Exam Bank Questions - Part 3

Question 1

Provide two rationales for why you have chosen to administer the Western Aphasia Battery - Revised (WAB-R), rather than the Comprehensive Aphasia Test (CAT).

Answer 1

The WAB-R can be used to determine the type of aphasia & infers the possible location of lesion, and measures both linguistic skills (such as content, fluency, auditory comprehension, repetition, naming, reading, & writing) & non-linguistic skills (such as drawing, calculation, block design, & apraxia). The CAT, on the other hand, only looks at linguistic skills, & screens for associated cognitive deficits. The CAT also does not provide any information on the type of aphasia or the possible location of lesion.

Question 2

Provide two rationales for why you have chosen to administer the CAT, rather than the WAB-R.

Answer 2

The CAT can be used to additionally screen for associated cognitive deficits and looks at the consequences of aphasia on the client’s lifestyle and emotional well-being (through the disability questionnaire). The WAB-R, on the other hand, only looks at the impairment level and doesn’t consider the client’s emotional well-being or the impact of aphasia on their lifestyle.

Question 3

List 4 typical steps in acute aphasia management.

Answer 3

Screening assessment & attempt to lead to diagnosis, communicating while in hospital, education & counselling, discharge planning.

Question 4

List 2 environmental modifications you could potentially make to assist in making an acute hospital setting more conducive to communication.

Answer 4

Reduce background noise, have resources on hand (e.g. pens, paper).

Question 5

List two aims of the Inpatient Functional Communication Interview (IFCI).

Answer 5

Identify communication situations that may be a focus of direct intervention, provide information to other health-care staff about communication strategies that may facilitate communication with the patient.

Question 6

List 4 communication situations that the IFCI assesses.

Answer 6

Following instructions, expressing feelings, gaining the patient’s attention, asking for something.

Question 7

List 4 general communication strategies that you may suggest a family member use to assist their communication with the person who has aphasia.

Answer 7

Gain their attention, maintain eye contact, reduce background noise, talk in short, clear sentences.

Question 8

Provide four examples of typically unhelpful ways of communicating with a person with aphasia.

Answer 8

Shouting, changing the subject quickly, jumping from topic to topic, treating the person with aphasia like a child.

Question 9

List four potential benefits of providing stroke patients with information about their health.

Answer 9

Informed decision making, independence & control, reducing anxiety & frustration, greater patient satisfaction.

Question 10

Provide examples of four appropriate activities that typically involve less communication which both the person with aphasia and the friend may be able to participate in together.

Answer 10

Playing bowls, gardening, taking photos, listening to music.

Question 11

Write a brief response to a family member’s question “Will his language get better?” using appropriate language.

Answer 11

Recovery is a very individual thing. We usually see the most marked improvement in the first 6-12 months post stroke, but further gains can continue for years. It is very important to keep working on your language skills, to keep talking. Together we can work on your speech or language in therapy and through homework.

Question 12

List 2 factors that need to be considered when deciding whether or not to commence impairment based therapy in the early post-stroke onset period.

Answer 12

Medical stability, cognitive stability.

Question 13

List the 3 stages of functional recovery from aphasia, according to Hillis and Heidler (2002).

Answer 13

Recovery of impaired neural tissue in the area surrounding the core infarct (during the first few days post stroke), reorganisation of brain structure & function relations (begins within days - may continue for weeks/months/years), and learning new pathways & compensatory strategies.

Question 14

What is spontaneous recovery and when does spontaneous recovery typically begin to plateau?

Answer 14

Spontaneous recovery is natural improvement without treatment and typically begins to plateau between 6-12 months post onset.

Question 15

List 2 factors that influence recovery post stroke.

Answer 15

Lesion site & size, personal factors (e.g. age, & psychosocial factors)

Question 16

Provide 2 stroke/aphasia specific examples of where you may source evidence to assist in ensuring your aphasia management is evidence-based.

Answer 16

Academy of Neurologic Communication Disorders & Sciences (ANCDS), National Stroke Foundation

Question 17

What is the focus of an impairment-based approach to aphasia therapy?

Answer 17

The initial focus of an impairment-based approach is on directly identifying & treating the underlying linguistic deficits presented by the client.

Question 18

Provide 2 different examples of tasks frequently used to target semantic processing skills (at the impairment level).

Answer 18

Spoken/written phrase/sentence completion task, odd-one-out task

Question 19

Provide an example of a semantically based cueing hierarchy (four distinct cues & examples) that could be used to assist a person with aphasia to name the target word “cow”.

Answer 19

1. Superordinate (“It’s an animal”)
2. Coordinate (“It’s like a horse”)
3. Associate (“It eats grass”)
4. Function (“You can milk it”)

Question 20

Provide an example of a phonologically based cueing hierarchy (six distinct cues & examples) that could be used to assist a person with aphasia to name the tarot word “dog”.

Answer 20

1. Phonemic cue (“It starts with /d/”)
2. Semantic cue (“It barks”)
3. Sentence completion cue (“It barks like a…”)
4. Sentence completion cue + phonemic cue (“It barks like a /d/…”)
5. Anagram using letter tiles (o g d)
6. Written word cue (dog)

Question 21

Provide an example of a cueing hierarchy typically used in script training (include 3 distinct cues).

Answer 21

Phrase repetition written cue, choral reading with clinician, independent production

Question 22

List 2 examples of computer based software programs that may be used with clients who have aphasia when providing impairment level therapy.

Answer 22

Aphasia Tutor, Step-by-Step

Question 23

Briefly describe Constraint Induced Language Therapy (CILT) and provide a brief example of a CILT task.

