreting the results, the clinician obtains a measure of how the client has met certain cognitive and linguistic milestones.

The CLQT assesses an individual’s strengths and weaknesses across 5 cognitive domains:

1. Attention
2. Memory
3. Executive functions
4. Language
5. Visuospatial skills

Examining the client’s scaled score on the subtests that measure these cognitive and linguistic areas can help clinicians determine the severity of the client’s impairments.

Scaled scores have an average of 10 and a standard deviation of 3. Looking at the individual’s scaled score can indicate whether a client’s scores are within the normal range, or are mild, moderately, or severely impaired.

Administration and implementation of the CLQT

When preparing for administration and implementation of the CLQT and CLPQ+, there are some helpful tips for therapists to keep in mind.

First, the therapist should thoroughly familiarize themself with the CLQT and CLQT+ examiner’s manuals and instructions. Referring to any picture stimuli and the accompanying record form while doing this can also be helpful.

The CLQT takes approximately 15 to 30 minutes to complete, and can be administered with clients between the ages of 18 and 89 years 11 months. It is available in English and Spanish (Traditional Administration only).

The CLQT+ can also be administered over telepractice. Pearson provides guidance for this, which can be found on their website.

The test should be administered in a comfortable environment that is free from distractions. The clinician can first establish rapport through motivating tasks and informal conversation surrounding the client’s topics of interest.

Instructions should be provided in a clear, concise manner for each subtest, as the SLP follows the general administration directions and prompts provided in the manual.

Data analysis and interpretation of CLQT results

By referring to Pearson Assessment’s Interpretation Support for the CLQT+ by Assessment Task, SLPs can obtain helpful information to assist in the interpretation of the examinee’s performance across subtests.

For example, the personal facts subtest assesses memory and language abilities. As Pearson’s guide explains, responses that are delayed and/or self corrected might indicate memory difficulties that are more mild.

Analyzing patterns of weaknesses enables speech therapists to more accurately make diagnoses.

Depending on what these weaknesses are, those diagnoses might include:

1. F06.7: Mild neurocognitive disorder due to known physiological condition (such as Alzheimer’s disease or TBI)
2. I69.0: Cognitive deficits following nontraumatic subarachnoid hemorrhage
3. I69.32: Speech and language deficits following cerebral infarction
4. I69.320: Aphasia following cerebral infarction  

A client’s areas of strengths on the CLQT and CLQT+ should also be noted by the SLP. This can provide the clinician with insight into what treatment techniques or activities might be most effective to incorporate into therapy.  

Treatment planning using CLQT and CLQT+ results

The results of the CLQT+ can serve as a basis for developing an effective treatment plan.

First, clear and measurable therapy goals can be developed, which should address the specific cognitive and linguistic deficits shown through the CLQT+ results, in addition to the rest of the SLP’s comprehensive evaluation.

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The clinician should then select evidence-based intervention strategies that align with these goals. These strategies might include compensatory strategies to aid with short-term and long-term memory.

For example, if the client demonstrates difficulties in memory skills but shows strengths in linguistic skills, he or she may be able to use strategies such as writing notes, setting alarms or reminders, and utilizing a calendar.

It’s important for the clinician to monitor the client’s progress and adapt goals as indicated. Ongoing monitoring can be completed through periodic administration of standardized assessments, such as the CLQT and CLQT+.

The SLP can compare a client’s performance on re-administrations of the test for valuable insight into their progress on improving specific skills and the effectiveness of the current therapy techniques or approach being used.

Team collaboration

Standard best practice is for SLPs to use a multidisciplinary approach when providing therapy for a client with cognitive and linguistic deficits. Clinicians can work with families and caregivers to collaborate on developing appropriate, functional goals for the client.

By participating in the assessment and intervention process, families can learn strategies to support a client’s cognitive and language skills during daily interactions.   

Collaborating with other professionals involved in the client’s care can provide the SLP with valuable insight into the client’s cognitive and linguistic functioning and needs across different functional settings. These might include the client’s primary care physician, a psychologist, occupational therapist, physical therapist, and social worker.

The speech therapist can collaborate with these other professionals to share helpful recommendations for supporting social communication skills in these environments.