Aphasia Flashcards
Aphasia
an impairment of language, affecting the production or comprehension of speech and the ability to read or write. It is always due to injury to the brain-most commonly from stroke, particularly in older individuals. Brain injuries resulting in aphasia may also arise from head trauma, brain tumors, or from infections.
Intellectual ability is not typically impaired.
What is language
Expressive- using words, using sentences, expressing thoughts
Receptive- Understanding directions, comprehension of words, comprehension of grammar, understanding words, sentences, and meaning
speech???
Aphasia is purely language (can be some overlying speech problems with aphasia)
Right hemisphere
difficulty with organization, abstract thinking, holistic tasks, melody
Holistic thought
Intuition
Creativity
Art and music
Left hemisphere
where language centers are located
Analytic thought
logic
language
science and math
Brain stem
Motor control
Left handed individuals sometimes have better cross over functioning.
Broca’s area
(very close to our motor strip) non fluent aphasia- language is very halting and effortful, by far the most common type you see.
Wernickes area
Fluent aphasia (difficulties with understanding) words sound normal with rate and rhythm but doesn’t make sense. (more difficult to treat). patients cant comprehend what you are saying.
Aphasia is not
Dementia,
Confused language,
Schizophrenia,
Neurogenic speech disorders (apraxia, dysarthria)
Classification of aphasia
- Language fluency- smooth easy, forward flowing
- –Language impairment
- Production (expression)- short/tiny words?
- Comprehension
- Naming- confrontational naming (naming objects)
- Repetition- being able to repeat a spoken word.
- Modality- Speaking, listening, writing, reading
Anatomical regions
TMA- non fluent
Transcortical motor aphasia- More rare, a non fluent aphasia (can understand and repeat but a very strong motor component)
good comprehension,
good repetition,
Grammar can be normal,
Difficulty initiating and organizing responses.
Global aphasia- non fluent
significant understand and speaking, all modalities impaired.
Poor comprehension, poor repetition, more guarded prognosis, A severe form of aphasia, inability to read or write,
Isolation aphasia- non fluent
rare, affected one small part
TSA- fluent
transcortical sensory aphasia (parrot) repetition is so intact the patient has a hard time controlling it and may repeat all the time.
output may be meaningless or unintelligible, poor comprehension, intact repetition, more rare, difficulty reading and writing
(similar to Wernicke’s but output is not intelligible (made up words with sounds that are transposed)).
Conduction- fluent
reading comprehension is well preserved/good
good comprehension,
poor repetition,
quite rare,
individuals are usually aware of their errors (unlike Wernicke’s)
Anomia-fluent
Word finding difficulties
Marked difficulty with word retrieval and naming, Comprehension is usually very good, usually mild, prognosis is good, Can use strategies to compensate,
Usually limited to infrequent ability to recall words.
Broca’s Aphasia
Non-fluent,
Poor repetition,
Good comprehension usually,
Halting, effortful,
“telegraphic) in nature,
Content words are present (nouns and verbs).
Function words are omitted (articles, auxiliaries)
Wernicke’s aphasia
fluent, poor comprehension, poor repetition, not as common as brocas, word jumble, often do not have accompanying hemiparesis.
Therapeutic interventions- SLP
variety of language based interventions depending on type of aphasia,
helpful to know prior level of function, occupation, educational level, and support network.
therapy tends to be compensatory and restorative
Factors impacting recovery
- Type of stroke
- Lesion size
- age
- handedness
- gender
- motivation
- depression
- mono vs bilingualism
Plasticity
the changes effected by repeated behavior following an injury; the changes in brain activity associated with tasks performed in an attempt to compensate for the impaired function.
Use it or lose it
OT????
may provide:
- therapeutic intervention
- patient education
- directions to a client who has a difficulty with receptive or expressive language.
Important to know their cognition and intelligence is not affected by stroke
important to know the clients personal goals
S.L.O.W.
S: shorter sentences! use shorter, simpler sentences
L: less information at a time! give one direction at a time
O: Observe! is your client understanding you? Do you need to use a gesture in addition to your words?
W: Wait! give the client time to process and respond. Even if their comprehension is good they may still need extra time.
