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Aphasia > Final > Flashcards

Final Flashcards

1
Q

What does it mean to say evaluation is ongoing?

A

Evaluation is always necessary in order to evaluate the patients progress towards their goals and if the intervention method we are utilizing is effective.

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2
Q

When do you use an AAC?

When do you not use an AAC?

A

Consider individuals linguistic strengths and weaknesses, limb apraxia, motor limitations, visual deficits, and motivation. Motivation is key. Most often used in patients who need a form of functional communication immediately or are so severely impaired that they cannot currently functionally communicate. It should not be used as be all end all means of communication. Intervention on speech still needs to occur, it is a tool in the mean time.

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3
Q

Auditory Simulation Approach

A

There is an impairment in the individuals ability to access the language production areas of the brain. Employs strong, controlled, and intensive auditory stimulation of the impaired symbol system as the primary tool to facilitate and maximize the patient’s reorganization and recovery of language It is most beneficial to individuals with severe aphasia because it is clinician driven and used for getting language back on track. Does not generalize well to environmental settings. See slow rise time, noise build up, attention deficit, and information capacity deficit.

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4
Q

Auditroy Simulation Approach Therapy

A

Intensive stimulation of impaired language processing. Reeducation and/or correction of the language impairment. Teaching others tactics to use to converse with the individual.

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5
Q

Cognitive Neuropsychology Approach

A

Describes aphasia as being caused by a collection of information processing impairments that can be modality specific, such as attention, memory, and so on.

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6
Q

Cognitive Neuropsychology Approach Therapy

A

Explicit teaching of langue processing in underlying language processing, knowledge, or alternative methods for achieving functional language such as reconstitution, compensation via mapping therapy and naming facilitation techniques.

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7
Q

Neurolinguistic Approach

A

The belief that aphasia is a neurological condition that can be described using linguistic concepts.

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8
Q

Neurolinguistic Approach Therapy

A

Focuses on reteaching linguistic cues and processes to restore a patients skills and grammatical structures. Such as wh- movement.

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9
Q

Psycho-Social Approach

A

Focuses on social and emotional aspects of aphasia. Such as social participation, self-esteem, and self identity. Particular attention is paid to social networks, communication strategies, psychological factors, and real life communication strategies.

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10
Q

Social Networks in Psycho-Social Approach

A

Identifying communication partners, communication settings, purpose of interactions, nature of relationships. Use interviews, observations, and self reporting.

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11
Q

Pyschological Factors in Psycho-Social Approach

A

Mood and emotional state, feelings using questionnaires, a

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12
Q

Real Life Communication Strategies in Psycho-Social Approach

A

Conversational skills, Social Communication Summary, assess communication abilities and challenges on daily basis. This can be done via direct observation, qualitative interviews, diaries from caregivers, and rating scales.

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13
Q

Psycho-Social Approach Therapy

A

Focuses on client driven goals, interests, conversation topics, vocabulary, social communication practices, community involvement, and incorporation of family, friends, and caregivers.

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14
Q

Deciding Prognosis

A

Examining medical state, mental state, personality, and helping factors such as environment and caregivers. Prognosis needs to be individualized for different communication settings.

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15
Q

The efficacy and effectiveness of therapy for aphasia is suspect.

A

Effectiveness has been found to be neither effective or ineffective. However, treatment will offer individuals the ability to move towards their personal communication goals, Not all interventions are appropriate for every individual. It is a highly heterogeneous population and therefor research is hard to interpret.

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16
Q

Benefits of Volunteer Usage

A

Free, easy to get, may have more in common with the patient than you do.

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17
Q

Limitations of Volunteers

A

Need extensive training, are conversation partners not therapists, are not a replacement for loved ones or caretakers, are limited in their knowledge of a person and what might upset them.

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18
Q

Psycho-Social Aphasia Groups

A

Forum for people with aphasia to discuss living with aphasia. There is a focus on developing emotional bonds. Helps with emotional problems and improving communication. Allows for individuals to enjoy social interaction, share concerns, and frustrations, and develop a sense of self.

