aphasia in special populations Flashcards
lang. changes in normal aging
-older people may develop slight dysfluencies in language expression and at the same time may produce language with diverse themes and meanings of words
-mild auditory comprehension problems are also possible which could be partially attributed to auditory perceptual deficits
some of the common changes due to aging include deficits in
word retrieval, circumlocutions, minimal deficits in discourse production, and variable deficits in auditory comprehension
factors causing these changes
-received working memory
-slow cognitive processing
-additional hearing and visual changes
dementia
progressive decline of cognitive functions, changes in personality and behavior, and impairment of social and psychosocial adaption
Alzheimers disease
common form begins with memory deficits followed by language dysfunction and visuospatial deficits. memory deficits are due to changes in medial temporal lobes. lang. deficits occur due to changes in lateral temporal regions. aphasia may coexist with AD ranging from anomic aphasia early on followed by transcortical sensory aphasia and wernickes aphasia
commonly used assessments
arizona battery for communication disorders of dementia (ABCD), CLQT, and dementia rating scale (DRS-2)
symptoms associated with mild stages of AD
-some self-awareness
-fluent, well articulated and grammatical verbal expression with mild word-finding deficits and empty, circumlocutory speech
symptoms associated with moderate stages of AD
-self-awareness begins to disappear
-memory deficits begin to interfere with language skills including difficulty remembering questions and answers
symptoms associated with late stages of AD
-severe lang. deficits in comprehension and expression
-swallowing deficits
primary progressive aphasia (PPA)
includes neurodegenerative disorders with progressive language deficits. may be of either fluent or nonfluent types
diagnosis of PPA is made when
an individual has had aphasia for at least 2 years from the recognized time of onset
language changes associated with nonfluent PPA
-spontaneous verbal output including shorter-than-normal phrase length, word-finding deficits, agrammatism, and deficits in speech production and prosody
-deficits in reading and writing
-relatively preserved auditory comp.
-as global dementia develops, cognitive problems in memory, executive functioning, and visuospatial functions may occur
lang. changes associated with fluent PPA
-fluent verbal expression including phrases and sentences of average or longer-than-average phrase length
-anomia
-content words are replaced by indefinite terms or empty circumlocutions
-fairly preserved grammar and artic.
-deficits in reading and writing
-semantic dementia has similarities with wernicke’s aphasia including deficits in ad. comp.
logopenic ppa
-defcits in word retrieval
-relatively intact grammar and motor speech skills
-deficits in lexical retrieval and repetition
-slow rate of speech
tx considerations for PPA
-aphasic tx programs useful for early stages of PPA
-tx should focus on maintenance of functions and prevention of decline rathr than improvement of functioning
-AAC options may be considered
-family counseling due to poor prognosis
cognitive-communication interventions for PPA
-AAC options may be beneficial for individuals with PPA who may not have developed demntia
-memory books helpful
multicultural considerations
-cultural differences should be taken into cosideration during assessment and treatment
-some cultures may view dementia as a natural consequence of againg rather than a disorder
-individuals of some cultures may therefore not want to seek assessment and treatment for dementiaissues
tbi
-penetrating head injures may lead to aphasia
penetrating head injuries (open)
when a brain injury leads to a fracture of the brain skull or cranium
closed head injuries
when brain injury does not cause a fracture
blast injury
includes injuries due to rocket-propelled grenades, landmines, and improvised explosive devices
diagnosing aphasia with concurrent TBI
-documented loss of consciousness
-amnesia for the actual traumatic event
-score of 3 or more on glasgow coma scale
mild injury
duration of amnesia up to 1 hour
moderate injury
duration of amnesia up to 1 day
