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ECU Brain, Language and Aphasia > 7 - Non-Standardized Aphasia Assessment + Aphasia Prognosis > Flashcards

7 - Non-Standardized Aphasia Assessment + Aphasia Prognosis Flashcards

1
Q

Do most aphasia patients change severity ranking due to treatment?

A

No but they can make functional progress

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2
Q

Those with mild aphasia struggle mostly with ____________.

A

Word finding difficulties

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3
Q

What is fluency like in Broca’s Aphasia?

Comprehension?

Repetition?

A

Poor

Good

Poor(ish)

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4
Q

What is fluency like in Wernicke’s Aphasia?

Comprehension?

Repetition?

A

Good

Poor

Poor

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5
Q

What six areas can we assess during an informal assessment?

A

Comprehension

Expression

Reading

Writing

Cognition

Pragmatics

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6
Q

What four things can we ask the patient to write to test their writing ability during an informal assessment?

A

Name

Address

Telephone

Contact

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7
Q

What are we looking when assessing cognition during an informal assessment?

(3)

A

Attention

Memory

Regulation

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8
Q

What kind of environment should we test comprehension in during an informal assessment?

A

A quiet setting free of distractions

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9
Q

What is an Aphasia Prognosis?

A

An educated, best estimate of where the patient will be in a specific time period (1 month, 6 months, 1 year, etc.)

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10
Q

What do patients want to learn when they ask about their prognosis?

A

When they will get better

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11
Q

What FIM score is associated with a higher likelihood of functional improvement after a stroke?

A

60+

Functional Independent Measure

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12
Q

What is the most common type of stroke in the acute phase?

A

Global

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13
Q

Aphasia _________ in first year post-stoke.

A

Improves in general

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14
Q

___% of patients experience complete recovery by one year.

A

40%

Don’t tell patients this

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15
Q

When does aphasia recover the FASTEST?

A

First 3 months

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16
Q

When does the GREATEST amount of aphasia recover occur?

A

First 6 months

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17
Q

When does aphasia recovery tend to slow down?

A

After 12 months

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18
Q

When do most aphasia types often resolve to less severe forms?

A

Within 12 months

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19
Q

___% of patients have residual impairments at 12 months.

A

61%

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20
Q

_______ and ______ of recovery may be different across language domains.

A

Degree

Rate

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21
Q

What is often QUICK to recover?

A

Repetition

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22
Q

What is often SLOWER to recover?

2

A

Naming

Fluency

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23
Q

Where is more improvement noted in aphasia patients: Auditory Comprehension or Language Production?

A

Auditory Comprehension

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24
Q

Where is more improvement noted in aphasia patients: Oral Expression or Written Expression?

A

Oral Expression

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25
Q

What is the most important predictor of aphasia recovery?

A

Initial aphasia/stroke severity

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26
Q

What are the second most important predictor of aphasia recovery?

(4)

A

Number of lesions (worse with multiple)

Size of lesion

Location of lesion

Type of aphasia

27
Q

What are weak predictors of aphasia recovery?

4

A

Age

Handedness

Education

Intelligence

28
Q

What medical conditions are predictors of aphasia recovery?

2

A

Physical dependence

Other diseases

29
Q

What psychological conditions are predictors of aphasia recovery?

(3)

A

Depression

Enthusiasm

Motivation

30
Q

What lifestyle conditions are predictors of aphasia recovery?

(3)

A

Family support

Unlimited professional support

Unlimited financial support

31
Q

What personal decisions might predict aphasia recovery?

What do we need to ascertain? (2)

A

Refusal of treatment

//

Cognitive status

Does/can patient understand the consequences?

32
Q

Greater initial severity of aphasia is associated with ___________.

A

Poorer outcome

33
Q

The size of the lesion causing patient’s aphasia has __________ on recovery.

A

Negative influence

34
Q

Damage to what cortical area affects memory?

What role does this play on recovery?

