Nonverbal patients present a particular challenge to the users of the Westmead PTA Scale. The examiner requires some skill and patience.

To test nonverbal patients reliably they need to be able to do one of the following:

1. Consistently and accurately indicate yes / no to all questions (i.e. by head shaking or hand gestures).
2. Produce legible writing, or be able to use a keyboard, an alphabet board or other augmentative communication device (consult with the Speech Pathologist).
3. Have sufficient upper limb control to point / indicate the correct answer from 3 options presented on either a white board, a large piece of paper or a series of cardboard cards (like flash cards). The size of the print on the white board / paper / cards used will be determined by the degree of accuracy of movement over which the patient has control.

These communicate modes can be used to break the nonverbal patients into 3 groups:

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