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Adult Language Disorders > Aphasia Final > Flashcards

Aphasia Final Flashcards

1
Q

Principles of Adult Learning

A

Self Concept
Prior Experience
Readiness to Learn
Psychosocial consequences of injury

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2
Q

5 Steps During Therapy

A
  1. Info gathering
  2. Collaborative goal setting
  3. Pretx assessment (baselining)
  4. Treatment
  5. Reassessment
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3
Q

Aphasia Treatment Essentials

A

CAPE

  1. Connecting PWA
  2. Augmentative/Alternative Communication
  3. Partner Training
  4. Education & Resources
    * “Aphasia friendly” info
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4
Q

Steps of Good Evidence-Based Practice

A
  1. Frame clinical question (PICO)
    - Population, intervention, comparison, outcome
  2. Find/assess scientific evidence
  3. Analyze evidence
  4. Integrate external evidence w/ client values and circumstances
  5. Self-assessment/evaluation
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5
Q

Phase 1 - Pre-efficacy Studies

A
  • See if evidence has therapeutic value

- Small sample sizes, case studies, single-subject design

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6
Q

Phase 2 - Pre-efficacy Studies

A
  • Develop, standardize, optimize & validate procedures
  • Explain why treatment works, who are ideal candidates
  • Small group and case studies
  • More hypothesis driven than phase 1
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7
Q

Phase 3 - Efficacy Studies

A
  • Test treatment efficacy under ideal conditions of use
  • Randomized control trials
  • Large samples, control/parallel groups
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8
Q

Phase 4 - Effectiveness Studies

A
  • Effectiveness of treatment under ordinary use

- Large samples of target population

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9
Q

Phase 5 - Effectiveness Studies

A

-Explore efficiency, cost-benefit, PT/family satisfaction, QoL

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10
Q

Class III Evidence

A

Weakest level

  • Expert opinion, case series, case reports, historical controls
  • Single subject multiple baseline across behaviours
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11
Q

Class II Evidence

A

Intermediate Level

  • Well-designed observational studies w/ concurrent controls
  • Single subject multiple baseline across subjects
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12
Q

Class I Evidence

A

Strongest Level

-One or more well-designed, randomized, controlled clinical trials, including overviews (meta analysis of such trials)

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13
Q

Constraint-Induced Language Therapy (CILT/CIAT)

A

Based on CIMT principles, it’s a “small group therapy”.. using therapeutic language games restricting responses to only spoken language

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14
Q

CILT Principles

A
  1. Constraint/Forced Use
  2. Massed Practice
  3. Behavioural Shaping
  4. “Enriched environment”
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15
Q

Pros of CILT

A
  • Large gains over short time
  • Group therapy
  • Quick/cheap materials
  • Sense of ownership over own rehab
  • Active engagement
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16
Q

Cons of CILT

A
  • Time commitment
  • Huge family involvement
  • Not appropriate for all aphasia types
  • People use non-verbals a lot
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17
Q

Intervention for Anomia

A

Cueing hierarchies

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18
Q

Cueing Hierarchy Steps

A
  1. Determine what cues facilitate PT’s word retrieval
  2. Arrange cues in hierarchy (least to most or most to least supportive)
  3. Present pictures/objects
  4. If PT can’t correctly name object, start with first cue @ the top of the hierarchy
  5. If following that cue PT is still wrong, use next cue
  6. Continue w/ cues until PT is able to name the item correctly
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19
Q

Semantic Anomia Treatment

A

Stimulation approach

  • Strengthen semantic representations
  • Increase comprehension & production (naming)
    ex: sorting or matching pics by categories, spoken or written word picture matching, answering Qs about target items, “Semantic Feature Analysis”
  • Use atypical exemplars to generalize
20
Q

Phonological Anomia Treatment

A

Stimulation approach
-Strengthen/facilitate access to phonological representations

Comprehension tasks: spoken word to picture or written word matching

Production tasks: repeating, reading aloud, naming using phonological cues in hierarchy

21
Q

Self Cueing Strategies

What is it, candidates?

A

“Self analysis” to avoid and self-correct errors
-Foster self-generated cues, facilitate removal of intended word

Chronic mild-moderate aphasia with anomia as major symptom

22
Q

Training Semantic Self-Cueing

What, who?

A
  • Facilitate circumlocution to trigger wd retrieval
  • Resolve communication breakdowns by producing semantic info
  • Mild-moderate aphasia (anomic, conduction, Broca’s), need some intelligible utterances
  • Not for AOS

-Train PT to use “Semantic Feature Analysis”

23
Q

Phonemic Self-Cueing

What, who?