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19
Q

Family Counseling and Support Groups for Aphasia

A

A forum for healthy members and individuals of the family. Mostly comprised of individuals who are caretakers. Individuals may learn about aphasia, discuss aphasia, and share personal experiences.

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20
Q

SLP Direct Language Groups

A

A clinician patient interaction driven therapy group. Similar to individual therapy but is carried out with multiple individuals.

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21
Q

SLP Indirect Language Groups

A

Clinician comes up with a topic and is minimally involved with interaction.

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22
Q

SLP Transition Group

A

Often used for individuals who have completed individual therapy and need to generalize to an environmental setting. Patients learn to communicate more independently and effectively.

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23
Q

SLP Maintenance Groups

A

Focus to stay active in communication.

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24
Q

Why use SLP groups?

A

May be the best form of therapy for individuals with mild/moderate aphasia because it can help generalize to daily life. May be utilized for individuals with severe aphasia but primarily after they have completed individual therapy and have established strategies for functional communication.

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25
Q

Prosody Expression Tasks

A

Teach features of emotional intonation in utterances by explaining a written description of emotional tones of voice, read sentence with prosody, contrastive stress drills, responses to questions, disambiguation exercises.

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26
Q

Prosody Comprehension Tasks

A

Determine moods from prosody, match emotional prosody to mood labels, ID discrepancies between prosody and explicit emotional contexts.

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27
Q

Neglect

A

Treat symptoms not the cause. Rigged leftward search tasks, visual scanning treatment (elicit head turn to the left), slow pacing, repetition is necessary to turn the practice into a habit, limb activation.

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28
Q

Attention Kinds

A

Focuses, sustained, selective, and alternating.

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29
Q

Attention Treatment

A

Complex cancellation, computer programs, compensation, graduate lengthening, checklist/chart use to check progress, train communication partners, enhance alertness, change environment. May have extralinguistic difficulties such as discourse and pragmatics, main point, intent, organization, and rules. Treat those using direct role play.

30
Q

Discoure

A

Often caused or complicated by other processing deficits or obstacles outside of the patients control.

31
Q

Discourse Macro-structure Difficulties

A

Summarizing, sorting and explaining stimuli, demonstrating appreciation of character motives in stories, identifying or explaining contradictions and abserdities.

32
Q

Discourse Micro-structure Difficulties

A

Self monitoring for typical errors, identifying ambiguity when it occurs. Will have to discuss when specific referencing is important, and how to self correct to avoid using ambiguity.

33
Q

Discourse Comprehension Deficits

A

Synthesize knowledge a word with stimulus information, problems identifying main ideas and relevant information, problems discarding relevant information, identifying clues that signal continuity in the narrative.

34
Q

Conventional Discourse Intervention

A

Strategies for topic control, monitor and respond to requests for clarification, ID sources of common breakdowns, discuss appropriate conversation, self monitor on a video and give feedback, give feedback to clinician who use inappropriate discourse.

35
Q

Pragmatics

A

Self monitoring training, group treatment on interpersonal skills, work on inferences, idioms, and metaphors, work on words or phrases with multiple meanings, denotative (literal) vs connotative (emotions about a word), practice in judging and generating semantic associations between words using sun diagrams.

36
Q

Semantic Deficits/ Word Meanings

A

Auditory modality (client says a real word or not), provide context, direct approaches (discuss intended meaning/feature of the word, using context to consider what is most relevant).

37
Q

Suppression Deficits

A

Stimuli ending in an ambiguous noun and contain a verb to bias interpretation of of the target word. Client manually indicates whether or not the word is related to the sentence. Client story telling involves the client staying on topic while the clinician introduces mental distractions.

