Intro To Lang Intervention Stategies In Aphasia

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Aphasia

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left-hemi focal lesion on brain;absence of without language

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Disphagia

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disorder in swallowing

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What is Aphasia

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Neurogenic,acquired, language problems, not a problem of sensation or intellect

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Components of language

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phonology, morphology, syntax, semantics, pragmatics, prosody

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Discourse

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actual communication/interaction.

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Ischemic Strokes

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fatty cells in artery block blood supply (atherosclerosis)

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Trombotic Stroke

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Ischemic attack that originates in the brain

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Embolic Stroke

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Ischemic attack that originates elsewhere and travels up to the brain

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Hemorrhagic Stroke

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broken vessel in the brain, usually in the thin arteries in the brain causing necrosis

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Aneurysm

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thin weakened area of the vessel balloons up. If taken care of on time, there won't be a hemorrhagic stroke.

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Tumor transient deficits

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once is removed, after time patients recover

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Tumor permanent deficits

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once removed, if malignant tissue in surrounding areas damage might be lasting

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Trauma

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car accident, fall

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Unknown etiology

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don't know why aphasia occurred

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Aphasia

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well-document but porrly understood syndrome, evidence that is treatable, potential increase of occurrence due to aging

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Incidence

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how often it occurs

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Prevalence

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How many people have it at any given time

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Interconnectivity

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all primary regions are connected by either association fibers (intra hemisphere) or commisural fibers (inter hemisphere=corpus collosum)

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Centrality

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CNS integrates all incoming/outgoing information. Allows for integration/synthesis of multiple sources of information

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Hierarchical organization

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highest, intermediate, and lowest

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Hierarchical (a) Highest

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cerebral cortex: higher mental functions

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Hierarchical (b) Intermediate

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brainstem:diencephalon, autonomic function

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Hierarchical (c) Lowest

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spinal cord: basic function, reflexes

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Laterality of organization

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bilateral anatomic symmetry between both hemispheres but lateralization of function; contralateral sensory/motor control at the medulla

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Structural/functional specialization

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structures have specific functions

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Topographical organization

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peripheral area of body are represented by pathways leading to specific parts on the brain

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Plasticity

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ability of brain to re-organize functions. Some functions are hard-wire (lie breathing) and won't change.

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Non-mythical brain

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syraight forward basic functioning of the brain

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Unidimensional Classification

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only "Aphasia" is used, no adjectives before it.

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Dichotomous Classification

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Fluent/non-fluent
Receptive/Expressive
Sensory/Motor
Anatomic: anterior/posterior
Linguistic: syntactic/semantic

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Connectionist Classification

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incorporates both behavioral characteristics and neuroanatomical correlates of the observed behaviors

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Connectionist Classification

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Assumes various aphasic subtypes reflect disruption of specific brain centers or to connections between the centers

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Naming deficits

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also seen in dementia=loss
in Aphasia=access

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Paraphasias

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incorrect substitution of words

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Verbal paraphasia

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entire word is substituted
Table for Cat

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Semantic paraphasia

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entire word is substituted by a related word
Dog for Cat

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Phonemic/literal paraphasia

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when they substitute a sound within the word
Gat for Cat

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Neologistic paraphasia

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when they say a completely new word that doesn't exist in their language
Fuvo for cat

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Fluent Aphasias
(Wernicke's. Conduction, Anomic, Transcortical Sensory)

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normal rate of speech normal length of sentences, normal melodic contour, overall ease of speaking

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Non-Fluent Aphasias
(Broca's, Transcortical Motor,
Transcortical Mixed, Global)

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slow rate of speech, sentence length is too short, production is effortful, many more pauses than usual

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Repetition

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ability to repeat may be entirely lost, may have numerous phonemic paraphasias and/or omissions of sounds/words.

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Comprehension Deficits

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Can be impaired to variable degree

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Agrammatism

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difficulty generating sentences in which words have very specific slots. Problem with functor words (like Broca's)

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Paragrammatism

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may or may not be syntactically correct. grammatial morphemes are usually incorrect (Wernicke's)

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Alexia with Agraphia

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presence of both reading and writing impairments. Usually with Wernicke's or Transcortical sensory aphasia

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Alexia without Agraphia

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Separate condition by itself in the presence of fluent, spontaneous speech and good comprehension.

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Writing deficits

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Usually mirror oral production deficits

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Apraxia

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Disorder in execution of learned movement that cannot be accounted for by weakness, incoordination, sensory loss or impaired comprehension