exam 3 RHD TX/Assesment Flashcards
Formal Assessments for RHD
-The Right Hemisphere Language Battery
- Mini Inventory of Right Brain Injury (MIRBI)
- Burns Brief Inventory of Communication
- Rehabilitation Institute of Chicago Evaluation of Communication Problems in Right Hemisphere Dysfunction
- Ross Information Processing Assessment
- Porch Index of Communicative Ability (PICA)
- Cognitive Linguistic Quick Test (CLQT)
- Discourse Comprehension Test (DCT)
Informal Assessments in RHD
Client/caregiver interview
-1st step or any assessment to obtain qualitative data on patients QOL
Client/caregiver interview gives measurable info about:
quantitative information about perceived deficits, quality of life, impact of impairments, and emotions
Assess multiple areas of deficit in RHD
- Attention
- Executive Function
- Anosognosia (unaware of deficit)
- Pragmatics, Social Communication, and Prosody
Attention
- Use a combination of observation & formal assessment
- Visual and auditory attention, are important to assess, especially for signs like left neglect
Executive Function
- Also use observation and formal tests
- Look at skills like planning, judgment, and (meta-cognition) self-awareness
Anosognosia
- Use questionnaires or rating scales
- Compare the client’s responses with those of a caregiver or clinician
Pragmatics, Social Communication, and Prosody
- Usually assessed informally
- Use observations and questionnaires to gather info
Unilateral Neglect Tasks:
- Drawing or copying
- Cancellation tasks
- Line bisection
- Picture description
(Some test batteries are available)
Informal assessment of Discourse:
- Conversational language sample, story retell, and procedural descriptions
- Picture description tasks, you can assess if the client can distinguish relevant from irrelevant information and check for neglect
- Examine both literal (e.g., “the woman cleaning dishes”) and interpretive (e.g., “the mom cleaning dishes”) concepts.
Informal Assessment of Prosody and
Apragmatism:
- Watch conversation skills: turn-taking, topic maintenance, shared vs. private info
- Check if the person gives context for what they say
- Example: Talks about “Maria” without saying who she is
- Listen for understanding of tone/stress in questions vs. statements.
Client/Caregiver Questionnaires
Pragmatics: Pragmatic Aspects of Language, La Trobe Communication Questionnaire
Awareness: Awareness Interview, Awareness Questionnaire
Executive Skills: Executive Skills Questionnaire
Nonverbal Cues: PONS, Florida Affect Battery
Emotions/QOL: WHOQOL-BREF (Quality of Life)
Restorative vs Compensatory TX approach
Restorative: Restoring the brain NEUROPLASTICTY
Compensatory: Proving strategies/way around proble, (AAC Device)
Treating Attention & Neglect
- Use functional tasks: pillbox, fridge search, dressing, reading
- Target multiple domains (attention + neglect or executive function)
Compensatory strategies:
Verbal cue: “Look left”, Red line/bookmark on left side, Divide visual field & scan all quadrants
Restorative tasks: Cancellation tasks (trails, letters, numbers), Right field patching
TX Unilateral Neglect
Object-Centered Neglect Bottom-up TX: Attentional window: Use different-sized objects to help widen focus.
Compensatory strategies: Red line on the left to cue attention, Verbal cues to turn head left
Modified word reading: Add extra letters to the left side to force attention left
TX memory
Memory: External memory aids and internal strategies like mnemonics.
TX Aprosodia
Motoric-Imitative Treatment: Produce emotional prosody through repetition and drill.
Work on different types of prosody/intonation (e.g., “I want ice cream!” with different tones).
Cognitive-Affective Treatment: Understand and produce emotional prosody.
Steps: Match facial expressions, descriptions, and tones to emotions.
TX Expressive Aprosodia
Cognitive–Linguistic Treatment: Teach emotional intonation using written tasks.
Imitative–Motor Treatment: Practice emotional prosody, starting from unison to independent production.
TX Receptive Aprosodia
Learn to recognize emotions (prosody) in speech and understand non-emotional sounds.(no strong evidence)
TX Pragmatics
Group treatments for social skills can help, Focus on using context clues, Teach how to interpret idioms, metaphors, and unclear meanings, Ask questions like “Why?” and “What happens next?”
TX Pragmatics/social cognition
Teach how to understand body language and facial expressions.
Discuss social rules, like how we can’t read others’ minds.
Practice conversations through role-playing or group activities.
Help stay on topic by giving guidelines and using gestures to signal when someone is off-track.
TX Discourse
- Practice sequencing/explaining simple tasks/ADLS
- Help with summarizing, sorting, and understanding story details.
- Self evaluate
TX for thoughts/organization
Work on developing self awareness such as, identifying when its
time to stop and plan
- Picture description/sequencing task
- Guided questions related to picture
TX for Prosopagnosia
and Simultagnosia
- pics of family/friends
- tv clips without audio for inferences
