Final Exam Flashcards
Definition of TBI
A distruption in the normal function caused by a nonpenetrating blow or jolt to the head or a penetrating head injury
Age Groups at Highest Risk for TBI
Children ages 0-4 and 15-19
Penetrating vs Nonpenetrating head injury
Penetrating= a wound in which an object breaches the cranium but does not exit it
nonpenetrating= closed head injury, the skull and dura mater remain intact
Damage that happens as a result of TBI Medically
- brusing and laceration of the brain
- secondary edema - swelling
- infection
- hypoxia- deprivation of oxygen
- intracranial pressure
- infarction - death of tissue deprived of blood supplu
- hematoma- focal bleeding
Cognitive Deficits of a TBI
Attention
Memory
executive functioning
Orientation
thought organization
reasoning and problem solving
Types of attention
joint, sustained, divided, alternating, selective
Types of memory
short term, long term, immediate, delayed, working, procedural
executive functioning
Involves the initiation, organization, and integration of information related to planning, problem-solving, and reasoning
Hemisensory Impairment
loss of ability to perceive sensory information on one side of the body
Hemiparesis
muscle weakness on one side of the body
hemiplegia
paralysis on one side of the body
Language areas that are affected with a TBI
Amonia, Impaired comprehension, pragmatics
Amonia
word finding difficulties
Pragmatics
the most distrubed language area and that with the most pervasive problems
Results from the inability to inhibit behavior and from errors of judgement
How are Pragmatic Deficits Identified?
through informal observation during conversational exchanges and reciprocal play
Orientation
time and space
Thought Organization
being able to organize thoughts, staying on topic, get wants and needs out
Psychological Deficits of TBI
- aggression/withdrawal
- apathy and indifference
- denial
- depression
- disinhibition and impulsivity
- impatient
- phobias
- socially inappropriate behavior and comments
- suspiciousness and anxiety
SLP’s role in interdisciplinary Team When assessing TBI
SLP assesses all aspects of communication, cognitive-communicative functioning and swallowing
Dynamic Assessment
Informal assessments are essential in determining which areas to probe.
An evaluation method used to identify an individual skill as well as their learning potential.
Ongoing Assessment.
Intervention Approaches for TBI
Cognitive Rehabilitation
RCA
Restorative approach
compensatory appraoch
adaptive approach
Cognitive rehabilitation for TBI
Involves increasing the individual’s ability to process incoming information in order to increase their functional independence
RCA
acrocym for restore, compensate and adapt
Restorative Approach
attempts to rebuild neural circuitry and function through repetitive activitives
Compensatory Approach
Cenceding that some functions will not be recovered and we develop alternatives
Adaptive approach
relates to modifying an individual’s environment to increase safety
3 stages of TBI Intervention
Early
Middle
Last stage treatments
Early State of TBI Intervention
focuses on orientation, sensorimotor stimulation, and recognition of familiar people and common objects and events.
Middle Stage of TBI Intervention
More structured and formal.
Goals are developed to reduce confusion, improve memory and increase goal-directed behavior.
Focus is directed towards increasing client’s orientation to everyday activities.
Receptive language is addressed, with primary focus on listening skills, auditory comprehension, and following directions.
Also focuses on increasing client’s ability to sue descriptive statement to describe
Late Stages of TBI Intervention
Goals relate to achieving functional independence.
SLP presents complex info to improve comprehension, ability to follow directions and engage in in-depth convo using appropriate social skills.
Alternative strategies are developed.
Conversational problem-solving tasks are targeted.
Dementia Definition
Umbrella term for a group of both pathological conditions and syndromes that result in declining of memory and at least one other cognitive ability that is significant enough to interfere with daily life activities
Causes of Dementia
Alzheimer’s disease, degenerative diseases
Cognitive Impairments of Dementia
Memory impairments= short term, immediate are very affected
Poor reasoning and judgement skills
impaired abstract thinking- lots of choices, not happening in real time, thinking ahead
Inability to attend to relevant information
impaired communication- trouble expressing
personality changes- can become more aggressive, irritable, can fluctuate during disease process
Cortical Dementia
Alheimer’s and Picks diseases, resemble those of of focal impairments such as aphasia and RHBD.
Deficits are…
visuospatial deficits
memory problems
judgements and abstract thinking disturbances
language deficits (naming, reading, writing, and auditory comprehension)
Subcortical Dementia
Patients experience a slow deterioration of cognitive functioning with deficits noted in memory impairments, problem-solving difficulty, receptive and expressive language impairment, poor neuromuscular control
Part of Brain most damaged with Alzheimer’s Disease
Hippocampus and temporal area
Assessment Techniques for Alzheimer’s
- Neuroimaging Techniques: determines loss of function in the temporal lobe
- Pupil dilation: can be an indicator of the presence of disease in early stages
- computerized assessment of Mild Cognitive Impairment (CAMCI)
- Medical history and behavioral observations: collecting family history, neurological health, communication in different environments
- writing assessment: difficulty writing a letter is one of the earliest affect areas of linguistic performance
Cognitive Rehabiliation for Dementia
SLP, Client, health professionals, and families develop individualized goals and implement strategies based on those goals EX: utilizing recall strategies to remember family member’s names
Cognitive Training for Dementia
An approach used to denote structured practice to improve specific cognitive functions, such as attention, memory, and executive functions EX: drilling
Cognitive stimulation for Dementia
Less direct appraoch, can typically be done in a group setting. EX: working on puzzles
