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76 Cards in this Set
- Front
- Back
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What is anomia?
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word finding problems
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What is alexia?
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reading problems
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What is agraphia?
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writing problems
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Where are reading and writing controlled in the brain?
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near occipital lobe (visual)
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True or false: Semantics widely distributed throughout the right hemisphere.
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False: left hemi (ACA, PCA, MCA supplies)
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Where is orthography function located in the brain?
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extrasylvian region (PCA supplies)
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Where is phonology and syntax located in the brain?
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perisylvian region (MCA supplies)
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What is semantic paraphasia?
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person substitutes semantically-related word for target word (e.g., desk for table)
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What is phonological paraphasia?
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person substitutes words that share similar phonetics (e.g., mable for table)
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What is jargon paraphasia?
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word generated is not a real word; more than half of word does not relate to target word; neologisms (e.g., faper for table)
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What could go wrong if there was a lesion in the semantic region (perisylvian and/or extrasylvian region)?
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-lose meaning info, but may access some semantic info so they come up with a related word
-anomia: say wrong word when shown pic -agraphia: may or may not write regular, irregular, and nonwords to dictation depending on extent of other damage; cannot write words when shown pic -alexia: may or may not read regular, irregular, and nonwords depending on extent of other and nonwords depending on extent of other damage; cannot associate read words with meaning - reading without comprehension |
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What could go wrong if there was a lesion in the phonology and orthography region (perisylvian and/or extrasylvian lesion)?
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-anomia: circumlocute when shown pic
-agraphia: may or may not write regular, irregular, and nonwords to dictation depending on extent of other damage; cannot write words when shown pics -alexia: may or may not read regular and nonwords depending on extent of other damage; cannot read irregular words or associate read words with meaning- reading without comprehension |
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What would impaired phonology area look like? (perisylvian lesion)
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-anomia: will produce jargon when shown a pic
-phonological/deep agraphia -phonological/deep alexia |
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What can go wrong with a lesion in the orthography region? (extrasylvian lesion)
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-no anomia: will say word correctly when shown a pic
-lexical/surface agraphia: cannot write irregular word correctly to dictation or when shown a pic -lexical/surface alexia: cannot read irregular words; reading is better than spelling overall, but worse nonword reading than spelling |
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What is phonological/deep agraphia?
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-regular nonwords will be incorrect and phonologically implausible
-regular and irregular words will be correct -spoken anomia- written language may be better preserved than spoken language |
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What is phonological/deep alexia?
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-regular nonwords will incorrect
-regular and irregular words will be correct (shows reliance on lexical reading procedures) |
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What is lexical/surface agraphia?
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-regular words and regular nonwords will be correct
-irregular words will be incorrect but phonologically plausible (shows reliance on phonological spelling procedures--eg. funnel=funal; wrath=rath) |
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True or false: People with aphasia typically have problems with anomia, alexia, AND agraphia. Rare to have problems in just 1 or 2 areas.
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True
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What is alexia without agraphia?
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trouble reading but can write just fine. can tell you what they wrote if you ask them right after because of memory
(rare) |
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True or false: You must administer aphasia tests to protocol.
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False: get to break the rules when giving standardized tests to aphasics
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What are the goals of aphasia assessment?
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-diagnose communication impairment
-differentially diagnose type of impairment (eg., aphasia, dementia, dysarthria, apraxia) -determine severity *-determine prognosis for recovery -identify strengths and deficits -plan tx -monitor improvements |
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True or false: Screenings are not common for aphasia.
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True
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What communication skills do you assess?
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-language
-cognition -speech -swallowing -hearing -communication interaction |
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What is lability?
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exaggerated emotional responses that are more extreme than the situation warrants
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What is the FIM score?
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-Functional Independent Measure score
-has to be reported within 72 hrs of admission -score ranges from 1 (dependent) to 7 (dependent) |
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What is a battery?
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a whole bunch of sub-tests that assess multiple modalities
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Describe the BDAE.
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-Boston Diagnostic Aphasia Examination
-1-4 hrs to admin.; 30-45mins short form -based on Boston Classification System -norm referenced -battery |
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Describe the BASA.
