Intro to Acquired Language Disorders Flashcards
What is Aphasia?
-Acquired
-Neurological Cause
-Affects reception and production of language, across modalities
-NOT a sensory, motor, psychiatric or intellectual disorder
What is often the problem of aphasia?
-Problem is access to stored linguistic representations, not the loss of representations themselves
brain pathology can cause other patterns of impairment and perseveration
-TBI
-Right-hemisphere dysfunction
-dementias, includeing PPA
Unidimensional vs Mult-dimensional Frameworks
-Uni: A whole, so a deficit anywhere will affect the language system
-If a patient needs to work on speaking, also work on other things to stimulate the language system
-Multi: understanding the different classifications
-Understand what kinds of things might help a particular person
Medical Frameworks
-Impairment label/deficit approach
-Don’t have to focus on medical approach if in a medical setting
Cognitive neuropsychological, psycholinguistic, and neurolinguistic models
-Think about language as a process
-See the object, visual processing, semantic concept
-If a pt can’t name an object there are multiple places where they system could be interrupted
Biopsychosocial model
-Environmental factors, social support, motivators
Social Models
-Understanding aphasia and disability as a social condition
-Subset of biopscychosocial
-Aphasia will affect everything in a person’s life
Social Detriments of Health
-Inequities and inequalities in health care; and these affect people with aphasia as well; no two people will be the same due to the social determinants of health
WHO Framework
-Health condition (stroke)
-Body functions & structures (impairments) [language]
-Activities (limitations) [how much is communication affected; talking to family members coworkers]
-Participation (restrictions) [occupation, sports, tiktok]
-Environmental factors
o Personal factors
Own personal motivation
Depression
Identity
Language vs. Cognition
o Use a multimodality approach
-Assess all modalities
-Which are more or less impacted
o Disorder of language, not intellect
-E.g., someone with aphasia may recognize an individual but not come up with name
Diagnosing Aphasia
o Includes
Naming (name the item or point to it from choice of 3)
Follow direction (touch nose, ceieling, move toes_
Answer questions (do you peel a banana before you eat it)
Orientation questions (your name? date? Where you are?)
Multimodality deficit: example
-Most common deficit with aphasia
-Word-finding difficulty
-“I know the word I just cant say it”
Diagnosing aphasia: goal
-Word level: Listen to word, point to object; read a word “; name objects (speaking); write names of objects
-Sentence level: follow simple commands; follow simple instruction (reading); describe simple actions (speaking); describe actions (writing)
-Discourse/text level: Listen to a story/answer questions; read a paragraph and answer questions; describe a complex picture (speaking); writes a letter (writing)
Challenges of Diagnosis
- Is it aphasia and motor speech disorder or just aphasia
- only neurologist can diagnose pathology; SLP diagnoses speech and language disorder by bx
- damage of aphasia is in ONE location
-Think of it as a “Central Disorder”
-i.e., “one grammar” is underlying “language” whether it is for talking or writing
Deficit of Propositional Language
-Statements about the world either true or false
-Use language to intentionally talk to people
-Every time you speak you are getting words putting them together, you are using your knowledge of speaking
-Automatic language is sometimes preserved (subpropositional language)
-Can’t use language to be as creative
-e.g., counting, singing a song, or producing routine greetings such
as , “How are you?” or “I’m fine”
Symptoms of Omission
whats missing? (certain words; grammatical words)
Symptoms of Commission
– whats wrong? Have the right words but something is wrong
Anomia
Problem of finding and retrieving words
-Not to be confused with anomic aphasia
-Omissions and Commisions
Circumlocution
-Talk around the word (error of commission)
-Describing item can be a useful strategy
Paraphasia
A word substitution error
(Think about the relationship between the PWA’s production and the target)
4 Types of Paraphasia
- Phonemic: Substitutes as sound in the word (e.g., kiger for tiger)
- Semantic: substitutes a related word for the intended word (e.g., lion for tiger)
3.Unrelated: e.g., flag for tiger - Neologism: nonword error (e.g., floosis for tiger)
Non-fluent
Individual speaks with effort and with fewer words than normal
Fluent
Individual talks with easy flow using complete sentences
Agrammatism
-limited grammar
-omitted units are grammatical morphemes
-The agrammatic individual produces many open-class or content words
Fluent Aphasia
-Main Issue: producing appropriate content words such as nouns, verbs, and adjectives
-May have (significant or mild) word-finding errors
-May use vague/general terms or circumlocutions
-words come easily, but not necessarily the right words
-High use of jargon and paraphasias (word salad/gibberish)
-Neologism one word, jargon is many
Stereotypic utterances
-Some PWA can only produce involuntary or subpropositional language
-Repetitions of the same word, phrase, or syllable
-Can be dictionary words, or neologism, or phrase
Why do some PWA have agrammatism and others speak fluently (but not always comprehensibly)?
-Multidimensional framework: syndromes correspond to lesions
-Cognitive, psycholinguistic neurolinguistic framework: based on models of representation
-We need to understand each approach
Sylvian Fissure
Separates Parietal and temporal lobes
frontal lobe
executive functioning, personality, motor, decision making, planning
Problems with Classical Model
o lesion doesn’t predict aphasia type
o underestimates the number for distribution of brain regions involved in language
o researchers don’t agree where these regions (specifically) are
Explaining aphasia: neurology
-Neurological explanation: link lesions to symptoms
-Wernicke: comprehension deficit ~ damage in the left temporalcortex
Explaining aphasia: cognition
-Knowledge: what we know
-Process: activity of the mind/quick mental response
-Mental representation: How information is represented in the brain
-Layers of knowledge
* Mental representation
* Cat: how do you conceive of this?
Memory: cognitive functions need memory
-LTM: long term memory (address, phone number) how to type, things you’ve learned how to do
-WM: working memory, shorter, thinking about it
-does brain damage affect working memory in a way that aggravates or even causes symptoms of aphasia?
* automatic processing vs. controlled processing
Aphasia: Cognition
aphasia is an impairment of processing rather than a loss of linguistic knowledge
Aphasia Treatment Settings
-Acute: Immediate and short-term
-Subacute: transition between acute
hospitalization and home (inpatient rehabilitation unit, SNF)
-Chronic: long term, outpatient
Ways to treat aphasia
Impairment-based: focus on linguistic/cognitive deficits
Communication-based: focus on activity/participation limitations
Central Disorder
one anatomical location for the lesion that is causing all of the problems
