III: Acquired Communication Disorders Flashcards
acquired LD
aphasia (4)
caused by acquired brain damage, language impairment NOT a speech impairment, intact nonverbal cognition and intelligence, anomia
acquired LD
grammatical competence (3)
the expression and comprehension of the formal grammatical aspects of language, syntax and morphology, deficits aka agrammatism
acquired LD
auditory comprehension (A/C) (1)
the ability to attach meaning to the words spoken by others
acquired LD
verbal repetition (2)
a skill to help differentiate the aphasia syndromes, repetition tasks: verbal short-term memory, verbal working memory
acquired LD
reading and writing deficits (6)
alexia, deep dyslexia (preserved whole word reading, difficulty with sound-by-sound), surface dyslexia (preserved sound-by-sound reading, difficulty with whole word), pure alexia without agraphia, letter-by-letter (LBL) reading, agraphia
acquired LD
persevervation (2)
inappropriate repetition of a response of continuation of a behavior when it is no longer required or appropriate, can be recurrent or continuous
acquired LD
recurrent vs continuous preservation
repeating a response to fill a delay :: immediately repeating a response without delay
acquired LD
stuck-in-set (1)
inability to shift response set when directed to (for example, stuck on counting when pt is asked to recite alphabet)
acquired LD
apraxia (1)
a disorder of the execution of a learned movement that is not cause by motor weakness, incoordination or sensory loss and it is not due to failure to understand the command
acquired LD
ideomotor apraxia (2)
most common particularly following left hemisphere strokes, difficulty with: selection, sequencing and spatial orientation of movements for gestures
acquired LD
AOS (2)*
apraxia of speech, a sensorimotor speech disorder with symptoms of impaired volitional production of articulation and prosody that does not result from: abnormal muscle strength, tone or timing NOR does it arise from aphasia, confusion, generalized intellectual impairment or hearing loss
*may co-occur in persons with aphasia
acquired LD
agnosia (3)
generally associated with cortical brain damage (parietal, temporal, occipital), not a result of primary sensory deficits, a disorder of recognition of: objects, people, sounds, colors, etc
acquired LD
prosopagnosia vs anosognosia
inability to recognize faces :: inability to recognize one’s own illness
acquired LD
language zone (2)*
fed by the middle cerebral artery (MCA) so often a left MCS stroke will result in an aphasia, includes: angular gyrus, broca’s area, wernicke’s area, arcuate fasciculus, supra marginal gyrus
*includes the cortical and subcortical regions of the frontal, parietal and temporal lobes of the left hemisphere
acquired LD
anterior vs posterior lesions (1::1)*
leads to confluent aphasia :: leads to fluent aphasia
*damage to both regions of the language zone of the left hemisphere may result in a severe aphasia with concomitant right hemiparesis
acquired LD
right hemiparesis (2)
impairment of motor functioning on the right side of the body, caused by damage to the motor strip (left pre central sulcus and deeper)
acquired LD
right hemiplegia (1)
paralysis on the right side of the body
acquired LD
etiologies (4)*
cerebrovascular disease (leading cause), TBI, brain tumor, neurodegenerative disorders
*damage occurs on the language zone of the left hemisphere
acquired LD
TIA (3)
transient ischemic attack, temporary loss of neurological function caused by interruption of blood flow to a brain region, warning sign for stroke
acquired LD
CVA (2)
cerebrovascular accident aka stroke, most common cause of aphasia
acquired LD
embolus vs thrombosis (1::1)*
blood clot formed in another body area and traveled up to the brain (usually from heart) :: blood clot formed in the brain
*each are considered occlusive strokes and may be treated using clot-bursting rugs such as TPA
acquired LD
hemorrhagic CVA (1)
rupture of vessels in the brain (rather than blockage of blood flow)
acquired LD
types of brain hemorrhages
ruptured aneurysm (ballooned-out area), arteriovenous malformation (AVM – tangled blood vessels usually congenital), intracerebral hemorrhage (rupture within neural tissue), subdural/subarachnoid hemorrhage (rupture in the meningeal coverings of the brain)
acquired LD
TBI (2)*
traumatic brain injury, damage may be focal or diffuse, causes include: motor vehicle accidents (MVAs), falls, head trauma, chronic traumatic encephalopathy (CTE – multiple concussions), blast injuries, gunshot/stab wounds, closed head injuries (CHIs)
