Communication and Praxis Flashcards
where should we position ourselves while we are assessing for neglect?
right at midline so we are not biting the assessment
where should we position ourselves during a neglect intervention?
it depends on how severe their neglect is and how aware of their neglect they are
what are dysarthrias?
collective name for neurological disorders
generally in dysarthrias where are lesions?
central or peripheral NS that are linked to the muscles of the mouth
are there deficits in brocas or wernickes areas with dysarthrias?
No
what do dyarthrias affect?
accuracy of respiratory resonation, articulatory and prosodic aspects of speech
what is expressive aphasia sometimes called?
Brocas aphasia
what do people with Broca’s aphasia also have trouble with?
reading and writing
what is Wernickes aphasia sometimes known as?
fluent aphasia
what is global aphasia?
has aspects of both brocas and wernickes aphasia
for someone with global aphasia, speech may be limited to what?
automaticisms (yes, social greetings & cursing)
speech repetition may be limited to serial speech (counting or over learned material like prayers or lyrics)
what are the most impairing aphasias?
global and wernickes aphasias
how can we enhance communication with someone with aphasia?
short, direct sentences paired with explicit language
e.g:
right arm first
provide visual cues or pictures
extra processing time
how do we break communication down into 3 ways for people with aphasias?
- get the message in
- help them get their message out (ex. ask yes/no questions, ask one thing at a time, encourage the person to write or draw a word if they can)
- Verify (summarize conversation, use yes/no questions to verify information)
is it possible for have wernickes aphasia and have intact cognition?
it is possible
how can you distinguish cognitive communication deficits from wernickes aphasia?
typically, when someone has cognitive communication deficits, things like reduced attention, concentration, memory, problem solving accompany it.
Someone with pure Wernickes will likely get dressed, pay attention, watch a movie, etc
what is integration?
making a cohesive picture of the sensory information coming in
what is praxis?
responding to the environment in an “adaptive” way
what are the 3 components of praxis?
- ideation - an idea of what I’d like to do
- motor planning- how do I do this new thing
- execution- actually doing it
what is apraxia?
inability to complete planned motor acts although someone has intact sensation, movement, and coordination
what are the types of apraxia?
ideational apraxia (ideation impairment)
ideomotor apraxia (motor planning impairment)
before we can assume someone has apraxia what do we need to do first?
screen for primary sensation (they can see and feel properly)
paresis comes from damage to what part of the brain?
primary motor cortex
apraxia comes from damage to what parts of the brain?
premotor area
supplementary motor area
what is ideational apraxia?
an impairment in your idea of what you’d like to do
whaat do we often see with ideational apraxia?
impaired object recognition
impaired mental process
cannot describe the function of a task (what do do with a pencil)
what are common errors observed in a client with ideational apraxia?
objects are used improperly (combing hair with lipstick)
what is idolator apraxia?
performance of task appears clumsy
they know what to do but have trouble with execution
what do people with ideomotor apraxia have difficulty with?
imitating gestures/movements purposefully
how do we assess for apraxia?
- the first step is to make sure primary sensation is intact
- assess their conceptual system (try to figure out if the client has an idea of what they’d like to do) ex. put “tools” in front of them and see if they can pick them up and use them properly
- production system (pantomime, imitation, object use)
what is constructional apraxia?
individuals have trouble making a sum of a bunch of individual parts (ex. setting a table with all the parts. They can put down a plate if given to them but if given plate, fork, knife, spoon they make have difficulty)
what does constructional apraxia correlate with?
ADL deficits
do people only have one type of apraxia?
no, often people have elements of both types
what is the cueing hierarchy?
verbal cueing
physical cueing
feedback
what is the least assistive type of curing?
verbal cueing
what is the first thing we do with verbal cueing?
determine level of awareness (is the client aware they are using lipstick to brush their teeth?)
-if yes, how aware
-if no, draw awareness to issue
what do we do after determining level of awareness for verbal cueing?
provide minimal/just right level of assistance
how can we grade/fade our verbal cueing?
how specific they are (“look to the left to find soap” vs “what do you need next?”)
frequency (how often per task)
number of cues used (how many per task)
what are types of physical cueing?
- manual contact (gently touch arm)
- task simplification (declutter the environment , one item at a time, backward/forward chaining)
- hand over hand (guide their hand through the task)
at the end of the task what do we always look for?
feedback:
- how did that go? (assess level of awareness)
- knowledge of results (basic)
- knowledge of performance (more advanced)
what are the stages of awareness?
- intellectual awareness
- emergent awareness
- anticipatory awareness
what is intellectual awareness?
the ability to understand that a function is impaired -“knowing you have a problem,”
what is merging awareness?
the ability to recognize a problem when it is happening
ex: walking and rubbing arm on the wall, the client is aware that it is happening
what is anticipatory awareness?
the ability to anticipate that a problem will occur as a result fo an impairment and so they make plans to compensate
ex. write a grocery store list because I know I will forget when I get there
what is perseveration?
an inability to shift from one concept to another or inability to change or stop a behaviour pattern after starting it
example: repeatedly shaving the same spot
is perseverance ‘all or nothing’? what does this mean?
No, some people can be very perseveration or you just se little signs of it
how do we assess for perseverance?
activity analysis
assessment tools
what are all of our interventions in this course based on?
awareness and severity of the deficit
