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93 Cards in this Set
- Front
- Back
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What is the purpose of Assessment?
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Determine whether there is a disorder
Determine the nature of the disorder (differential diagnosis) Determine whether treatment is indicated Determine prognosis Estimate the kind of treatment that might be beneficial Assess treatment outcomes |
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What is the first step in completing an in depth eval. ?
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1. Compile Case History
Review medical chart Feedback from other medical tem members Information from patient and caregivers via interviews or intake forms |
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What is the 2nd step in an in depth eval?
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2. Observation of a patient
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What is the 3rd step of an eval?
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3. Screening procedures
Sensory deficit screening (may be collected from medical records) Hearing screening Bob: passed hearing screening Vision screening Bob: Passed vision screening Touch (e.g., is there hemianesthesia?) Bob: No report of loss of sensation |
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What are some examples of screenings?
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Screening for motoric impairments
Apraxia of speech Bob: Signs of apraxia of speech Dysarthria Bob: No signs of dysarthria Limb apraxia Bob: No signs of limb apraxia Perceptual deficits See Table 4-7 Bob: No signs of auditory or visual perceptual deficits Psychiatric well-being measures See Table 4-8 Example: Geriatric Depression Screening Bob: Borderline |
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What is the 4th step in an eval?
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4. Administer formal tests
Test batteries Examples: Western Aphasia Battery, Boston Diagnostic Aphasia Examination Formal tests of linguistic and cognitive functions |
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What is the 5th step in an eval?
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5. Qualitative Assessment.
Observations of client, family, important others in the environment Modifications of formal tests (e.g., multicultural/bilingual issues) |
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What is the 6th step in an eval?
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6. Caregiver Assessment
Observations (e.g., interviews) Formal measures (e.g., social validity measures such as the Communicative Effectiveness Index) |
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What is parallel recovery?
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Parallel = both languages recovered simultaneously
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What is selective recovery?
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Selective = one language never recovered
Antagonistic recovery = second language to recover replaces or inhibits first |
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What is successive recovery?
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Successive = one language recovers before the other
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What is differential recovery?
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Differential recovery = one language recovers much better than the other
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What is Alternating antagonistic recovery?
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Alternating antagonistic recovery = one language accessible for short periods of time
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What is Paradoxical translation behavior?
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Paradoxical translation behavior = translate into one language that is not available for spontaneous speech
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What are the types of impairment in bilingual aphasia?
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Parallel impairment
Differential impairment Differential aphasia Blended or mixed pattern Selective aphasia |
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Do Bilinguals have a greater incidence of crossed aphasia.
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NO
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Do they have increased use of pragmatics as a tool
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YES
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Do they have new learning/controlled processing network associated with right hemisphere involvement
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YES
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There is direct evidence of ..
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Both languages are organized in dominant language areas
Within these areas, slightly different loci have been observed |
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What are two types of processing resources
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Activation and inhibition
Explanations of observed phenomena in bilingual aphasia |
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Is attention automatic and controlled processing?
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Yes
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Is directed attention associated with explicit memory
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YES
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What is Analysis?
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Analysis: Conscious reflection of unconscious processes
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TRUE OR FALSE:
Different learning techniques may facilitate storage in the different functional memory systems |
TRUE
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TRUE OR FALSE:
Natural learning (such as native language learning) = explicit knowledge |
FALSE:
Natural learning (such as native language learning) = implicit knowledge |
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TRUE OR FALSE:
Formal instruction, rule-learning = explicit knowledge |
TRUE
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What are the levels of bilingualism?
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Self-ratings
Ratings by family members Patterns of use for each language Acquisition historyTesting in Various Languages |
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What are the Practical considerations for assessment?
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Level of Bilingualism
Self-ratings Ratings by family members Patterns of use for each language Acquisition historyTesting in Various Languages Bilingual Aphasia Test Multilingual Aphasia Test Monolingual tests in other languages In-house translation of tests |
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What is Anomia?
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Difficulty recalling the names of people, objects, locations, concepts, and actions.
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What is Circumlocution?
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The use of descriptions, definitions or sound effects for target words.