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-Boston Assessment of Severe Aphasia
-battery (sometimes) -30-40mins to admin. -normed for severe or global aphasia -score gestural and verbal responses -more functional assessment (personal info related to individual) |
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Describe the WAB.
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-Western Aphasia Battery
-battery -1-2hrs to admin. -based on Boston Classification System -score correlate with BDAE -calculate aphasia quotient (out of 100) and cortical quotient -norms for scores and type of aphasia -common in NE *only test that gives you a score (aphasia quotient) |
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What problem is there for the WAB scores?
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Broca's score is lower than Wernicke's (doesn't work for continuum)
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Describe the PICA.
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-Porch Index of Communicative Ability
-1hr to admin. *special scoring (requires intensive training to admin and score-- multiple categories of responses-- poor interjudge reliability) -18 subtests assess language by modality -norm referenced *Hope slope (predictive recovery scale) -not used often |
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Describe the CADL.
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-Communicative Abilities in Daily Living
-battery (sometimes) -45mins to admin. -norm referenced -functional tasks -score by success of communication -doesn't have different subtests that assess different modalities -gives situations that person can respond to with any modalities -more of a pragmatic and functional assessment (role playing situations) |
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Describe the ALPS.
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-Aphasia Language Performance Scales
-Battery? (screening) -20 mins to admin. -screening measure for multiple modalities (typically don't give screening tests for aphasia) |
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What is a specialty test?
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assess greater detail of one modality
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Describe the RTT.
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-Revised Token Test
-specialty test -test of auditory comprehension/memory and/or attention, processing -tokens are different colors, sizes, and shapes -test arranged in increasing difficulty levels -10 subtests, 10 commands each -not normed -sometimes done in reverse and called an expressive test (reporter's test) |
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Describe the TROG.
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-Test for the Reception of Grammar
-10-20 mins to admin. -assesses increasing levels of grammatical difficulty -normed ages 4-adult |
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Describe the RCBA.
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-Reading Comprehension Battery for Aphasia
-specialty test -assesses reading comprehension -silent/oral reading -30 mins to admin. -7 additional tests |
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Describe the BNT.
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-Boston Naming Test
-specialty test -15-30 mins to admin (easy) -normed on children 5:5-10:5yrs; normal adults and adults with aphasia -assesses word finding abilities and affect of semantic and phonemic cues (naming) -now part of BDAE, but can be a stand-alone test -all nouns -poor normative data |
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The effect of aphasia therapy beginning in the _______ stage of recovery is nearly twice as great as the effect of ________ recovery alone.
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acute; spontaneous
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Why does aphasia tx work?
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-spontaneous recovery (regression of diaschisis)
-brain plasticity -alterative hemi theory of recovery -substitution of non-language based communication system |
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When does the most spontaneous recovery occur?
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with first 2 months post-stroke (occlusive)
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There is a delayed period of spontaneous recovery for people who have what type of stroke?
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hemorrhagic stroke
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How long does spontaneous recovery continue for post-stroke?
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6 months (insurance companies)
1-2 yrs (rehab professionals) |
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What is spontaneous recovery also known as?
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regression of diaschsis
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What is diaschisis?
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loss or decrease of function that is observable in early periods of recovery and that involves structurally unaffected brain regions connected directly to damaged areas
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What is the alternate hemi theory of recovery?
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-corresponding structures in the non-dominant hemi take over language functions when the dominant hemi is damaged
-right hemi does not operate in same manner, so language functioning differs |
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What is brain plasticity?
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-multiple parts of the brain can perform a specific function (tho one region tends to dominate when no damage exists)
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True or false: Language and thought are 2 separate processes.
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True
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What do you focus your treatment on for the restoration model?
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-stimulation-facilitation
-modality -linguistic -processing -minor hemi (combo of restoration and compensation model) |
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What do you focus your tx on for the compensation model?
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-minor hemi (combo of restoration and compensation model)
-functional communication |
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How do you do aphasia therapy?
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-deficit reduction
-compensatory tx -communication facilitation -pharmacological tx |
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What is deficit reduction?