A

Temporal

Always bad for recovery

35
Q

Persistent non-fluency is associated with lesions in ___________ and ____________.

A

Rolandic cortical areas

Underlying white matter

36
Q

Sparing of ___________ is positive prognostic sign for recovery of non-fluent speech.

This area is associated with ______ aphasia.

A

Lower Pre-Rolandic (face) area

Broca’s

37
Q

Sparing of ___________ is a positive prognostic sign for recovery of auditory comprehension.

This area is associated with ______ aphasia.

A

Posterior-superior temporal lobe

Wernicke’s

38
Q

For best aphasia recovery outcome, _____ needs to be dominant initially but ________ needs to regain control.

A

Right hemisphere

Left hemisphere

39
Q

What are the recovery odds if both hemispheres are involved?

40
Q

Compensatory right-hemisphere activity is inversely related to the _______________.

A

Restoration of the left-hemisphere language networks

41
Q

Comprehension in patients with Wernicke’s aphasia had a significantly higher greater median increase in their AQ than _______ and _______ at week 12 + 24 but less than ______ at week 24

A

Conduction Aphasia

Anomia

Global Aphasia

42
Q

Patients with ______ appear to have best prognosis for improvement in first year of stroke.

Why? (2)

A

Broca’s Aphasia

//

Comprehension preserved

Self-monitoring preserved

43
Q

The extent of improvement in patients with global aphasia is better than patients with _______.

Why?

A

Wernicke’s aphasia

//

There’s more room to improve

44
Q

Prognosis of post-stroke aphasia appears to depend, at least partially, on the __________.

A

Type of language impairment

45
Q

Patients with _______ had a better prognosis than those with Global and Wernicke’s Aphasia.

A

Broca’s Aphasia

46
Q

Lesions involving the _______ were seen to have worst overall scores and differed from controls

A

Medial-Temporal Gyrus

47
Q

Anterior portion of BA22 may be critical for comprehension of ___________.

A

Simple sentences

48
Q

In Laska et al.’s study, “Aphasia in acute stroke and relation to outcome” (2001), ___% had complete recovery, ___% continued to have significant aphasia, and ___% died.

A

~25%

~50%

~25%

49
Q

Were patients with non-fluent aphasias younger or older than patients with fluent aphasia?

50
Q

Did younger patients with aphasia show higher or lower degrees of recovery?

51
Q

What is a better predictor of aphasia recovery: fluency or CT results?

A

Fluency (better results with impaired fluency)

52
Q

When aphasia changes it typically progresses to a __________.

A

Milder form

53
Q

_______ is a common endpoint of aphasia evolution for both recovering fluent and non-fluent aphasias.

A

Anomic aphasia

54
Q

What aphasia types are associated with GOOD recovery?

4

A

Anomic

Conduction

TCMA

TCSA

55
Q

What aphasia types are associated with FAIR-GOOD recovery?

2

A

Broca’s

Some Wernicke’s

56
Q

What aphasia types are associated with FAIR-POOR recovery?

A

Wernicke’s

57
Q

What aphasia types are associated with POOR recovery?

58
Q

What aphasia types are associated with FAST recovery?

2

A

Conduction

Wernicke’s

59
Q

What aphasia types are associated with INTERMEDIATE (moderate speed) recovery?

(3)

A

Broca’s

TCMA

TCSA

60
Q

What aphasia types are associated with SLOW recovery?

2

A

Anomic

Global

61
Q

What information do we give for a prognosis?

2

A

What is going to improve (aphasia, functional communication, etc.)

When it is going to improve (2 weeks, 3 months, etc.)

62
Q

The question prognosis answers is will this patient with this __________
characterized by these _______ at given ___________ improve in communication functions given ____________ at ____________.

A

Specific syndrome

Symptoms

Levels of severity

Specified treatments

Specific points in time

63
Q

We should give patients hope but always err on the ___________.

A

Side of caution

ECU Brain, Language and Aphasia (11 decks)

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