Example: “You lie on it outside” for “hammock” |
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Semantic paraphasias
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“It’s a swing” “a bed”
TARGET WORD: hammock |
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Phonemic paraphasias
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“It’s a kammick”
TARGET WORD: hammock |
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Neologistic paraphasias
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“It’s a sklerver”
TARGET WORD: hammock |
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Stereotypy
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“more, more, more”
TARGET WORD: hammock |
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Empty statements
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“It’s one of those things”
TARGET WORD: hammock |
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Errors in Speech used for scoring the Aphasia Diagnostic Profiles (ADP)
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Phonemic Paraphasia (“kack” for jack)
Semantic Paraphasia (“clock” for watch) Augmentation (“sojie watch” for watch) Part Word (“noculars” for binoculars) Paraphrase (“here she is” for “is she here”) Partial Phrase (“three hundred dollars” for three hundred and twenty-one dollars) Circumlocution/Description (“blow it” for whistle) Phonemic Error on Semantic Paraphasia (“miskroscope” for binoculars) Neologistic Paraphasia (“kargy” for whistle) Unrelated Real Words (“thunder time” for scissors) Stereotypy (“bukky, bukky” for wrench) Other (“I know this one but I can’t think of the word”) Unintelligible, nontranscibable Visual Perceptual (“trash cans” for binoculars) Perseveration (see perseveration section for further details) |
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TRUE OR FALSE
Fluent aphasias: usually are associated with lesions anterior to the Rolandic Fissure. |
FALSE
Fluent aphasias: usually are associated with lesions POSTERIOR to the Rolandic Fissure. |
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TRUE OR FALSE
Nonfluent aphasias: usually are associated with lesions superior to the Rolandic Fissure |
FALSE
Nonfluent aphasias: usually are associated with lesions ANTERIOR to the Rolandic Fissure |
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Rolandic Fissure =
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Rolandic Fissure – Central Sulcus
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What are the Two Major Forms of Aphasia?
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FLUENT
NONFLUENT |
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Fluent Speech Output:
Approximates normal speech in terms of: |
Rate of word production
– Length of each utterance produced without notable pause. – Melodic contour of utterances/sentences – Overall ease of the speaking act |
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Nonfluent Aphasic Speech is
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-Slow rate
– Short utterances – Effortful production |
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Fluency in Nonfluent Aphasia
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Nonfluent
Quantity Sparse Effort Effortful Articulation Affected Phrase length 1-2 words Prosody Dysprosodic Content Excessive Content words |
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What is quantity like in nonfluent aphasia?
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sparse
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what is the phrase length in nonfluent aphasia?
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1-2 words
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fluency in fluent aphasia
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Fluent
Quantity Normal Effort Normal Articulation Normal Phrase length 5-8 words Prosody Normal Content Lacks content words |
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what is content like in fluent aphasia?
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speech lacks content words
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what is phrase length in fluent aphasia?
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5-8 words
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what are the 5 cognitive domains?
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Attention
Memory Executive Function Language Visuospatial skills |
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What is the most commonly used cognitive screening tool
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the Mini Mental Status Examination (MMSE)
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What is the purpose of a cognitive battery
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The purpose of a cognitive battery is an attempt to measure across the domains of cognition; often, the output of a cognitive battery is a general score and subscores for the various cognitive domains it purports to assess
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Describe the CLQT
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-10 subtests--comprehensive
-Encompasses all cognitive domains -Gives severity rating for each domain and overall composite score -Less than 30 minutes to give, -easy scoring |
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What are language related measures?
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Word memory
Verbal fluency Animal Naming Category Naming |
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Domain-specific assessment tools
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Most likely to be used after a screening and/or cognitive battery
Purpose would be to obtain more detailed information about a particular cognitive domain Aid in treatment planning Meausre treatment outcomes/effects |
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What are the 4 types of attention
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Focused attention (selective)
Sustained attention (vigilance) Alternating attention (attention switching) Divided attention |
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Assessments of Attention
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Formal
Test of Everyday Attention (Robertson, Ward, Ridgeway, & Nimmo-Smith,1994). 8 subtests—all aspects Sample activities Map search Lottery Elevator counting |
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Informal Assessments of Attention
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Card sorting
Visual search—symbol cancellation Mazes Perform task with radio or other distraction Visual discrimination tasks |
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Episodic memory
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memory for events
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Semantic memory
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memory for word knowledge
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Declarative memory
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being able to say what you know
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Procedural memory
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recalling procedures for actions and events
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Formal Memory Assessments
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The Rivermead Behavioral Memory Test-Extended Version. (Wilson, et al.,1999).