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-traditional aphasia tx
-process-oriented approach -relies on drill and practice routines -most recent advances involve 2 approaches |
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What are the different types of drill and practice?
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-word retrieval drills
-auditory comprehension drills -yes/no reliability -social interaction drills -reading/writing -producing words, phrases, and sentences -syntactic structures -constraint induced therapy |
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Describe word retrieval drills.
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-drill and practice tx
-confrontation naming of core pics -naming family members |
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Describe auditory comprehension drills.
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-drill and practice tx
-answering yes/no questions -following one-step commands -receptive naming -functional naming -conversations -tv/radio programs |
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Describe yes/no reliability.
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-drill and practice tx
-using head nods/shakes -pointing to written words -verbalizing yes/no |
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Describe social interaction drills.
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-drill and practice tx
-greetings/closings -social politeness forms -scripts |
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Describe reading/writing drill and practice.
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-single words
-functional items (signature, universal signs/symbols, etc.) -reading and writing social cards/letters -reading newspapers, recipes, books, etc. |
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Describe producing words, phrases, and sentences tx.
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-drill and practice tx
-sentence completion tasks -phrase- and sentence-length responses to questions |
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Describe syntactic structures tx.
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-drill and practice tx
-directly teach "who did what whom" in selected syntactic structure -teach complex structures and generalization will take care of easier structures -if you work on the hardest structures, the easier ones will come automatically |
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Describe constraint-induced language therapy.
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-drill and practice tx
-not effective -ethical? -constrain person from communicating in alternative means |
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List compensatory tx's.
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-MIT
-communication boards and notebooks -CVIC -MossTalk -writing words or letters -drawing pictures |
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What is MIT?
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-Melodic Intonation Therapy
-compensatory tx -pair spoken phrase/sentence with a melodic tune (usually 2 pitches) -hum then add words -best for those with good comp., mild aphasia and apraxia -generalization? |
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What is CVIC?
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-compensatory tx
-Lingraphica -"language in a box" -effective? -still language (aphasics don't have language!) -requires hours and hours of therapy |
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What types of speech and language groups are there for aphasia?
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-direct
-indirect -sociolinguistic -transition -maintenance |
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What types of communicators are there for partner-dependents?
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-emerging
-contextual choice -transitional |
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What types of independent communicators are there?
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-stored message
-generative -specific needs |
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How does the Boston differ from the Garrett and Lasker?
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-Boston: modalities; for those with aphasia; how severe?
-Garrett and Lasker: not widely known; communicative interactions (modalities don't matter); not just for people with aphasia (for partner-dependent communicators) |
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Describe emerging communicators.
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-for global aphasia
-require maximal assistance -contextual awareness -no initiation or repetition of verbalizations -messages carry no meaning |
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What are emerging communicator intervention goals?
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-develop turn-taking (non-verbals)
-develop choice-making ability (concrete, binary choice) -develop referential skills -develop clear signals for agreement and rejection -teach partners to provide appropriate opportunities for above |
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What is partner training for emerging communicators?
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-develop contextual routines
-create scrapbook/remnant photo book (some phrases--very simple) -provide contingent feedback (referential, joint attention, affirmation, rejections) -augmented input |
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What are some augmented input strategies to use for aphasics?
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-writing key words on paper
-gesturing symbolically -gesturing deictically (pointing) -pantomiming |
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Describe contextual choice communicators.
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-cannot consistently initiate communication acts
-retains skills in automatic/familiar activities (waving, nodding,..) -persistent global aphasia, expressive aphasia, or receptive aphasia -minimal output |
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What are intervention goals for contextual choice communicators?
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-to call for attention and/or assistance
-to introduce self in structured situation -to communicate specific and biographical info by pointing to written choices -to communicate opinions/preferences by pointing to qualitative rating scale -develop use of AAC strategies -teach both patients and partners to participate in these exchanges |
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What is the primary communication strategy for contextual choice communicators?
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written choice
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Describe traditional communicators.
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-retains a variety of fragments of communication skills
-attempts to communicate, including via natural speech -uses multiple modalities -usually expressive or conduction aphasia -initiates communication with minimal cues |