38
Q

Processing Emotional Content

A

Facial comprehension and expression, direct teaching of what facial expressions mean, teach what to do in emotional situations, determine if it is an overall lack of arousal or concern, determination of lack of pragmatic understanding, train communication partners to specifically state their emotions, ID and build awareness of nonverbal behaviors, what they signal, and how they are signaled. Determine if above are from decreased arousal, emotional liability, cognitive processing, depression, or motor programming/perceptual deficit.

39
Q

Theory of Mind

A

Discussion of social norms or demonstration that no one’s thoughts are transparent. Use role playing.

40
Q

Social Cognition Deficit

A

Client identifies occasions when the clinican provides insufficient information based on what the client knows. Client lists what is known or assumed by two communication partners. Client plans how to make the purpose of an exchange clear, answer questions based on story/communication such as what did X mean? What cues did you use to figure it out? Which cues are important and not important? What is X’s point of view?

41
Q

Reading and Writing

A

If caused by visual processing or attention deficits; treat based on importance to the individual and severity of impairment. Establish compensatory, organizational guides, or structured sets of questions for self instruction and self analysis of reading comprehension, cue cards and visual graphic representation of text. It caused by visuospatical deficits use discrimination and matching tasks, figure ground differentiation, visual integration.

42
Q

Executive Function Deficits

A

Problem solving strategies-plan daily life problems and solutions, meta-cognitive strategy instruction.

43
Q

Hidden Victims of Aphasia

A

Family members are often impacted by the change in social roles, and additional considerable strain.

44
Q

PACE

A
  1. Exchange of new information.
  2. Equal participation.
  3. Free choice of communication channel.
  4. Functional Feedback.
    Best for individuals who need functional communication or who are easily distressed or saddened.
45
Q

CILT

A

Constraint induced language therapy. Cannot use gestures, only verbal communication. Continues for two to three hours a day. No feedback is supplied until the person relies the information correctly. Built on the belief that building up the neural pathways that need to be created for correct speech, neural plasticity.

46
Q

Therapy Outcomes

A

Different from therapeutic goals. Therapeutic outcomes are what the patient wants in therapy and what they wish to do in their daily life. Clinician goals should encompass therapeutic outcomes.

47
Q

Schuell Approach

A

Classic cuing based on phonemic, semantic, and repetition cuing at the word level. Is based off of the idea that auditory signals are vital to remediating aphasia. Involves intense auditory simulation. Basic principle is that individual still has language but is having difficulty retrieving the language. Primarily successful for individuals who have Broca’s aphasia.

48
Q

If client fails blame yourself…….

A

If therapy activity is not going well tell the patient that it was a bad activity or you picked bad words. This will boost patient morale and allow the patent to feel like are making significant progress. Intervention needs to be adjusted for maximal success of client.

49
Q

Considerations for Partner Training

A

Training on how intervention works, conversational style and how that pairs with the patient. Individual should be highly willing and motivated. They will need to be trained on how to to cue an individual, how the selected intervention works, and how to be a conversation facilitator. Counseling on conversational strategies, conversational goals, resolving and helping identify communication breakdowns.

50
Q

Stress in SO

A

SO of individuals with aphasia have higher levels of stress, depression, and other emotional problems. Marriage is negatively impacted. Stroke caregiver support, education, and training programs have short term effects on caregiver stress levels but are likely to require ongoing involvement to maintain their effect.

51
Q

Intensity of Treatment

A

Higher intensity leads to longer and more beneficial outcomes for measures of language impairment in individuals with chronic or acute aphasia. Less or more intensive therapy does not affect the individual in activity and participation. Maintenance effects were mixed as well.

52
Q

Aphasia Impairment

A

Focus on body structure and function, more traditional. Main goal is to provide treatment for the aspects of language impaired. Uses models of normal language and cognitive functioning to determine weaknesses in language areas and how to treat them. Guided by what is known about normal language processing. Language is not lost individual just cannot access it. Functional language will emerge as a by product of successful treatment.

53
Q

Aphasia Consequences

A

Focus on activities and participation, goal is to reduce consequences of aphasia on individual life. Targets outcome and participation portion of ICF. Working at impairment level to gain better participation. Based on the fact that aphasia is a psychosocial disorder and both language and communication abilities are impaired and barriers should be the focus of intervention.

