Communication and Praxis

Question 1

where should we position ourselves while we are assessing for neglect?

Answer 1

right at midline so we are not biting the assessment

Question 2

where should we position ourselves during a neglect intervention?

Answer 2

it depends on how severe their neglect is and how aware of their neglect they are

Question 3

what are dysarthrias?

Answer 3

collective name for neurological disorders

Question 4

generally in dysarthrias where are lesions?

Answer 4

central or peripheral NS that are linked to the muscles of the mouth

Question 5

are there deficits in brocas or wernickes areas with dysarthrias?

Answer 5

No

Question 6

what do dyarthrias affect?

Answer 6

accuracy of respiratory resonation, articulatory and prosodic aspects of speech

Question 7

what is expressive aphasia sometimes called?

Answer 7

Brocas aphasia

Question 8

what do people with Broca’s aphasia also have trouble with?

Answer 8

reading and writing

Question 9

what is Wernickes aphasia sometimes known as?

Answer 9

fluent aphasia

Question 10

what is global aphasia?

Answer 10

has aspects of both brocas and wernickes aphasia

Question 11

for someone with global aphasia, speech may be limited to what?

Answer 11

automaticisms (yes, social greetings & cursing)

speech repetition may be limited to serial speech (counting or over learned material like prayers or lyrics)

Question 12

what are the most impairing aphasias?

Answer 12

global and wernickes aphasias

Question 13

how can we enhance communication with someone with aphasia?

Answer 13

short, direct sentences paired with explicit language

e.g:
right arm first
provide visual cues or pictures
extra processing time

Question 14

how do we break communication down into 3 ways for people with aphasias?

Answer 14

1. get the message in
2. 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)
3. Verify (summarize conversation, use yes/no questions to verify information)

Question 15

is it possible for have wernickes aphasia and have intact cognition?

Answer 15

it is possible

Question 16

how can you distinguish cognitive communication deficits from wernickes aphasia?

Answer 16

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

Question 17

what is integration?

Answer 17

making a cohesive picture of the sensory information coming in

Question 18

what is praxis?

Answer 18

responding to the environment in an “adaptive” way

Question 19

what are the 3 components of praxis?

Answer 19

1. ideation - an idea of what I’d like to do
2. motor planning- how do I do this new thing
3. execution- actually doing it

Question 20

what is apraxia?

Answer 20

inability to complete planned motor acts although someone has intact sensation, movement, and coordination

Question 21

what are the types of apraxia?

Answer 21

ideational apraxia (ideation impairment)

ideomotor apraxia (motor planning impairment)

Question 22

before we can assume someone has apraxia what do we need to do first?

Answer 22

screen for primary sensation (they can see and feel properly)

Question 23

paresis comes from damage to what part of the brain?

Answer 23

primary motor cortex

Question 24

apraxia comes from damage to what parts of the brain?

Answer 24

premotor area
supplementary motor area

Question 25

what is ideational apraxia?

Answer 25

an impairment in your idea of what you’d like to do

Question 26

whaat do we often see with ideational apraxia?

Answer 26

impaired object recognition
impaired mental process
cannot describe the function of a task (what do do with a pencil)

Question 27

what are common errors observed in a client with ideational apraxia?

Answer 27

objects are used improperly (combing hair with lipstick)

Question 28

what is idolator apraxia?

Answer 28

performance of task appears clumsy

they know what to do but have trouble with execution

Question 29

what do people with ideomotor apraxia have difficulty with?

Answer 29

imitating gestures/movements purposefully

Question 30

how do we assess for apraxia?

Answer 30

1. the first step is to make sure primary sensation is intact
2. 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
3. production system (pantomime, imitation, object use)

Question 31

what is constructional apraxia?

Answer 31

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)

Question 32

what does constructional apraxia correlate with?

Answer 32

ADL deficits

Question 33

do people only have one type of apraxia?

Answer 33

no, often people have elements of both types

Question 34

what is the cueing hierarchy?

Answer 34

verbal cueing

physical cueing

feedback

Question 35

what is the least assistive type of curing?

Answer 35

verbal cueing

Question 36

what is the first thing we do with verbal cueing?

Answer 36

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

Question 37

what do we do after determining level of awareness for verbal cueing?

Answer 37

provide minimal/just right level of assistance

Question 38

how can we grade/fade our verbal cueing?

Answer 38

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)

Question 39

what are types of physical cueing?

Answer 39

1. manual contact (gently touch arm)
2. task simplification (declutter the environment , one item at a time, backward/forward chaining)
3. hand over hand (guide their hand through the task)

Question 40

at the end of the task what do we always look for?

Answer 40

feedback:

1. how did that go? (assess level of awareness)
2. knowledge of results (basic)
3. knowledge of performance (more advanced)

Question 41

what are the stages of awareness?

Answer 41

1. intellectual awareness
2. emergent awareness
3. anticipatory awareness

Question 42

what is intellectual awareness?

Answer 42

the ability to understand that a function is impaired -“knowing you have a problem,”

Question 43

what is merging awareness?

Answer 43

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

Question 44

what is anticipatory awareness?

Answer 44

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

Question 45

what is perseveration?

Answer 45

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

Question 46

is perseverance ‘all or nothing’? what does this mean?

Answer 46

No, some people can be very perseveration or you just se little signs of it

Question 47

how do we assess for perseverance?

Answer 47

activity analysis
assessment tools

Question 48

what are all of our interventions in this course based on?

Answer 48

awareness and severity of the deficit