Aphasia Assessment And Treatment Flashcards
Screenings:
Boston naming
ALPS
quick assessment for aphasia
Informal assessment areas:
Conversation(pragmatics, syntax, prosody, articulation, phrase length)
Naming tasks (confrontation naming/generative naming)
Repetition
Auditory comprehension
Reading comprehension
Writing
Automatic sequences
Orientation X3
Formal assessment:
BDAE
WAB
CLQT
Treatment options
Treat cognitive domains as well:
Also treat metacognitive skills:
Memory, problem-solving, pragmatics, attention, and visuospatial skills
Self-awareness, insight, motivation, self-monitoring, goal oriented behavior
Unique considerations for aphasia:
A) teach compensatory strategies-likely not to regain 100% of skills
B)functional goals
C) repeated practice-massed and intensive
D) client specific goals
E)co treat whenever possible
Rosenbek’s Principles for Aphasia
a. Prepare for a lifetime of aphasia
b. Patient’s personality is generally intact
c. May need psychological counseling
d. Individualized therapy initially, later group may be beneficial
e. Motivate with success
F. Give homework for best results-promotes generalization
G. Consider AAC
Restorative therapy approaches:
Melodic intonation therapy (MIT)
Errorless learning therapy
Compensatory therapy activities
Melodic intonation therapy (MIT)
Uses in tact Melody processing and right hemisphere to help retrieve words and expressive language
75% of patients improved with MIT in original study
Modeling and eliciting functional words/phrases and progress through various levels
May sound sing-songy….it’s hard to train out
Errorless learning therapy:
The concept is to prevent the patient from producing errors in therapy to avoid reinforcing error production
Set difficulty level just above patient’s ability
Difficulty level set low to avoid errors
Lots of repetition and drill, slowly increased difficulty
Compensatory therapy activities
AAC
Low tech devices or high-tech devices
Better with low-tech
Formal treatment for nonfluent aphasias:
- MIT
- SPAA/HELPSS
- Rosenbeck changing criteria program
MIT for nonfluent aphasia a:
Work on incorporating prosody back into speech by using tactile cues and unison intonation to help the client to remember prosodic cues
SPPA/HELPSS
Increased complexity of sentence usage by client
Use repetition and story completion tasks to go through a series of sentence types in order to help the client increase utterance length and use a different array of sentence types
Rosenbeck changing criterion program:
Used to increase length of utterance
Discuss a picture with the client and ask different questions
Reinforce different utterance links that increase as you continue through the program
Treatment for global aphasia
Gesture approaches- AmerInd, pantomime
AAC (lingraphica, C-speak aphasia
Back to the drawing board
Auditory comprehension (matching pictures, playing cards)
Verbal expression (conversational prompting, associating meeting with speech movements)
Treatment for fluent aphasia
Increase auditory comprehension of every day messages
CAIAC-cognitive approach to improving auditory comprehension
Decreased jargon and improve intelligibility
Treatment for wernickes aphasia:
Increase auditory comprehension of every day messages
Client goes from matching pictures and written words to reading the words, then repeating them, to identifying the picture upon hearing the word
CAIAC-cognitive approach to improving auditory comprehension
To improve understanding of every day messages
Uses cognitive skills outside the modality of verbal output where the client uses attention to improve auditory comprehension
Goes through a series of different tasks such as cancellation, alternating pattern and odd man out pictures
Decreased jargon and improve intelligibility:
Use a theme to have individual know what they’re talking about and slow the rate down
Begin by addressing yes/no responses then increase the phrase like
Treatment of right hemisphere impairment
Deficit areas:
o Initiation
o Memory
o Left-neglect
o Pragmatics
o Attention
o Facial Recognition o Prosody
Right hemisphere impairment assessment:
Screening (interview, scene interpretation, cancellation tasks)
Mini inventory of right brain injury
Rivermead behavioral memory test
Treatment of right hemisphere impairment:
MIT-Prosody
o APT – attention and memory
o Environmental changes – neglect
o Story interpretation – initiation
o Social stories and convo about social
appropriateness
