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Aphasia > Discourse/RH Damage > Flashcards

Discourse/RH Damage Flashcards

1
Q

Why should we investigate discourse?

A
  • affects Social participation
  • Personal narrative contribute to self-awareness
  • psychosocial adjustment
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2
Q

What does discourse involve?

A
  • establishing coherent relationships between sentences
  • imagining situations
  • adopting different points of view
  • attributing mental states to protagonists
  • inferences and gist
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3
Q

What are the types of narrative

A
  • narrative (story)
  • procedural (how to make a PB&J)
  • conversational (2 people)
  • expository (lecture)
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4
Q

One suggestion for discourse structure is

A

story grammar

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5
Q

What does it mean for a story to be coherent?

A

it is chronological, logical and causal

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6
Q

What is local coherence?

A

coherence within a sentence, linking between clauses

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7
Q

What is global coherence?

A

coherence across discourse- a unified message overall

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8
Q

What cognitive skills are involved in discourse?

A

language
memory (semantic & episodic)
attention
goal-directed planning

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9
Q

What is the micro level of discourse

A
  • sequence of propositions (information)
  • includes lexical-syntactic difficulty, informativeness and cohesion
  • corresponds to local coherence
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10
Q

What is the macro level of discourse

A
  • schema/plan of story
  • includes coherent, relevance and gist
  • corresponds to global coherence
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11
Q

What are the 3 key elements of discourse production

A
  1. personnel - 2+ participants
  2. accumulation of common ground (personal and communal)
  3. Contributions
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12
Q

What are some ways we can assess discourse impairment

A
  • personal narratives
  • picture description
  • story telling
  • procedural language
  • persuasive language
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13
Q

What are some task variables to consider when assessing discourse impairment?

A
  • memory demands
  • sequencing/organizational skills
  • modality (written/verbal)
  • stimulus complexity
  • linguistic specificity and complexity
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14
Q

What are ways to assess the micro-structure of discourse?

A
  • length of utterance
  • syntactic complexity
  • semantic accuracy
  • pauses/restarting
  • sentence fragments
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15
Q

What are ways to assess the macro-structure of discourse?

A
  • Information content: quantity, quality, efficiency, relevance, manner
  • Cookie theft picture: literal information and inferences
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16
Q

What do we look at when looking at supra-structural/conversational analysis of discourse?

A
  • turn taking
  • topic manipulation/maintenance
  • speech acts
  • paralinguistic and non verbal
  • repair
17
Q

Which side of the brain is responsible for understanding metaphors, sarcasm and humour?

A

right hemisphere

18
Q

T or F: the left and right hemispheres are functionally different but physically the same

A

False! they are different both physically and functionally

19
Q

How are the RH and LH physically different?

A
  • Frontal lobe bigger on RH
  • Occipital lobe bigger on LH
  • Sylvian fissure longer on RH
  • Neuronal and neurochemical differences
20
Q

How are the RH and LH functionally different

A

LH: piecemeal (time)
RH: holistic (spatial)

21
Q

The _______ hemisphere is responsible for fine semantic coding, while the _______ hemisphere is responsible for coarse semantic coding

A

left

right

22
Q

RH damage leads to _________ comprehension of implied information, and _________ in comprehension of explicit information

A

poorer

no difference

23
Q

Describe the suppression deficits hypothesis

A

-when the RH activates many meanings of a word, understanding is hampered by ineffective suppression of incorrect meanings

24
Q

Describe the cognitive resources hypothesis

A

-demands on attentional resources

25
Q

Describe the social cognition deficit hypothesis

A

RH damage can reduce the ability to engage in social relations and understand social information which influence language performance
-reduced complex inferencing in general

26
Q

Describe right hemisphere damage (RHD) effects on cognition

A
  • anosognosia
  • attention
  • visuoperceptual/visuospatial processing (neglect)
  • memory
  • executive functioning
27
Q

Describe the RHD damage effects on discourse production (macrostructures and microstructures)

A
  • issues generating macrostructures (gist, topic, moral)
  • microstructures: words, clauses or turns in conversation
  • diminished informational content
  • paucity
  • production based on scripts with tangential associations
  • difficulty telling an integrated, coherent story
  • impaired organization on story recall
  • inaccurate incomplete main concepts etc.
28
Q

Describe RHD effects on discourse comprehension

A

problems abstracting overall meanings, themes or gist

29
Q

Describe RHD effects on pragmatics

A
  • emotional non-verbal communication
  • speech acts
  • figurative and implied meaning
  • sensitivity to listener needs
  • humour
30
Q

Describe RHD effects on prosody

A
  • aprosodia
  • hypermelodic tone
  • monotonous voice
31
Q

Describe RHD effects on reading and writing

A
  • process visual info
  • scanning line of print, tracking back to margin to find next line, or scan a page for info
  • neglect dyslexia
32
Q

What information do you need for an initial Ax of RHD?

A
  • identify impairments

- consider patient’s cognitive-communicative activity limitation and participation restrictions

33
Q

What should you assess in your informal assessment of RHD?

A
  • discourse production

- discourse comprehension

34
Q

Why do we need to exercise caution when using formal assessment to look at RHD?

A

a lot of standardized tests were only validated for LH damage

35
Q

What are some formal tests we can use for RHD?

A
  • Burden of Stroke Scale (BOSS)
  • Discourse Comprehension Test (DCT)
  • Assessment of language-related functional activities (ALFA)
  • Rey complex figure test and recognition trial

Aphasia (10 decks)

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