3.1 - TBI Assessment - General Guidelines Flashcards
What might we see in Speech when assessing TBI patients?
Motor speech deficits
What might we see in Language when assessing TBI patients?
2
Confused language
Intact semantically & syntactically
What might we see in Communication when assessing TBI patients?
(4)
Confabulation
Circumlocution
Tangents
Pragmatic disruptions
Where might we use Informal Assessments for TBI patients?
3
Intensive Care
Specialty Neurotrauma/Multi-Trauma
Long-Term Acute Care
Where might we use Informal + Formal Assessments for TBI patients?
(2)
Comprehensive Integrated Inpatient Brain Injury Rehabilitation Hospital
Sub Acute Rehabilitation
Where might we use Formal Assessments for TBI patients?
7
Outpatient/Day Treatment
Home-Based Treatment
Post Acute Residential Transitional Rehabilitation
Independent Living
Supported Living
Home w/ Family
Nursing Care Facility
What 5 areas do we assess in TBI patients?
Cognitive-Communication
Hearing/Balance
Speech
Swallowing
Voice
Communication Disorders in TBI encompass difficulty with any aspect of communication that is
by ___________,
Disruption of cognition
What 3 aspects of communications might be affected by disruptions of cognition?
Receptive abilities
Expressive abilities
Pragmatics
What are the 5 areas of Communication?
Listening
Speaking
Gesturing
Reading
Writing
What are the 9 areas of Cognition?
Attention
Perception
Orientation
Memory
Organization
Executive function
Reasoning
Problem solving
Judgement
What 5 areas are SLPs knowledgeable about that are related to the cognitive aspects of communication?
Normal development
Abnormal development
Brain-behavior relationships
Pathophysiology
Neuropsychological processes
What does their education and clinical background prepare an SLP’ to assume a role in?
Habilitation and rehabilitation of individuals with cognitive-communicative disorders
What 10 things do SLPs perform for TBI patients?
Identification
Assessment
Intervention
Counseling
Collaboration
Case Management
Education
Prevention
Advocacy
Research
What other 5 professions do SLPs often collaborate with when treating TBI patients?
PT
OT
TR
Nursing
Medicine
Assessment in TBI is
_______.
Dynamic ( Ongoing )
What kinds of assessments are used to diagnosis TBI patients?
(2)
Standardized measures
Non-standardized
measures
TBI Assessment should be _______, ______, and _______.
Ongoing
Contextualized
Collaborative
How is TBI assessment influenced by Ranchos Levels?
I-III = Pt. in a coma -> no assessment
IV = Pt. agitated -> no assessment except perhaps a bedside screening
V = Very short assessment, one subtest
VI+ = Formal assessments ok but keep it short
What Cognitive + Communicative Problems can result from a TBI?
(5)
Difficulty concentrating for varying periods of time
Difficulty trouble organizing thoughts
Easily confused or forgetful
STM problems.
Difficulty solving problems, making decisions, and planning.
What causes Cognitive + Communicative problems to vary in TBI patients?
(3)
Individual personality
Pre-injury abilities
Severity of brain damage
What are the 5 Assessment Factors in TBI?
NoSeverity of injury
Current level of cognitive functioning
Physical injuries
Emotional state
Other
Do SLPs rate patients on the Glasgow Coma Scale (GCS)?
No
At what Glasgow Coma Scale (GCS) level do patients need lots of stimulation?
I-III (pre-agitation)
What kinds of stimulation should we give those a low Glasgow Coma Scale (GCS) level?
(4)
Auditory
Visual
Tactile
Olfactory
What 14 Emotional + Motivational Disturbances are associated with a TBI?
Irritability
Agitation
Restlessness
Inappropriate social response
Anxiety
Paranoia
Tires easily
Belligerence
Anger
Aspontaneity
Depressed (high risk)
Impulsiveness
Rapid mood changes
Loss of drive or initiative
What should we consider when assessing Emotional + Motivational Disturbances in TBI patients?
Is this a new trait, a premorbid trait, or a magnified trait?
What are the 6 types of Attention?
Alertness
Sustained attention
Selective attention
Divided attention
Alternating attention
Concentration
What are the two types of Alertness?
Tonic
Phasic
What is Tonic Alertness?
What is it important for?
Intrinsic arousal that fluctuates on the order of minutes to hours
Sustaining attention and functions such as working memory and executive control
What is Phasic Alertness?
What is it the basis for?
Rapid change in attention due to a brief event
Operations such as orienting and selective attention
How is Orientation in early stages of TBI recovery?
Profound disorientation
What 2 types of assessments do we use to gauge Orientation in TBI patients?
Non-Standardized
Standardized
When do we use Non-Standardized measures to assess Orientation in TBI patients?
Most frequently in the early recovery phase
What do Non-Standardized Orientation Assessments measure in TBI patients?
(4)
Person
Place
Time
Situation
What are 2 Standardized Orientation Assessments for TBI patients?
Galveston Orientation and Amnesia Test
Mini–Mental State Examination (MMSE)
What does Galveston Orientation and Amnesia Test measure?
Post-Traumatic Amnesia (PTA)
How is the Galveston Orientation and Amnesia Test scored?
2
It begins w/100 points
Points subtracted for each failed test
What is an Average score on the Galveston Orientation and Amnesia Test?
80-100
What is a Borderline score on the Galveston Orientation and Amnesia Test?
66-79
What is an Impaired score on the Galveston Orientation and Amnesia Test?
0-65
What to What is an average score on the Galveston Orientation and Amnesia Test scores correlate with?
Severity of brain injury
What are the 6 subcategories of memory?
Retrospective
Prospective
Declarative
Procedural
Episodic
Semantic
What is Retrospective Memory?
3
Past events
Past experiences
Information previously acquired
What are the 2 components of Retrospective Memory?
2
Declarative
Procedural
What is Declarative Memory?
What we know about things
What are the 2 components of Declarative Memory?
Episodic
Semantic
What is Episodic Memory?
Memory for personally experienced events
What is Semantic Memory?
Our organized knowledge of the world
What is Procedural Memory?
What we know about how to do things
What is Prospective Memory?
2
Remembering to do things at certain times
“Remembering to remember”
What is another name for Pre-Traumatic Memory Loss?
Retrograde amnesia
What is Retrograde Amnesia?
Inability to remember events that occurred BEFORE the
incidence of trauma/disease that caused the amnesia
What is another name for Post-Traumatic Memory Loss?
Anterograde amnesia
What is Anterograde Amnesia?
Inability to remember ongoing events AFTER the incidence of trauma/disease that caused the amnesia
What is Reasoning?
1+3
Capacity for…
- Logical thinking
- Appreciation of relationships
- Practical judgment
What is Abstract Thinking?
The ability to think in useful generalizations, at the level of ideas, or about persons, situations, events not immediately present
What 3 things are contained in Abstract Thinking?
Proverb interpretation
Similarities + differences
Categorization + sorting tasks
What 4 things are included in Problem Solving?
Thinking ahead
Understanding the future consequences of present actions
Considering alternatives
Making choices