*common site of damage is uni/bi-lateral prefrontal area(s)
acquired LD
coup vs countrecoup (1::1)*
site of impact :: opposite site of impact
*types of focal injuries
acquired LD
DAI (2)
diffuse axonal injury, a type of diffuse injury
acquired LD
tumors of the neural tissues of the brain (2)*
glioma, meningioma
*metastatic tumors originate elsewhere in the body
acquired LD
dementia syndromes that also have significant language defects as part of the profile (4)
alzheimer’s disease, frontotemporal dementia (includes primary progressive aphasia), vascular dementia, dementia with lewy bodies
acquired LD
standardized aphasia assessments (7)
boston diagnostic aphasia examination (BDAE-3), boston naming test (BNT), western aphasia battery-revised (WAB-R), aphasia diagnostic profiles (ADP), cognitive linguistic quick test (CLQT), porch index of communicative abilities-revised (PICA-R), minnesota test for the differential diagnosis of aphasia (MTDDA)
acquired LD
aphasia assessments that address functional communication abilities (4)
communication activities of daily living (CADL-2), functional assessment of communication skills for adults (ASHA FACS), communicative effectiveness index (CETI), boston naming of severe aphasia (BASA)
acquired LD
verbal expression tasks (9)
spontaneous narrative production, complex picture description, story retell, social responding, naming task, word list generation, repetitions, oral reading, automatic naming tasks and songs
*decide if pt is fluent vs nonfluent
acquired LD
paraphasic errors (5)
semantic, phonemic, verbal unrelated, neologism (naming an item using a nonword), mixed
acquired LD
auditory comprehension tasks (5)
word discrimination, following commands, answering yes/no questions, understanding of grammatical forms, comprehension during conversation
acquired LD
reading comprehension tasks (5)
word-picture matching, sentence-picture matching, lexical decision (ID real from non real words), sentence and paragraph comprehension, functional reading
acquired LD
writing expression tasks (5)
writing name, automatic naming, narrative descriptions, written confrontation naming, functional writing tasks
acquired LD
modalities of limb and oral-facial apraxia assessment (3)*
following verbal commands for motor movements, motor imitations, performing actions with objects
*pt may have limb apraxia and not oral-facial apraxia and vice versa
acquired LD
BAT (2)
bilingual aphasia test, three parts: (A) evaluation of multilingual history, (B) assessment of language disorder in each language known by the subject, (C) assessment of translation abilities and interference detection in each language
acquired LD
nonfluent aphasia types (3)
broca’s, transcortical motor, global
acquired LD
fluent aphasia types (4)
wernicke’s, transcortical sensory, conduction, anomic
acquired LD
boston classification system (broca’s)
nonfluent, preserved auditory comprehension, impaired repetition
acquired LD
boston classification system (transcortical motor)
nonfluent, preserved auditory comprehension, preserved repetition
acquired LD
boston classification system (global)
nonfluent, impaired auditory comprehension, impaired repetition
acquired LD
boston classification system (wernicke’s)
fluent, impaired auditory comprehension, impaired repetition
acquired LD
boston classification system (transcortical sensory)
fluent, impaired auditory comprehension, preserved repetition
acquired LD
boston classification system (conduction)
fluent, preserved auditory comprehension, impaired repetition
acquired LD
boston classification system (anomic)
fluent, preserved auditory comprehension, preserved repetition
acquired LD
four subcortical aphasia syndromes
anterior capsular-putaminal, posterior capsular-putaminal, global capsular-putaminal, thalamic
acquired LD
psychosocial effects via organic causes (4)
left-frontal lesions linked to depression, prefrontal lesions linked to apathy/indifference, left-posterior lesions linked to unawareness/agitation, left-hemisphere lesions linked to catastrophic reactions
acquired LD
reactions to aphasia diagnosis (5)
detail, anger, bargaining (“if I do X, then I will recover”), depression, acceptance
acquired LD
diaschisis (1)
temporary loss of function in brain regions remote from the lesion but connected via neural networks (i.e., not actually damaged but temporarily dysfunctional)
acquired LD
deblocking (1)
using an unblocked modality to deb lock a blocked modality
acquired LD
MIT (2)