54
Q

SFA

A

Semantic Feature Analysis is the sue of an analysis chart to generate semantic features of target concepts the clinician guides the individual in achieving maximum activation of the target by detecting feature generation. Activating the semantic and distinguishing features builds stronger semantic connections and increase likely hood of producing the name. Primary role of clinician is to cue patient to generate semantic features.

55
Q

Computer Use in Aphasia

A

Computer assisted treatment- patient and clinician working together on the computer program, clinician administers therapy and monitors patient.
COT: Computer only treatment. Patient practices without the supervision of direct assistance. Patients with aphasia can engage in interactive treatment actives more often and for longer periods of time.

56
Q

Computer Use in Aphasia Advantages

A

Advantages of computer only is that they can provide more intense treatment for cheaper.
Advantages for SLP and computer is that the SLP can immediately modify cues and supports according to patient response while changes on the computer are not immediate.

57
Q

A-FROM

A

Adaptation of ICF for individuals with aphasia. Does not have body structure or function. Has language impairment, life participation, environmental support, and person/psychological factors.

58
Q

Supportive Converstation

A

Individuals with aphasia converse with a trained conversation partner. Evidence suggests it can lead to better communication.

59
Q

Life Participation Approach to Aphasia

A

Focuses on individuals ability to participate and be connected in a social environment. Measures of success include documented life changes. Addresses what therapists can do in optimum communication and participation in life with aphasia. Intervention is responsive to personal needs and desires of the person with aphasia and their family. Therapist and client set goals together, therapist monitors clients response to therapy and monitors goals.

60
Q

Core Values of LPAA

A

Enhancement of life participation, all those effected are entitled to service, the measures of success include documented life enhancement changes, both personal and environmental factors.

61
Q

Social Networks after Aphasia

A

Individuals frequently experience social isolation, and exclusion after aphasia. Qualitative research indicates a reduction of social networks after aphasia. Overall reduction of social networks does occur but meaningful relationships can be built with others. In individuals with aphasia it is the quality of the social interaction not the quantity.

62
Q

Medical Model

A

Treat XYZ because it is impaired. Schullel approach.

63
Q

Social Model

A

Looks at aphasia as a communication disability with environmental barriers. Views a person on their social context and directs intervention and assessment to that environment. Acknowledges that the environment is a part of treating the disorder.

64
Q

Slow Rise Time

A

Caused by delayed timing tune in. Will not understand the first few words. Give individual time to tune in and make sure they are paying attention via eye contact and name calling. Repeat first word.

65
Q

Noise Build Up

A

Caused by lack of attention to statement. They understand the first word but get lost after the renaming words. Make into short utterances in order for better understanding.

66
Q

Intermittent Attention

A

Caused by inability to pay attention while individual is talking. They are drifting in and out of the conversation. Happens more when an individual is tired. Observe and give the sentence when the person is paying attention and stop when they are not attending.

67
Q

Working Memory and Assessment and Intervention

A

Ability to hold information in your brain for a short period of time. Lack of WM would cause individual’s ability to remember information that they have just been told. In assessment and intervention it may cause individual to seem more aphasic than they really are.

68
Q

Discourse Intervention

A
  1. Directly teach via the rule and flow.
  2. Therapy is the context of intervention (group therapy).
  3. Treatment outcome, all goals lead up to being able to have better discourse.
  4. Discourse is method to deal with psychosocial consequences of aphasia.
69
Q

Health Related Quality of Life

A

The impact of health on self evaluation of leading a fulfilling and happy life. Is more narrow than QoL. Includes subjective evaluation of patient beliefs of their mental, physical, and emotional states into consideration.

70
Q

Counseling as an SLP

A

Provide counseling only as it relates to communication disorders, while you many not advise you may listen, refer to necessary individuals (at least three).

Aphasia (2 decks)

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