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Adult Cognition, Language and Neuropsychology -

Putney Auditory Comprehension Screening Test (PACST)
J Graham Beaumont, Julia Marjoribanks, Sarah Flury and Tracey Lintern, 2002

Assess auditory comprehension in severely 
physically disabled patients

Age Range:

Individual - Untimed

Patients with severe physical and/or visual impairments are frequently unable to perform tasks required in existing tests of auditory comprehension. This is for reasons unrelated to their comprehension skills but because the procedures often require physical manipulation of the test materials and good vision. The Putney Auditory Comprehension Screening Test (PACST) provides a screening tool for such patients. It has been designed to improve methods of assessing auditory comprehension for patients with severe physically disabling conditions, as found in some cases of advanced multiple sclerosis, Huntington’s disease, brain injury and brainstem stroke.

Nature of the test
The test provides an indication of how appropriate it is for the patient to (a) make decisions regarding their care, (b) give consent to procedures such as insertion of gastronomy tube or other surgical interventions, or (c) indicate their understanding of complex legal issues such as Power of Attorney. It uses a simple form of communication involving a number of yes/no questions, and develops a test of ‘ability to understand’, which can be completed even by those with limited movement, impaired vision, unreliable episodic memory, or no speech.

To confirm a level of understanding in patients where it was not previously apparent has important implications for that patient’s quality of life and their opportunity to regain some control over their environment by making decisions for themselves. The PACST will also assist carers and relatives to communicate appropriately with the patient, and in providing the patient with a suitable level of stimulation.

The PACST provides a screening assessment that gives an indication of how much a patient can understand spoken language, and indicates the level of complexity of language presentation that would maximise their understanding. It requires only the ability to communicate ‘yes’ and ‘no’ by whatever means and does not rely on a patient’s abilities with respect to orientation, episodic memory, visual skills, or the manipulation of test material. There are 60 questions to which responses can be expressed verbally or by any means of assisted communication (chart, buzzer or other signal). 

Available Products


Complete kit: Includes manual, pack of 25 questionnaires/scoring sheets
Additional copies of materials:
Questionnaires/scoring sheets, pack of 50