Aphasia Therapies Flashcards
1
Q
What is Melodic Intonation Therapy
A
- MIT
- Hierarchical treatment that uses the musical elements of speech (melody & rhyme) to improve expressive language by utilizing the preserved function of singing which engages the right hemisphere.
2
Q
Who is MIT for:
A
- Nonfluent aphasias, especially severe cases
- Broca’s aphasia
- Relatively good auditory comprehension
- Poor repetition
- Poor articulatory agility
- Good emotional stability, motivation, and attention span
3
Q
Why singing with MIT?
A
- The reason why MIT is based on using melodic and rhythm elements of speech is because although we know that expressive language is severely impaired in nonfluent aphasias, the ability to sing remains intact
4
Q
MIT Hierarchy
A
- 3 levels
- First two levels- multisyllabic words and short, high probability phrases are intoned musically and tapped out syllable by syllable
- The third level introduces longer or more phonologically complex phrases.
- – These longer phrases are first intoned and then produced with exaggerated speech prosody and then spoken normally.
5
Q
MIT and auditory motor feedback
A
- When words are sung, phonemes are isolated and thus, can be heard distinctly while still connected to the word.
6
Q
Response to Elaboration (RET)
A
- Response to elaboration training is a loose training and patient response initiation intervention centered upon forward-chaining.
- RET uses modeling, scaffolding, and expansion to get more linguistic information out of nonverbal patients
7
Q
Methods we use in RTI-
- Scaffolding
- Expansion
- Cueing
- Shape
- Modeling
A
- SLP wants to constantly budge against the ZPD and help the client along with scaffolding
- Clinician expands on patient’s response and adds more content words
- Ask open ended questions when patient gets stuck
- Improve patient’s response and make it more conversational
- Connect uttered words and make model sentences, asking the client to repeat
8
Q
6 Steps for RET Intervention
A
- Show pt. picture (action usually)
- Pt. responds, SLP reinforces, expands, and shapes pt.’s utterance.
- Wh- questions to further promote speech
- Pt. 2nd response, SLP reinforces, combines, and shapes two responses into a sentence
- Clinician models sentence and requests imitation
- Reinforce pt. sentence, provide 2nd model
9
Q
About RET
A
- generative and spontaneous
- SLP should encourage and build upon pt.’s utterences
- Generalization is key
- Use both verbal and non-verbal reinforcement to promote pt. response initiation
- Pictures, photos, or line drawings all work for stimuli, so choose whichever best fits the therapy setting.
10
Q
Life Participation Approach to Aphasia
A
- LPAA
- consumer driven service delivery approach that supports individuals with aphasia and others affected by it in acheiving their immediate and long term life goals.
11
Q
5 Core Values of LPPA
A
- Enhancement of life participation
- Emphasis on availability of services
- Personal and environmental factors are targeted
- Success is measured by life-enhancement changes
- All those affected are entitled to services.
12
Q
LPPA focus
A
- focuses on real-life goals of people affected by aphasia
- Emphasizes re-engagement in life by participating in activities of choice
- This therapy approach relies on motivation and a consistent and dependable support system
- Clinicians need to consider both transmitting and receiving messages as well as maintaining social links
13
Q
Role of SLP in LPPA
A
- facilitator of functional independence
- Assists and advices in decision making
- Treats all involved
- Creates goals of life enhancement with input from the client
- Seeks mutual agreement on the duration of therapy with the client
- Helping the client stay socially connected
- Helps empower the person with aphasia
14
Q
Visual Action Therapy (VAT)
A
- Functional/ compensatory approach
— focuses on production at the single gesture level
- Uses real line drawings, pictures, and simple figures using the objects to train the client
- Non-vocal visual/gestural program
— SLP models for the patient how to communicate non-verbally via gestures and pantomime
15
Q
Who is VAT for?
A
- Individuals with severe aphasia
- Left hemisphere stroke
- Global (needs to be mild) or Broca’s Aphasia
— Inability to speak or write
— limb or oral apraxia
— limited ability to communicate through gestures
— good nonlinguistic visuospatial and memory skills
16
Q
VAT includes 3 phases/variations
- Proximal
- Distal Limb
- Bucco-facial
A
- Whole/gross arm movements of shoulders, arms, and fingers
- Finer movements of finger’s and hands
- Movements of the mouth and face
17
Q
3 Levels of VAT
A
- Level 1- real objects (all 10 steps)
- Level 2- action pictures of objects (start at step 5)
- Level 3- pictures of objects (start at step 5)
18
Q
VAT Steps 1-5
A
- Matching pictures and objects
- Manipulating objects
- Instruction of action picture commands
- Following action picture commands
- Pantomimed gesture demonstation
19
Q
VAT Steps 6-10
A
- Recognizing pantomimed gestures
- Instruction of pantomime gestures
- Producing pantomime gestures
- Instruction of pantomimed gesture for absent object
- Producing pantomimed gestures for absent objects
20
Q
Divergent Word Retrieval
- Definition
- Emphasis
- Goal
A
- generation of logical alternatives from a set of given information
- Is on a variety, quantity and relevance of output form one source
- Generate many different ideas about a topic in a short period of time.
21
Q
Divergent responses are evaluated according to:
A
- Number of ideas produced (fluency)
- Variety of ideas suggested (flexibility)
- Originality
- Relevance
** 1 stimulus with a lot of potential solutions (convergent only converges on 1 pt, 1 soulution, divergent has numerous solutions
22
Q
Divergent Semantic Model
A
- spontaneous communication requires the use of a divergent semantic strategy
- initally focuses on orientation and attention
—- pt. need to hear and grasp the divergent semantic behaviors of others over and over
—- no verbal response needed during intial stage
—- if patient does respond verbally it is important to reinforce heavily
- When individuals produce divergent verbal responses, intervention should focus on strengthening the ability to retrieve numerous and varied semantic responses through continuous reinforcement of relevant responses.
23
Q
Recommendations for Divergent Word Retrieval Therapy
A
- Common situations- list problems that are inherent in a common situation
- Brick uses- list many different uses for a common object
- Product improvement- suggest ways to improve an object
- Consequences- list the effect of a new and unusual event
- Object Naming- list objects that belong to a broad class of objects (name all objects that roll)
24
Q
Non-symbolic Movements for Activation of Intention
Intention Treatment or Intention Gesture Treatment
A
- Activating areas in the rt. hemisphere that are responsible for intention, through nonsymbolic movements with the left hand to improve word production.
- Intention areas support language by facilitating word selection and initiation of speech.
- Research studies had shown that left handed nonsymbolic movements while naming objects will increase naming ability.
