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Aphasia > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Goals of Interviewing

A
  1. Obtain information
  2. Provide information
  3. Provide Release and support
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2
Q

Key Components of Medical Recort

A
  1. Patient ID information
  2. Doctor’s orders
  3. Personal History
  4. Medical History
  5. Physical and Neurological Exam
  6. Specialists Consultations
  7. Progress Notes
  8. Lab Results and Imaging
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3
Q

Obtaining information

A

Be aware of nonverbal messages given both by you and the client.

Avoid yes/no questions or questions that inhibit full responses including negativistic or moralistic responses.

Always record information

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4
Q

Giving Information

A

Avoid providing too much information or information too soon.

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5
Q

Provide Release and Support

A

Demonstrate empathy and promote a state of comfort and well-being

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6
Q

Behavioral, cognitive, and emotional effects of brain injury (7)

A
  1. Altered responsiveness (do not assess a pt. who is not alert)
  2. Perseveration (frequent repetition)
  3. Diminished response flexibility
  4. Concreteness
  5. Impaired self-monitoring
  6. Poor attention
  7. Emotional lability
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7
Q

Purposes of testing (6)

A
  1. Deciding a diagnosis
  2. Making a prognosis
  3. Determining severity and nature of comm. impairments
  4. Determining appropriateness and focus of tx
  5. Measure recovery
  6. Measure efficacy of tx
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8
Q

NIH Stroke Scale

A

15-item neurological examination which can serve as a measure of stroke severity; takes less than 10 minutes to complete

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9
Q

Functional Independence Measure (FIM)

A

7-1 scale of how independently the patient performs specific tasks necessary to independent living such as grooming, eating and mobility

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10
Q

Stroke Impact Scale (SIS)

A

5-1 scale of difficulty completing various physical, mental, emotional, and communication tasks with additional self-assessment of recovery

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11
Q

Burden of Stroke Scale (BOSS)

A

Measures impact of stroke on phsyical, communication, emotional, and social aspects of life.

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12
Q

Input modalities of assessment batteries

A

Verbal and written

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13
Q

Output modalities of assessment batteries

A

Speech, writing, gesture (i.e. pointing)

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14
Q

Communicative activities of assessment batteries

A

Speaking, listening, reading, and writing

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15
Q

Screening Tests

A

Both designed by clinicans and commercially available. Determines the need for further assessment; gives a general sense of nature and severity of deficits

Can be useful in the event a patient cannot tolerate or afford a full assessment or in the early stages of recovery.

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16
Q

Language Screening Test (LAST)

A

Bedside test designed for “emergency” setting. Subtests in naming, repetition, automatic speech, recognition of images, and following verbal instructions.

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17
Q

The Aphasia Rapid Test

A

26-point bedside assessment to rate aphasia severity in acute stroke pts. Can be completed in less than 3 minutes.

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18
Q

Variables that influence single-word comprehension (4)

A
  1. Frequency of occurrence
  2. Semantic or acoustic relationship to foils
  3. Part of speech
  4. Ambiguity
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19
Q

Variables that influence sentence comprehension (4)

A
  1. Length and syntactic comprehension
  2. Reversibility and plausibility
  3. Predictability
  4. Personal reference
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20
Q

Tests of Sentence Comprehension (2)

A
  1. Token Test

2. Northwestern Syntax Screening Test

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21
Q

Variables that influence discourse comprehension (5)

A
  1. Salience
  2. Directness
  3. Redundancy
  4. Cohesion and coherence
  5. Rate and emphatic stress
22
Q

Tests of Discourse Comprehension (1)

A

The Discourse Comprehension Test

23
Q

Speech Characteristics in Aphasia (6)

A
  1. Paraphasias
  2. Neologisms
  3. Stereotypies
  4. Jargon
  5. Agrammatism
  6. Paragrammatism
24
Q

Informal Speech Production Tests

A

Recitations, rhymes, and automatized sequences
Sentence completion
Repetition

25
Q

Informal Naming Tests (2)

A
  1. Confrontational Naming

2. Responsive Naming

26
Q

Variables that my affect naming accuracy (4)

A
  1. Frequency of occurrence
  2. Length and phonologic complexity
  3. Semantic categories
  4. Context
27
Q

Minnesota Test for Differential Diagnosis of Aphasia

A

Differentiates among clinical sydromes, tests all modalities, uses graduated difficulty and a variety of non-language tests. Very old.

28
Q

Porch Index of Communicative Ability

A

Somewhat old and rather long to administer (1 hour), certification required to administer.

29
Q

Revised Token Test

A

30 minutes with 10 brief subtests involving a variety of colorized tokens; focuses on comprehension

30
Q

Aachen Aphasia Test

A

German test; sometimes shows up in research

31
Q

BDAE Authors

A

Harold Goodglass; Edith Caplan

32
Q

BDAE administration time

33
Q

BDAE structure

A

Interview, 27 subtests, BNT (60 items), 9 rating scales. Pattern of rating scales gives information on aphasia type.

34
Q

Picture associated with BDAE

A

Cookie Theft picture

35
Q

WAB author

A

Andrew Kertesz

36
Q

Which is more psychometrically sophisticated, BDAE or WAB?

37
Q

Aphasia Quotient

A

Score on WAB comprised of scores on the speech, auditory comprehension, repetition, and naming subtests

38
Q

Aphasia Quotient cutoffs

A

0-39=Severe
40-79=Moderate
80-93.7=Mild
93.8-100=Anomic or no aphasia

39
Q

Other Components of WAB

A 
Language Quotient
Cognitive Quotient (entire test)
40
Q

Boston Naming Test

A

60 item measure of confrontational naming; uses line drawings
Short, 15 item version available

41
Q

Reading Comprehension Battery for Aphasia-2

A

10 subtests with 10 items each; examines severity and quality of reading after aphasia

42
Q

Functional Communication Assessments

A

Communicative Effectiveness Index (correlation with WAB)

Communicative Abilities in Daily Living

43
Q

Stroke and Aphasia Quality of Life Scale-39

A

49 items on a 5 point scale

44
Q

Picture associated with WAB

A

Picnic scene

45
Q

Areas of Nonstandardized Assessment (6)

A 
Auditory Comprehension
Verbal Expression
Reading
Writing
Cognition
Pragmatics
46
Q

General Predictors of stroke outcome

A 
Functional ability upon admission
INITIAL APHASIA SEVERITY
Number and size of lesions
Location of lesion
Aphasia type
Other medical conditions
Motivation
Family support
Professional and financial support
Age, handedness, etc. are weak predictors
47
Q

Improvement patterns in stroke

A

MOST improvement over first 3 months
SOME improvements until 12 months
Improvements may come with increased effort after 12 months

Repetition is the quickest to recover, fluency and naming are the slowest to recover

48
Q

Sparing of lower prerolandic (face) area

A

Positive prognostic sign for nonfluent speech

49
Q

Sparing of posterior superior temporal lobe

A

Positive prognostic sign for auditory comprehension

50
Q

Pattern for hemispheric recovery and language

A

Right hemisphere should take on some language functions temporarily, but best recovery is when language functions return to the left hemisphere

51
Q

Recovery pattern by stroke type

A

Wernicke’s and global aphasia had the highest median recovery rates in the first 24 weeks, but Broca’s aphasia had the best prognosis for improvement within the first year

52
Q

Overall patterns of aphasia recovery

A

Typically aphasia becomes a milder form of aphasia.
Anomic aphasia is a common endpoint for other types of aphasia.
Patients can change from non-fluent to fluent.
Initial severity is the best indicator of recovery

Aphasia (2 decks)

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