melodic intonation therapy, a type of intersystem reorganization task that uses intoning and hand tapping to assist verbal expression
acquired LD
RET
response elaboration therapy, a type of divergent therapy targeting verbal expression with the goal of increasing phrase lengths and lexical retrieval
acquired LD
PACE principals (2)
a type of pragmatic approach, promoting aphasics’ communication effectiveness which involves equal participation by client and clinician and freedom for the client to express themselves whatever way they wanton (and then clinician provides feedback)
acquired LD
recovery patterns seen in bilingual/multilingual persons with aphasia (5)
parallel recovery, differential recovery, antagonistic recovery (recovery is inverse), blending recovery (uncontrolled mixing of languages when trying to speak in only one language), selective aphasia (loss in one language and not in another)
acquired LD
VCUI (3)
voluntary control of involuntary utterances, a treatment for improving verbal expression that uses oral reading to improve production of single words to communicate ideas in people with severe aphasia, the idea is to expand the patient’s vocabulary set
acquired LD
TUF (3)
treatment of underlying forms, a treatment for agrammatism that focuses on underlying linguistic deficit, the idea is to treat complex forms and simpler forms will be achieved without having to actually treat them
acquired LD
SPPA (3)
sentence production program for aphasia, a structured treatment for agrammatism, a treatment method used to stimulate production of sentence-level verbal output and to increase use of selected syntactic constructions (based on 14 different sentence types by persons with aphasia)
acquired LD
CILT (3)
constraint-induced language therapy, aka constraint-induced aphasia therapy (CIAT), the person with aphasia must only communicate via verbal expression and cannot use any other mean including gesturing or drawing
acquired LD
ORLA (2)
oral reading for language in aphasia, uses reading aloud tasks of phrases and short sentences to stimulate language improvement
acquired LD
AphasiaScripts (1)
a computer program with an avatar clinician who helps practice a personalized verbal conversation script
acquired LD
TAP (2)
treatment for aphasic preservation, an anomia treatment for people with severe verbal perseveration that focuses on increasing conscious awareness of perserverative behaviors so that the person with aphasia will learn to inhibit perseverations
acquired LD
VNeST (2)
verb network strengthening treatment, improves lexical retrieval of content words in sentences by having the pt use verbs to create agent-verb and verb-object pairs/phrases
acquired LD
TWA (3)
treatment of wernicke’s aphasia, a structured method designed to improve auditory comprehension in people with wernicke’s aphasia who have significant difficulty understanding spoken language, uses reading comprehension to assist auditory comprehension (aka deblocking)
acquired LD
multiple oral reading (2)
a method designed for people with aphasic alexia (letter-by-letter readers) who have impaired access to words in the graphemic input lexicon, read a short passage over and over to shift from LBL reading to whole-word reading
acquired LD
ACRT (3)
anagram copy and recall treatment, a treatment approach for agraphia that aims to strengthen words in the graphemic output lexicon so that they can be used for functional writing, uses drill to reinforce visual and kinesthetic aspects of writing
acquired LD
VAT (3)
visual action therapy, used for people with severe aphasia as a means to treat limb apraxia so gesturing may become an option, pt learns manual gestures that represent objects
acquired LD
Amer-Ind gestural training (2)
a system of manual gestures to communicate concrete ideas for functional communication, based on “universal american indian hand talk”
acquired LD
AAC systems for persons with aphasia (7)
c-speak aphasia, dynavox, lingraphica, proloquo2go, SentenceShaper, TouchSpeak, visual scene displays
acquired LD
BDB (2)
back to back drawing board, a communicative drawing approach that trains drawing of people in action sequences
acquired LD
CDP (2)
communicative drawing program, a series of drawing tasks (grouping colors/shapes, finishing incomplete drawings, copying, drawing from memory, etc.)
acquired LD
LPAA (2)
life participation approach to aphasia, a community-based approach focuses on adapting the pt to their environment instead of focusing on their impairments (book clubs, support groups, etc.)