A

-Get PT to provide own phonemic cue

Need intelligible expressive language, good auditory comprehension, can write word or initials

“Relay words” to make letter sound association

24
Q

Pure Alexia

A

LBL reading
Impaired access to orthographic lexicon
Word length effect
PCA stroke

25
Q

Surface Alexia/Agraphia

A

Difficulty w/ irregular words
Over-reliance on sublexical phonology
Regularity Effect
PCA stroke

26
Q

Phonological Alexia/Agraphia

A

Difficulty with non-words
Impaired sublexical route
Lexicality effect
MCA stroke

27
Q

Deep Alexia/Agraphia

A

Damage to lexical-semantic & sublexical
Semantic errors
MCA stroke

28
Q

Global Alexia/Agraphia

A

Damage to lexical-semantic & sublexical
Severely impaired spelling words & nonwords
Large MCA stroke

29
Q

Multiple Oral Reading (MOR)

A

Repeated oral reading of text to increase rate/accuracy
Text-based alexia treatment
For: pure, phonological, mixed, deep alexia

30
Q

Oral Reading for Language in Aphasia (ORLA)

A 
Repetitive multimodal (reading, pointing & auditory input) stimulation presented to elicit response
For: deep, mixed alexia/aphasia across range of severities (possibly AOS too)
31
Q

Cross-modality Cueing

A

Tactile/kinesthetic tx that bypasses the visual access to the orthographic lexicon “training up” letters to speed up accuracy of reading

For: Pure alexics with POOR letter identification/ naming

32
Q

Writing Treatment: Lexical Approach

A

Retraining spelling of specific words
For: Global, deep agraphia (maybe severe aphasia)
Tx: CART, ACT

33
Q

Copy and Recall Treatment (CART)

A 
Lexical spelling treatment:
Present a picture
PT names it
If right, PT writes it
If wrong, they write it 3 times
34
Q

Anagram & Copy Treatment (ACT)

A

Lexical spelling treatment:
They write word
If wrong, present letters & make them spell it
If right copy 3 times
If wrong, clinician arranges letters correctly & they copy 3 times
etc.

35
Q

Writing Treatment: Phonological Approach

A

Retraining sound-letter correspondences using “key words”, CART, & cueing hierarchy
For: Phonological agraphia

36
Q

Interactive Approach

A

Training interactive use of residual lexical and phonological knowledge to improve spelling
*Establish problem-solving procedures: use phonology to sound out, self-detect, check w/ app
For: Surface agraphia

37
Q

Treatment for Aphasic Perseveration (TAP)

A

Bring perseveration to awareness, help PTs suppress it & produce correct responses
For: Mod-severe perseveration during confrontation naming, good auditory comprehension, good memory

38
Q

Melodic Intonation Therapy (MIT)

A

3 level hierarchical tx to stimulate prepositional speech skills
-Intone high probability phrases & sentences
For: LH stroke, non-fluent, poor artic, some intelligible utterances while singing, poor repetition, good auditory comprehension, good attention/motivation, can do intensive therapy

39
Q

3 Types of Perseveration

A
  1. Stuck in set - frontal lobe
  2. Continuous - dementia, RHD
  3. Recurrent - aphasia
40
Q

Management of Perseveration

A 
TAP
Explain tasks
Establish when using new sets
Use visual cues
Avoid quick stimulus presentation
41
Q

LPAA Core Values

A
  1. *Enhance life participation
  2. All affected get services
  3. Documented life-enhancement changes
  4. Personal/environmental factors considered
  5. Emphasis on available services at all stages
42
Q

Health Related Quality of Life (HQoL)

A

Impact that health status has on a person’s ability to lead a fulfilling life

  • Functional communication ability/linguistic ability
  • Emotional state/psychological well-being
  • Social support
  • Social participation
43
Q

Parameters that Define Cultures

A 
Individualism vs. Collectivism
View of work
Space & time
Language (formal/informal, pragmatics, non-verbals)
Roles
Rituals/superstitions
Class & Status
Values
44
Q

Factors affecting Aphasic Impairments in Bilingual/Multilinguals

A

Sociocultural history
Acquisition & communicative experiences
Cognitive stratgies

45
Q

Types of Bilingual Aphasia Recovery

A 
Parallel recovery (most)
Non-parallel recovery (differential, blended, selective)
46
Q

Aphasia Framework for Outcome Measurement (A-FROM)

A 
Considers: WHO-ICF (QoL) +
Language impairments
Participation
Personal Factors
Communication envt
Goal: Living successfully w/ aphasia!

Adult Language Disorders (1 decks)

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