9.3 RHD and Nonlinguistic Impairments

Question 1

what are nonlinguistic impairments that occur in people with RHD?

Answer 1

attention deficits
neglect
higher-level cognitive processing
anosognosia

Question 2

what is anosognosia?

Answer 2

lack of awareness of deficit or reduced awareness of deficits

Question 3

attention deficits in RHD

Answer 3

• reduced sustained attention (bad topic maintenance)
• reduced alternating attention
• reduced divided attention between multiple stimuli
• reduced selective attention; irrelevant content; inability to shift topics

Question 4

what is neglect in patients with RHD?

Answer 4

failure to report, respond, orient, attend to stimuli on the left side of the body despite normal motor/sensory function
although hey an see perfectly well

Question 5

what percentage of RHD show neglect?

Answer 5

80%

Question 6

assessment of neglect

Answer 6

scanning/cancelation tasks, line bisection, drawing, reading/writing

Question 7

treatments for neglect

Answer 7

scanning tasks
external stimulation; left neck vibration, prism glasses
presenting stimuli spanning the midline: have them actively attend to the entire space
training patient to actively manipulate objects in their space (remember to look at the left side of the page)

Question 8

higher-level cognitive processing deficits

Answer 8

organizing and sequencing: disjointed narratives with reduced cohesion
reasoning: impairment when needing to rely on implied meanings, assumptions of other’s knowledge, etc
problem solving: reduced ability to repair conversational breakdowns, reduced ability to convey emotions wen faced with dysprosodia

Question 9

assessment for higher-level cognitive processing

Answer 9

informal and formal methods; taking species from other tests

Question 10

treatment for higher level cognitive processing in RHD

Answer 10

no specific protocols for RBD but can use tx for cognitive impairments due to other causes

Question 11

issues with compensatory strategies

Answer 11

• strategies that are too specific may not generalize
• strategies that are too general are difficult for the person to teach and apply
• patient may have difficulty in abstract thinking, reasoning and problem solving impacts their use of the strategy)
• strategies may rely on attention which can be impaired with RBD

Question 12

for treatment it may be better to train patients with

Answer 12

habitual use of strategy to facilitate overcoming deficits (not to pick and choose)