AOS and RHD Assessment

Question 1

RHD Assessment

Answer 1

• often assessments are task specific
• may use subtests from other cognitive/TBI evaluations
• mini inventory of right brain injury (MIRBI)
• behavioral inattention test (BIT)
• rehabilitation institute of chicago evaluation (RIC)

Question 2

RHD Linguistic Deficits

What should you assess?

Answer 2

• assessment should provide evidence for ruling in/out aphasia; usual test batteries will serve well
• be sure to assess metalinguistic tasks

— interview

— picture description

• antonyms?
• does your pt have excessive/rambling speech?
• does your pt focus on insignificant details?
• humor; failed attempts at expressing humor
• can your pt order/arrange sentences into appropriate/coherent narratives?

Question 3

RHD Nonlinguistic Tasks 1

Answer 3

• neglect:

— use more than one task to assess for neglect deficits

— cancellation tasks: “cross out all of the circles”

— scanning tasks

— line-bisection tasks

— read aloud using compound words/sentences (linguistic)

— copy a paragraph

— draw an object with radiating features

———-clock, sun, bicycle, wheel, daisy (symmetrical items)

— draw a self-portrait

Question 4

RHD Nonlinguistic Tasks 2

Answer 4

• visuospatial perception:

— judgment of line orientation (JLOT)

— raven’s colored progressive matrices

• graphic expression:

— writing to dictation

— pt may perseverate w/images/letters that contain vertical lines

a. example: mom, minimal, nominal, lillian
b. llllllliiiitttttttlllllllllllllle
c. counter this by having the pt fill in boxes
- Visual memory and 2D constructions:

— Rey Odterrieth Complex Figure Test

Question 5

AOS Assessments

Answer 5

1. Detailed case history, careful examination of the medical records, interview of client and family members, and detailed observation of speech production are necessary to make a diagnosis
   - Procedures designed to diagnose aphasia should be used if the individual also shows signs of broca’s aphasia
   - Apraxia is sometimes known as dyspraxia (disordered movement)

Question 6

AOS Assessment Procedures

Answer 6

Use informal procedures

• tape record speech samples and transcribe responses (note dysfluencies, delayed reaction, artic. errors, facial grimacing, and other apaxic behaviors)
• evoking imitative production of a speech sound
• AMR’s /pʌ/ /pʌ/ /pʌ/
• SMR’s /pʌ/ /tʌ/ /kʌ/
• imitative production of words of increasing length
• imitative production of phonetically complex words (statistics, catastrophe, statistical analysis)
• imatitative producation of sentences
• counting responses (1-20) (check for consistency)- automatics
• picture descriptions
• assessment of oral reading
• Assess for oral apraxia
• perform formal assessments also

Question 7

Oral Apraxia

Answer 7

• Informal assessment
• test the integrity of the patient’s nonverbal speech movements
• Have them:
• blow
• whistle
• puff out cheeks
• show me your teeth
• pucker your lips
• bite your lower lip
• smack your lips
• stick your tongue out
• move tongue in and out
• cough
• alternately pucker and smile

Question 8

Formal AOS Assessments

Answer 8

1. Apraxia Battery for Adults
   - Diadochokinetic tasks, words of increading length, naming pictures (timed), oral reading, automatic speech tasks (counting), and spontaneous speech
2. Motor Speech Evaluation
   - Screening tool, takes less than 20 minutes
   Descriptive scoring and includes 11 traditional tasks
   Multidimensional with the use of PICA
3. The Comprehensive Apraxia Test (CAT)
   - Oral volitional movements, phoneme production, AMRs, syllables in nonsense and real words, utterances of increasing length, and nonsense items.