Assesses all aspects of memory Story retell—immediate and delayed Face recognition Routes and messages—immediate and delayed Orientation and date - Woodcock-Johnson Tests of Cognitive Ability (Woodcock & Johnson, 1989) Subtest 12—Picture recognition (supplemental) Shown pictured item(s), then choose from increasing set of item(s) |
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Informal Memory Assessments
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Digit span task
Word span task Picture recall Sorting task Orientation questions Recall session events |
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Executive Function
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Planning
Problem-solving Organization Sequencing Mental flexibility Set and achieve goals |
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Formal Executive Function Assessments
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Wisconsin Card Sorting Test (Grant & Berg, 1948)
4 cards facing client—shapes and colors Give card to client to match, respond yes/no Goal is for client to deduce sorting pattern from clinician cues |
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Informal Exec Func Assessments
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Copy block design
Mazes Sequencing cards Multi-step card sorting Card games, checkers, chess Clock generation task |
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Visuospatial Skills
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Difficulty judging distances, depth, and direction,
or localizing points in space Difficulty drawing, writing, or copying words and figures. Perception of letters or other figures |
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What are informal assessments for visuospatial skills?
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Copying complex designs and figures
Mirror reversed letters Clock generation Drawing a house or flower Mazes |
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True or False:
Because many of these cognitive abilities rely on broad networks of other skills and also broad networks of brain areas, we observe some overlap in types of cognitive impairments across diagnostic categories |
TRUE
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Diffuse, non-progressive etiologies (such as TBI)
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Orientation, attention, memory problems
Episodic memory affected; difficulty laying down new memories Poor Executive function |
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Focal, non-progressive etiologies (such as RHD or aphasia)
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Specific attentional impairments (type of attention, or type of stimulus)
Specific memory impairments (stimulus-bound) Subtle but detectable executive function impairment (specific) |
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Focal, progressive etiologies (such as primary progressive aphasia)
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Initial presentation similar to focal non-progressive profile
May progress to more diffuse-type cognitive impairment |
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Diffuse, progressive etiologies (such as Alzheimer’s dementia)
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Initially, difficulties with high-level executive function, memory for recent events or new information
Progresses to more severe memory impairment and affecting attentional abilities Ultimately, orientation, attention, memory, language, and executive function are all severely impaired |
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Social approaches take a broad view of
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functional therapy
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Assessment includes
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relevant life participation needs and discovering competencies
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Treatment includes
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facilitating the achievement of life goals
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Intervention routinely targets
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environmental factors outside of the individual
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Social approaches
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Goal: Target the ability to function in the world by focusing on social circles.
Change occurs as a result of positive social interaction. Assessment is typically descriptive and informal. Family or group treatment; community-based centers; communication partners. |
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Ways of Obtaining perspectives of people with aphasia
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Ethnographic interviews
Communicative effectiveness index Personal Narratives |
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Functional communication measures
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ASHA FACS
CADL-2 |
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Psychosocial, QOL, and Well-being measures
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Life satisfaction index
Satisfaction with life scale Well-being index |
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Professional judgments of communication
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Discourse analysis
.Correct information units .Content units -Everyday language test -Pragmatic assessments |
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What is quality of life?
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Perceived life satisfaction
Frequency and independence of life activities |
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Accomplishment or participation measures
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Community integration questionnaire
Personal goal attainment scales |
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A Key Life Activities assessment
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Maximizes client input/development of autonomy
Brings the focus to life participation Shows changes on personally-relevant end goals over time Does not provide specific evaluation or feedback opportunities for each activity (needed to foster self-evaluation) |
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Goal Attainment Scaling is
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a goal-setting procedure that has the strongest empirical support for its validity and effects
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Goal Attainment Scaling – evaluation
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Most favorable outcome
More than expected outcome Expected outcome Less than expected outcome Least favorable outcome +2, +1, 0, -1, -2 OR 0, 1, 2, 3, 4 |
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Goal 1: Catching the bus
Most favorable outcome |
Able to use the bus without assistance without error all of the time
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More than expected
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Able to use the bus with the help of his wife without error all of the time
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Expected outcome
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Able to use the bus with the help of his wife with some errors some of the time
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Less than expected
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Too much help required and too many errors made for continued use of the bus
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Least favorable
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Unable to use the bus at all
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Advantages of Goal Attainment Scaling
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Focused on life participation
Provides evaluative component Provides time limit Can be customized to particular social environments Structure and process could be internalized by clients to facilitate autonomous goal-seeking |
