chapter 7 Assessment of Communications and Related Functions

Question 1

What should be considered when selecting a test

Answer 1

• patient, place of employment, insurance, type/severity of injury, time limitations
• screenings vs comprehensive test
• time limitations
• suspected severity of lesion
• need to find site of lesion
• relationship between characteristics and site of lesion
• referral, recovery rehabilitation
• progress documentation

Question 2

what information should be included in an administered test

Answer 2

• purpose(screening, comprehensive, type of disorder )
• Administration/scoring (reliability, validity, user-friendly, etc.)
• Interpretation (severity characteristics, diagnosis, modality strengths/weaknesses,etc)
• Standardization (norms are available)

Question 3

What are the components of a Standard Language Assessment (Aphasia)

Answer 3

Auditory
Verbal (oral) Expression
Visual (reading) Comprehension
Graphic (writing) expression
Other areas

Question 4

Auditory component of standard language assesment includes:

Answer 4

• should require little verbal responses; should use pointing, yes-no, short answers
• should progress from easy to hard, from pointing to short answer narrative questions
• good comprehension= broca’s ; Poor comprehension=Wernickes

Question 5

Verbal component of standard language assesment includes:

Answer 5

• goal is to determine if fluent (Wer.) vs non-fluent (Bro)
• -includes word repetition (conduction aphasia or Transcortical aphasia), word retrieval (anomia), automatic speech (Bro. patients will improve), connected speech (Wer. patients more fluent than Bro patients), oral motor skills (checking for AOS, oral apraxia and or dysarthria typical of broca patients)

Question 5

Visual component of standard language assessment include:

Answer 5

• tests for visual agnostic, hemianopsia, dyslexia, STMemory, etc.
• should test for silent reading comprehension vs oral (out loud) reading

Question 6

Graphic expression components of a standard language assessment include

Answer 6

• remember that Bro. Patients may have right arm paresis, restricting their ability to write
• may reveal some visual perception/dysgraphia problems
• may reveal language problems (syntax, morphology, semantics)
• may reveal word-retrieval issues
• may reveal memory issues

Question 7

Other areas that may be included in a standard language assessment

Answer 7

• math computations (dyscalculia)
• visual screening or hearing screening
• dysarthria
• or further testing in a particular area, such as the Boston naming test for anomia

Question 8

What are the components of a nonstandard assessment:linguistic description

Answer 8

• generally a linguistic description is a conversational analysis, more commonly known as a language sample. Table 7.2 in book
• phonological variables
• morpho-syntactic variables
• semantic variables
• pragmatic variables
• dialectal variations

Question 9

Phonological variables involved in a nonstandard assessment

Answer 9

-generally only looking for paraphasias (literal or neologistic)

Question 10

Morpho-syntactic variables involved in nonstandard assessment

Answer 10

• some clinicians compute a MLU
• based on conversation, is the patient fluent or non-fluent
• is the patient agrammatic (uses only content words; leaves out function words)
• unsure what paragramatic is… Grammatically correct but incomplete

Question 11

Semantic variables involved in nonstandard assessments

Answer 11

• include problems understanding words (semantic disorder)
• also includes six different types of word retrieval patterns
• must eliminate apraxia of speech as the problem
• successful retrieval indicates good strategy/self monitoring skills

Question 12

Pragmatic variables involved in nonstandard assessments

Answer 12

• appropriate social responses can be verbal or non-verbal
• verbal may be limited to single-word utterances or even a repetitive utterance
• sample can be analyzed according to degree of topic repair, topic maintenance, etc.
• or sample can be analyzed according to any other language sample procedures (pg131)

Question 13

Dialectical variations involved in nonstandard assessments

Answer 13

• dialectical errors can be phonemic (eg dis for this)
• dialectical errors can be morphological (eg omission of “ed” or plural s)
• dialectical variations can be verb disagreements ( they was, or he be going)
• dialectical variations can occur on negation a ( eg ain’t/am not double negatives)

Question 14

Assessment of cognitive communication non-aphasic/degenerative

Answer 14

Cognitive assessment is not the same as a language assessment. Basically cognition is assessed by examining different residual functions of the executive center
Parkinson’s, Alzheimer’s, degenerative disease, tbi
(AAPOAAA)

Question 15

Arousal/consciousness/attention

Answer 15

• immediately after the brain insult, a person may be unable to speak. In these situations, patients are tested to determine their degree of awareness via speech, tactile, visual or thermal stimuli
• lack of response is not a good sign, indicative of possible severe brain damage or a coma state.
• if the patient is responsive, the patient should be able to attend for 20min (after initial brain insult has stabilized)

Question 16

Affective behaviors/reactions of assessment of cognitive communication

Answer 16

• immediately after a brain insult, it is not unusual for a patient to lose control of their emotions .
• after a patient is stable, check for inappropriate behaviors compared to per morbid conditions
• these behaviors expand after injury, loss of inhibition after head injury

Question 17

Perceptual problems involved with assessment of cognitive communication

Answer 17

• visual or auditory agnosias may occur after a brain injury, as well as sensory agnosias (Typically uncommon)
• these problems may not be considered cognitive issues

Question 18

Orientation to person , place and time assessment of cognitive communication

Answer 18

• again after a brain injury it is common for a patient to lose track of his/her surroundings
• after stabilization, patients should be able to orient to his/her environment

Question 19

Amnesia involved in assessment of cognitive communication

Answer 19

• memories are stored inSTM or LTM, depending on the importance of the information
• LTM is broken down into implicit memory or explicit memory
• implicit: procedural= routine motor acts; emotional= limb if system involvement
• explicit: semantic= facts; episodic= events; iconic= symbol interpretation/reading
• retrograde amnesia is the inability to retrieve information from LTM
• anterograde amnesia is the inability to store new information from STM

Question 20

Auditory comprehension/verbal expression portion of an assessment of cognitive communication

Answer 20

Same as the standard components of a language assessment

Question 21

Abstract reasoning of functional communication of assessments of cognitive communication

Answer 21

-these subtexts examine for problem solving, sequencing, calculation,planning/execution, interpretation of figurative language, etc.

Question 22

Assessment of functional communication

Answer 22

• Individuals who suffer a brain trauma want to return to the most normal life routine as possible
• therefore being able to function in his or her environment is critical(ie,the third column referred to as participation)

Question 23

Examples of tests that measure/assess functional communication skills included:

Answer 23

1. Functional communication measures (FMC) available through ASHA
2. Ranches Los amigos(RLA)
3. Functional communication scale(FCS)
4. Functional independence measure(FIM) (only 5 subtests are relevant)
5. Aphasia needs assessment (handout)
6. The communication effectiveness index (CETI)