Italian cross-cultural adaptation of the brief evaluation of receptive (aspects of) aphasia (BERA) for assessing language comprehension in severe acquired brain injuries

Introduction: Language comprehension impairments are a major barrier to communication and rehabilitation outcomes in patients with severe acquired brain injury (sABI). The present study aimed to translate and cross-culturally adapt the Brief Evaluation of Receptive Aphasia (BERA) into Italian language and to evaluate its feasibility in healthy participants. Methods: The adaptation included independent forward translations, back-translation, expert panel review, and Italian phonological, semantic, and morpho-syntactic items developing. Visual stimuli were newly generated and culturally adapted. An assessment of feasibility was conducted in a sample of 22 Italian healthy participants. Results: Most verbal and all visual stimuli were renewed with respect to the original French version, while preserving the overall structure of the original instrument. The Italian BERA was administered successfully to all participants, with a mean duration of approximately 4 min. No difficulties were observed in understanding instructions, recognizing stimuli, or recording responses through ocular fixation. Accuracy was uniformly high, with only rare rapid self-corrections for reversible morphosyntactic items. Conclusion: The Italian version of the BERA is a feasible and culturally appropriate tool for the rapid bedside assessment of language comprehension. Its low behavioral demands make it promising for neurorehabilitation contexts concerning aphasia, sABI, and disorders of consciousness.