acquired LD
SCA (2)
supported conversation for adults with aphasia, a conversation training program for communication partners of persons with aphasia
acquired LD
aphasia recovery patterns (2)
first 6 months is known as the period of spontaneous recovery, neuroimaging studies show peri-lesional (adjacent) and homologous (same area but opposite side) regions may take over functions of the affected area of the brain
acquired LD
FYIs of aphasia recovery etiologies (3)
recovery for traumatic aphasia > stroke-induced aphasia, recovery for hemorrhagic stroke aphasia > ischemic stroke aphasia, primary progressive aphasia (or any neurodegenerative condition) will not recover but will deteriorate over time
acquired LD
common changes in wernicke’s recovery
wernicke’s -> conduction -> mild anomic
acquired LD
common changes in global aphasia recovery
global -> mixed nonfluent (and in some cases, -> severe broca’s)
acquired LD
common changes in broca’s recovery
broca’s -> milder broca’s
acquired LD
crossed aphasia (1)
aphasia resulting from a right-hemisphere lesion in a right-handed person
acquired LD
symptoms of right hemisphere brain damage (8)
problems understanding nonliteral/figurative language, poor theory of mind, poor ability with melodies or recognizing tunes, flat affect and poor recognition of emotions/facial expressions, left neglect, impaired viseioconstructive (drawing) abilities, inattention/distractibility, anosognosia (more seen in right brain damage than left)
acquired LD
assessments for right brain damage (2)
MIRBI-2:mini inventory of right brain injury :: RIPA-2:ross information processing assessment
acquired LD
circumlocusions (2)
naming errors produced by elders, they are able to provide semantic information but unable to name the target
acquired LD
MCI (3)
mild cognitive impairment, subtle but measurable memory disorder, considered a prodrome state (pre syndrome) to alzheimer’s or another form of dementia
acquired LD
dementia (1)
a progressive neurological disorder affecting multiple cognitive domains (memory, language, visuospatial skills, executive functions, behavior)
acquired LD
DSM-IV criteria for alzheimer’s (4)
impaired memory, at least one other impaired cognitive domain, the disorder must impair work or social functioning, the disorder must be progressive
acquired LD
treatment themes for dementia (2)
treat cognition and language in the early and middle stages, treat dysphagia in the later stages
acquired LD
MMSE (3)
mini-mental state exam, commonly used for assessment of cognitive dysfunction in adults, test measures: orientation to time/place, concentration, memory, language
acquired LD
ABCD (2)
arizona battery for communicative disorders of dementia, a comprehensive assessment tool using 17 subtests including: story retell, following commands, word learning, reading comprehension, naming
acquired LD
AD (4)
alzheimer’s dementia, a dementia syndrome and leading cause of dementia in adults, average duration from onset to death is 8-15 years, disorder of the protein tau (tauopathy)
acquired LD
VaD (4)*
vascular dementia, second most common form of dementia, a dementia syndrome caused by severe cerebrovascular disease impairing multiple cognitive domains, subset of a larger syndrome called vascular cognitive impairment (VCI)
*memory impairment is not always seen, not always progressive, may co-occur with alzheimer’s
acquired LD
binswanger’s disease (2)
etiologic subtype of vascular dementia, multiple small infarcts in the subcortical white matter usually related to severe hypertension
acquired LD
lacunar state (2)
etiologic subtype of vascular dementia, multiple small infarcts in subcortical regions of the: basal ganglia, thalamus, midbrain or brain stem
acquired LD
CADASIL (2)
cerebral autosomal dominant anteriopathy with subcortical infarcts and leukoencephalopathy, etiologic subtype of vascular dementia that is inherited
acquired LD
FTD (3)*
frontotemporal dementia, findings of brain atrophy in the frontal and temporal lobes, a group of neurogenerative disorders that includes: primary progressive aphasia, pick’s disease and a non aphasic frontal dementia syndrome
*also: circumscribed cerebral atrophy, lobar atrophy, progressive subcortical gloss, corticodentatonigral degeneration, frontal lobe degeneration, semantic dementia, corticobasal degeneration, dementia lacking distinctive histopathology (DLDH), dementia with motor neuron disease (MND), primary progressive apraxia
acquired LD
three major clinical variants of FTD
frontal dementia, semantic progressive aphasia, progressive nonfluent aphasia
acquired LD
frontal variant FTD (1)
frontal dementia characterized by: disinhibition, poor impulse control, apathy and antisocial behavior
acquired LD
FTD symptoms (6)
executive function impairments, spared memory compared to AD, stereotypical/ritualized behaviors, use of sterotypyies (catch phrases), preference for sweet foods, elements of kluver-bucy syndrome (increased sexual activity, hyperorality, apathy and placidity)
acquired LD
PPA (2)
primary progressive aphasia (includes semantic dementia, progressive nonfluent aphasia and logopenic/phonological PPA), progressive language disturbance is the main clinical finding
acquired LD
PD (4)
parkinson’s disease, a significant movement and neurodegenerative disorder, caused by dysfunctions in brain regions that produce the neurotransmitter dopamine, often includes hypokinetic dysarthria
acquired LD
DLB (2)
