Aphasia Flashcards
What is aphasia?
an disorder resulting from damage to the areas of the brain responsible for LANGUAGE
What are the aphasia pathway best practice statements?
consistency in _______, _______ and _______ for PWA
guidelines and _______ for _______, _______, and _______ _______
consistency in evidence, care and outcomes for PWA
most up to date guidelines and recommendations for assessment, management and client care
Which modalities does aphasia affect? (4)
ALL - speaking, reading, writing, singing
Does aphasia affect cognition?
Not necessarily
Explain the language component PHONOLOGY:
the study of the sound structure in language
Explain the language component MORPHOLOGY:
structure of words parts
Explain the language component SYNTAX:
how words and morphemes form phrases and sentences
Explain the language component SEMANTICS:
word meanings
Explain the language component PRAGMATICS:
appropriate communication in social situations
What are 6 general symptoms of aphasia?
trouble…
speaking clearly
understanding speech
writing clearly
understanding written words
remembering words
remembering object names
What are the 4 types of FLUENT aphasia?
(left to right on the Y/N blood flow chart)
wild…
Wernicke’s
Transcortical sensory
conduction
anomic
What are the 4 types of NON-FLUENT aphasia?
(left to right on the Y/N blood flow chart)
gibberish…
global
mixed transcortical
broca’s
transcortical motor
Anatomy: Broca’s area is also referred to as Brodmann’s area numbers…
44 and 45
Anatomy: Wernicke’s area is also referred to as Brodmann’s area number…
22
What is the common cause of a Broca’s lesion?
infarct of the superior division of the left MCA (middle cerebral artery)
What is the common cause of a Wernicke’s lesion?
infarct of the inferior division of the MCA (middle cerebral artery)
What is the Circle of Willis?
provides compensatory blood flow if damage to one artery occurs.
reduces damaging effects
What are the symptoms of Broca’s aphasia? (4)
limited verbal output
articulation errors
understanding may be better than speaking
verbal output mirrors writing (reading intact)
What are the symptoms of Wernicke’s aphasia?
verbal output intact (can use nonsense words)
comprehension affected
no awareness
difficulty understanding written words and trouble writing
What are some features of anomic aphasia?
Think: orange naming activity
verbal output is good
word finding difficulties
naming difficulties
What are some features of global aphasia?
severe verbal and comprehension deficits
reading and writing highly impacted
What is communication partner training?
Conversation Partner Training is an evidence-based intervention that teaches communication partners how to best support conversation and interaction for a person with aphasia (PWA).
What are some strategies to teach in communication partner training? (7)
writing key words
gesturing
drawing
picture supports
simplifying speech
asking questions to verify
eliminating distractions
What are the two aims of supported conversation in adults?
Competence x2
acknowledging competence (speak naturally, keep trying, use resources)
revealing competence (support to get the message IN and OUT)
What is the purpose of formal assessment of aphasia? (4)
base
type
dev
rev
baseline - strengths and weaknesses
type of aphasia
development of treatment goals
review progress
What are the three types of assessment for aphasia?
(level of assessment not names)
screeners (identifies the need for further assessment)
full test batteries
specific test batteries for specific functions (cognition, reading etc.)
Explain what a comprehensive aphasia assessment involves: ICF (5)
impairment of body structures and functions
comorbid deficits
limitations in activity and participation
environmental and personal factors - barriers or facilitators
impact of communication impairments on quality of life
Speech and language areas assessed for aphasia: (6)
spont…
spontaneous speech
repetition
speech comprehension
naming
reading
writing
What is neuroplasticity and how does it occur?
ex
rep
Our brains adapting and building new pathways through exposure and repetition
Occurs through repeated environmental and behavioural changes
What are the 5 processes in aphasia therapy?
info
collab
base
ther
reax
information gathering and sharing
collaborative goal setting
pretherapy assessment/baseline
therapy
reassessment
What are some examples of aphasia goal setting tools?
aphasia impact questionnaire
social network maps
A-FROM
What is the A-FROM and it’s four domains?
Aphasia - framework for outcome measurement
adapted from the ICF - helps with goal setting
- language and related impairments (your aphasia)
- environment
- participation
- personal factors
What is the LPAA?
Life participation approach to aphasia
It focuses on re-engagement in life
Across the continuum of care
Therapy: impairment based vs participation/function based?
Why do we use both?
We need to balance impairment based with functional/participation based approaches to ensure we are supporting PWA to adjust to life with aphasia.
What is functional based therapy? Give an example
Functional based therapies target the person with aphasia’s ability to complete a task that impacts their participation in important and every day activities.
Example: A PWA attending an aphasia group to participate in conversational therapy and practice communicating in a supported environment
What is impairment based therapy? Give an example
An impairment based therapy targets a very specific impairment to try and improve accuracy.
Example: A PWA will read out 10 x 5 word short sentences to improve accuracy of word finding.
What is the speech pathologist’s role in working with PWA?
Give two examples
It is our role to support PWA and others in their network/world to adjust to living with aphasia in a client centred way
examples:
reducing barriers to inclusion and participation
supporting the PWA’s QoL
When planning speech pathology services to PWA, we need to understand…
Give three examples
individ
values
choose
the highly individualized experiences
values, wants and priorities of the PWA
PWA right to choose
What are the two main psychosocial impacts of aphasia?
social isolation
depression
What is the relationship between stroke and depression? (3)
One in three people experience depression at some point during the five years after their stroke.
Depression is most common in the first year after a stroke, however it can happen at any time. Anxiety may also occur, either by itself or together with depression.
Partners, carers and family members of stroke survivors can experience depression and anxiety as well.
How do we assess the psychosocial impacts of aphasia? (2)
Assess the i_____ …
Quality of life measures
Assess the impact not the impairment
What are the three quality of life measures?
wellbeing related
social participation
health related
What are four therapy options that address psychosocial impacts and adjustments for PWA?
group therapy
LPAA (life participation approach to aphasia)
conversation therapy/conversation partner training
working with friends, family and carers
What is the link between
identity
quality of life
depression
poor outcomes
Aphasia / loss of ability to communicate impacts upon our IDENTITY
Loss of IDENTITY impacts upon QUALITY OF LIFE
Reduced QUALITY OF LIFE can lead to DEPRESSION
DEPRESSION leads to poor outcomes
What are the 5 main causes of aphasia?
Categorize as sudden (2) and gradual (3)
sudden: stroke, head injury
gradual: infection in the brain, brain tumor, dementia
What are paraphasia’s? Give an example for each below
Semantic (related word substitution)
Phonemic/literal (part word-sound substitution)
Verbal (unrelated word substitution)
Neologisms (non-English substitution)
substitution of a word by a sound, an incorrect word, or an unintended word
Semantic: orange instead of apple (often same part of speech)
Phonemic/literal: paker for paper
Verbal: pillow instead of lemonade
Neologisms: tilto for table
What is perseveration?
repetition of words or parts of words, phrases
What are two frameworks for assessment of aphasia?
ICF
Best Practice Statements