Answer 23

Constraint Induced Language Therapy (CILT) uses the theory of “use it or loose it” by practicing intensively while restricting language use to spoken response only (for example playing go fish without being able to use gestures or other non-verbal communication by using a barrier between the players).

Question 24

Briefly describe 2 different potential recovery patterns reported in the literature for people with bilingual aphasia.

Answer 24

A parallel pattern of recovery refers to the recovery of 2 languages at the same rate & degree relative to the client’s premorbid levels. A differential pattern of recovery refers to the recovery of one language better than the other.

Question 25

Define code-switching in terms of bilingual aphasia.

Answer 25

Code-switching refers to the use of one language when using another language. PWAs may use code-switching as a mechanism for overcoming word-retrieval problems.

Question 26

Why is it important for speech pathologists who are working with clients who have bilingual aphasia to have knowledge of code-switching?

Answer 26

For bilingual aphasia it is important to know whether the PWA is using normal code-switching or whether it’s an error due to aphasia.

Question 27

List 4 pieces of information that relate specifically to language use which are important to obtain when conducting an initial interview with a client who has bilingual aphasia.

Answer 27

Premorbid ability in each language; persons with whom each language was used; situations & purposes each language is used for (e.g. home, work, recreation); situations & people when in bilingual mode.

Question 28

Name 2 assessment tools you may use in assessing bilingual aphasia.

Answer 28

Bilingual Aphasia Test, & American Speech-Language-Hearing Association - Functional Assessment of Communication Skills for adults (ASHA-FACS)

Question 29

Briefly define the term ‘cognate’ with respect to bilingualism and provide an example.

Answer 29

Cognates are words that are similar in meaning & form across languages (e.g. “telefono” & “telephone”)

Question 30

Why is it important for speech pathologist who are working with clients who have bilingual aphasia to have knowledge of cognates?

Answer 30

It’s important to know about cognates because treatment should focus on commonalities in the language in order to maximise generalisation.

Question 31

Provide 2 examples of activity/participation focussed aphasia interventions that focus on changing the communication behaviour of the person with aphasia.

Answer 31

Script training, & Communicative/Interactive drawing

Question 32

List the 4 guiding principles of Promoting Aphasics’ Communication Effectiveness (PACE) therapy.

Answer 32

Equal participation (SP & PWA participate equally as senders and receivers of messages), exchange of new information (interaction incorporates the exchange of new information between SP and PWA), free to use any modality/multiple modalities (e.g. gesture, writing, communication boards, drawing), natural feedback (based on the PWA’s success in communicating a message).

Question 33

Provide 2 examples of how Constraint Indued Language Therapy (CILT) and Promoting Aphasics’ Communication Effectiveness (PACE) therapy clearly differ.

Answer 33

Constraint Induced Language Therapy (CILT) involves the use of only one modality, verbal expression, whereas Promoting Aphasics’ Communication Effectiveness (PACE) therapy promotes the use of any modality. CILT is also delivered intensively.

Question 34

Proved 4 examples of potential ways to measure outcomes for Aphasia Script therapy.

Answer 34

Rate of production, number of nouns, number of verbs, mean length of morphemes per utterance.

Question 35

List 4 strategies that may be used to support conversations when communicating with an individual who has moderate to severe verbal expressive language difficulties as the result of aphasia (i.e. communication strategies you could use to reveal competence by ensuring the person with aphasia has a means of responding).

Answer 35

Fixed choice questions (e.g. multiple choice formats), yes/no questions, encouraging the use of drawing & writing (pen & paper handy), having resources/objects (e.g. calendars, maps, numbers) so that the person can point to respond.

Question 36

List 4 strategies that may be used to support conversations when communicating with an individual who has moderate to severe receptive language difficulties as the result of aphasia (i.e. communications strategies you could use to reveal competence in understanding).

Answer 36

Use short, simple sentences; use meaningful gestures; use simple & clear drawings; use resources (e.g. calendars, maps, numbers).

Question 37

Briefly describe what acknowledging competence means and provide an example of something you could say to a person with aphasia to acknowledge their competence.

Answer 37

Acknowledging competence means being respectful & not patronising, talking to the PWA as an adult, not a child, & being sensitive to the person’s attempts to engage in conversation. An example of something that could be said to acknowledge a PWA’s competence is “I know you know what you want to say”.

Question 38

Provide 4 evidence-based ways written health information can be formatted to assist people with aphasias’ reading comprehension.

Answer 38

Reduce the readability level of the information to reading grade of 6 or lower, avoid abbreviations, write in the first or second person, present information using bullet points & lists where possible.

Question 39

Identify 4 ways you could modify the formatting of a written speech pathology report to make it more “aphasia-friendly”.

Answer 39

Use bullet points where possible, add a photo signature, use 1.5 or double line spacing, use a minimum of 14 point font.

Question 40

Define ‘communication access’.

Answer 40

Communication access is about developing communication that is clear, comfortable, & easy to understand & interact with.

Question 41

Provide 4 examples of environmental factors that you could consider modifying in order to make your speech-language pathology outpatient department more accessible for your clients with aphasia.

Answer 41

Formatting appointment letters to be “aphasia friendly”, using “aphasia-friendly” formatting on forms, training staff in Supported Conversation for Adults with Aphasia (SCA), having a procedure in place for clients to cancel appointments.

Question 42

List 2 ways you could measure outcomes of aphasia group therapy.

Answer 42

Communications Interaction Rating Scale for Aphasia Group (CIRSAG), Informal Discourse Rating Scale

Question 43

List the four domains that speech pathologists rate on a five-point scale from the Australian Therapy Outcome Measure Scales (AusTOMS).

Answer 43

Impairment, activity limitation, participation restriction, distress & well-being.