dementia with lewy bodies, a disorder caused by dysfunctions in brain regions that produce the neurotransmitter dopamine
acquired LD
treatment of communication in people with neurodegenerative syndromes (2)
includes pharmacological treatments and medical treatments for people with dementia, cognitive-communication interventions: AAC, memory books, simulated presence therapy, group reminiscence therapy, spaced-retrieval training (SRT – training memory associations), caregiver-administered active cognitive stimulation, educating caregivers on alzheimer’s disease and training communication strategies, computer-assisted cognitive interventions (CACIs), montessori-based interventions
MSDs
relevant terms (5)
motor speech disorder (MSD), apraxia of speech (AOS), childhood apraxia of speech (CAS), developmental dysarthria (DD), childhood dysarthria (CD)
MSDs
dysarthrias (1)
a group of speech disorders associated with an impairment to motor speech control and execution processes resulting from damage to the peripheral nervous system (PNS) and.or central nervous system (CNS)
MSDs
anarthria (2)
aka anorthic mutism, the inability to speak due to severe impairment to motor speech control and execution processes as a result of damage to the PNS and/or CNS
MSDs
AOS (5)
apraxia of speech, neurogenic speech disorder associated with impairment to motor planning and/or motor programming, lesion(s) to the frontal or parietal lobe of the left cerebral hemisphere, lack of neuromuscular impairment, often coexists with aphasia, deficits in: articulation, rate and prosody
MSDs
CAS (3)*
childhood apraxia of speech, a neurological pediatric speech sound disorder in which the precision and consistency of movements underlying speech are impaired in absence of neuromuscular deficits, core impairment in planning and/or programming spatiotemporal parameters of movement sequences resulting in errors in speech sound production and prosody
*controversial, no apparent lesion site discovered
MSDs
assessment areas of MSDs (6)
naturalness, speech intelligibility, speaking rate, efficiency, articulation adequacy, motor planning/programming
MSDs
assessments of articulation adequacy
PIT:phoneme intelligibility test :: PCT:phonetic contrast test
MSDs
ABA-2 (2)
apraxia battery for adults-2, differentiates performance between: AOS, aphasia and dysarthria
MSDs
principle standardized measures of CAS (4)
KSPT:kaufman speech praxis test for children :: STDAS-2:screening test for developmental apraxia of speech-2 :: VMPAC:verbal motor production assessment for children :: the apraxia profile (differential diagnosis of CAS)
MSDs
nonstandardized measures of CAS (2)
motor speech examination for children (similar to motor speech examination for apraxia), assessment of children with developmental apraxia of speech
MSDs
neuroplasticity (4)
reorganization of the nervous system through transfer of restored or new behavior to spared parts of the system, can be adaptive or maladaptive, can occur immediately or slowly, influenced by type of experience (high demands of specific tasks in rich environments) and timing of experience (younger systems are more plastic)
MSDs
motor learning principles (6)
precursors to learning (establishing motivation, setting specific instructions), massed (drill) and distributed (intermittent short breaks) practice schedules, type and amount of feedback, implicit and explicit learning, specificity of training, intensive practice
MSDs
KR vs KP
knowledge of results (feedback describing degree of success) :: knowledge of performance (feedback describing quality)
MSDs
treatments for improving respiratory support (4)
non speech tasks, postural adjustments, prosthetics, speech treatments
MSDs
physical strategies for treating hypoadduction (3)
used to improve phonatory function, strategies: effortful closure, postural adjustments, physical manipulation
MSDs
LSVT for treating hypoadduction (3)
lee silverman voice treatment, application go huh-effort tasks to increase loudness and improve vocal fold function, also used for individuals with idiopathic parkinson’s disease
MSDs
treatments for hyperadduction (2)
non speech (relaxation, biofeedback), speech (tension-reducing strategies, biofeedback, head positioning, improving phonatory coordination impairments, AAC)
MSDs
treatments of the velopharyngeal subsystem (3)
surgical (pharyngeal flap, teflon injections or surgical implants into the posterior pharyngeal wall), prosthetic (palatal lift for those with velopharyngeal weakness, minor devices such as nose clips or nasal obturators), behavioral (resistance treatments, biofeedback, non speech tasks)
MSDs
treatments of the articulatory subsystem (6)
strengthening, reducing muscle tone, traditional approaches (integral stimulation, phonetic placement, phonetic derivation), surgical (neural anastomosis which involves surgically attaching a healthy nerve to a damaged nerve), pharmacological (botulinum toxin “botox” injections), prosthetic (bite block)
MSDs
treatment overview of AOS (3)
target reestablishing motor planning and programming, use principals of motor learning, major goal is to: improve naturalness, effectiveness and efficiency, with a focus on articulation and prosody
MSDs
treatment overview of CAOS (3)
focus of therapy is to develop/improve motor planning and/or programming skills for speech sound production and prosody, pay attention to other deficit areas (language phonology, phonological awareness, literacy), consider other processing deficits (cognition, attention)
