Chapter 15 Flashcards
Aphasia
An impairment of the ability to interpret and formulate language resulting from brain injury
More than 1 million people in the US live with aphasia
Most people with aphasia acquire it after the age of 60
Up to 40% of all people with aphasia will experience chronic, severe language impairments across all modalities
Aphasia
Sequence of Neurological Steps for Communication are Affected
Comprehending what others say
Creating ideas
Retrieving words and sentence structures
Executing the motor movements to speak
Aphasia
Activities Impacted
Reading Writing Computing Emailing Using electronic devices and ATMs Listening in crowded or noisy venues Placing an order fro tangible goods Asking and answering questions in face-to-face situations and by telephone
Aphasia
TX Overview
Defies a straightforward, unitary tx approach
Early stages:
Help reestablish meaningful communication as rapidly as possible
Partner-supported AAC strategies can be beneficial
Determine whether individuals are likely to regain natural speech and functional comprehension
Restorative intervention strategies are emphasized
Later stages:
AAC strategies and interventions if aphasia continues to restrict participation in important life activities
High- and Low-tech Supports Serve Many Functions
- Enhancing the comprehension of individuals with auditory comprehension deficits
- Providing a means of expressing preferences, needs, or basic personal information
- Serving as a word or phrase bank for more elaborate topics
- Serving as a comprehensive communication tool to generate both spoken and written language
- Offering a specific technique to enable some individuals to participate with more independence
Aphasia Comm Strat
Usually involves multimodal communication strategies
Classification system:
Individuals who can learn to communicate independently with AAC strategies
Individuals who function best when AAC is used in partner-supported contexts
Hierarchy for Designing Interventions
Partner-Dependent AAC Communicators with Aphasia
-Emerging AAC Communicators
-Contextual Choice AAC Communicators
-Transitional AAC Communicators
Independent AAC Communicators with Aphasia
-Stored-Message AAC Communicators
-Generative AAC Communicators
-Specific-Need AAC Communicators
-Speech-Generating Device Choices for Independent AAC Communicators
Emerging AAC Communicators
Characteristics
- May be labeled as having global aphasia
- Have extreme difficulty speaking, using symbols, and responding to conversational output
- Apraxia of speech may be profound
Intervention Strategies
- Low-tech AAC strategies can assist
- Develop turn taking, choice-making ability with tangible -objects or photographs, referential skills, and clear signals for agreement and rejection
- Partners learn to provide choice-making opportunities
- Table 15.1
Contextual Choice AAC Communicators
Characteristics:
- Indicate basic needs spontaneously
- Recognize visual symbols
- Are aware of daily routines and schedules
- Do not have the linguistic ability to initiate or add to a conversation on their own
- May be labeled with global, severe Broca’s, transcortical motor, or severe Wernicke’s aphasia
Intervention Strategies
- Typically embedded within conversations about familiar topics
- Teach to point to what they are talking about, understand the meaningfulness of graphic symbols, make choices, and begin to ask questions
- Partners use “augmented input” techniques
- Table 15.2,
Intervention Strategies Continued
Written choice conversation approach
Figure 15.5
Yes/No Responses to Partner’s Tagged Questions
Figure 15.6
Augmented Comprehension (input) Techniques -Gesture, write key words, or draw to supplement speech (augmented input/augmented comprehension)
Transitional AAC Communicators
Characteristics
Use external symbols and strategies to help them communicate
May have fluent or nonfluent aphasia
Some gesture, draw, or speak to initiate conversations
May have communication notebooks or SGDs
Typically need cues from the partner to use an external strategy
Intervention Strategies
Focus on teaching to initiate
Intervention Strategies Continued
Introductions and topic setters
-Scripted interactions/role playing
-Present a remnant
Asking Questions
-Encourage them to point or gesture toward conversational partners to ask questions
-Hand-over-hand to point then move to modeling
Storytelling
-Consecutive segments of the story are prestored
Visual Scenes
-Action photographs with phrases printed adjacent to the photo
Stored-Message AAC Communicators
Characteristics
- Can independently locate stored messages within their low- or high-tech AAC systems
- Initiate communication
- Seldom generate enough novel info due to insufficient spelling, speech, and AAC skills
Intervention Strategies
- Create an inventory of messages and topics for specific situations
- Assist in storing these messages
- Need practice using their systems in role-playing or actual communication situations
Generative AAC Communicators
Characteristics
- Speakers and/or writers who can convey some novel info on their own
- Often fragmented or inconsistent for effective communication – breakdowns result
- May have conduction, moderate anomic, or Broca’s aphasia
Intervention Strategies
- Identify anticipated participation patterns, clarify communication needs, identify topics of interest, manage a variety of AAC techniques
- Include instruction and guided practice to teach when to use techniques
- Page 427 – difficulties using high-tech AAC systems
Generative AAC Writers: Intervention Strategies
Use writing with software
Includes spell checker, predictive text, and maybe prefabricated sentences
Page 429 Lightwriter mentioned
