Language cognition and communication in adults Flashcards

1
Q

What 5 things does cognition comprise of?

A

Attention
Memory
Executive function
Interactions with sensory processing
Social cognition

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2
Q

What is executive function according to Brookshire?

A

Incorporates aspects of attention, memory, planning, reasoning, and problem solving to organise + regulate purposeful behaviour

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2
Q

What are the 7 levels of the communication chain?

A
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3
Q

What is social cognition?

A

How we operate together

note: can link to personality changes, think relationships

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4
Q

What are the 2 broad types of conditions the adult population can have that can affect LCandC?

A

Acquired
- stroke
- TBI
- progressive degenerative conditions (eg: dementia)
Developmental

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5
Q

What are the 2 approaches to studying language, cognition, and communication?

A

Individual and their mind/brain: medical model approach

Social interactions in everyday life: social model approach

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6
Q

What are 2 disorders that affect LCandC from neurological damage?

A

Aphasia (post-stroke, tumour)
Cognitive-linguistic disorders (TBI + dementia)

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7
Q

How does aphasia impair language processing?

A

Impairs how words are generated, impairs…
- auditory +reading comprehension
- spoken + written language production

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8
Q

At which ‘levels’ does aphasia affect language processing?

A

Single word level, sentence level, and how these are put together in discourse + conversation

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9
Q

Where can language breakdown occur for those with aphasia?

A

Meaning
Word form

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10
Q

What do those with cognitive-linguistic deficits have difficulty with? (5)

A

Word finding
Making inference & links
Abstract language
Remembering what info is shared (over/ under explaining)
Turn taking (reduced awareness)

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11
Q

What do those with cognitive-linguistic deficits fail to do? (5)

A

Self-correction, reliant on others for this
Start/maintain conversation
Ask for clarification
Read social cues
See other points of view

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12
Q

What do those with cognitive-linguistic deficits tend to have/do? (5)

A

Disorganised/confusing discourse
Topic bias (eg: stick/reverting to fav topic)
Repetitiveness
Perseveration (stuck on word/phrase/behaviour and can’t get past)
Confabulation (say something that isn’t true, individual believes it’s true in the moment)

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13
Q

What is the cognitive-linguistic function framework by Body & Perkins?

A
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14
Q

How do cognitive-linguistic disorders impact social interaction?

A
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15
Q

Where is damage in aphasia vs cognitive-linguistic disorder?

A

Aphasia: focal
CLD: diffuse

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16
Q

What is the cognitive status in aphasia vs cognitive-linguistic disorder?

A

Aphasia: usually good
CLD: impaired

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17
Q

What is the language status in aphasia vs cognitive-linguistic disorder?

A

Aphasia: impaired
CLD: variable

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18
Q

What is the communication status in aphasia vs cognitive linguistic disorder?

A

Aphasia: often better than language status
CLD: often worse than language status

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19
Q

What are the types of linguistic impairments contributing to communicative difficulties in aphasia vs cognitive-linguistic disorder?

A

Aphasia: lexical semantic + grammatical (not often pragmatic)
CLD: pragmatic (sometimes lexical semantic too)

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20
Q

What is the role of naturalistic observation for aphasia vs cognitive-linguistic disorder?

A

Aphasia: important for observing compensatory behaviours
CLD: important for observing impairments, and also compensatory behaviours

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21
Q

What is behaviour like in aphasia vs cognitive-linguistic disorder?

A

Aphasia: generally appropriate
CLD: may be ‘inappropriate’

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23
Q

What are the 3 functions of memory?

A

Putting information in
Holding information
Re-accessing information

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24
Q

What are 3 other words for ‘putting information in’ in regards to memory?

A

Acquisition
Input
Encoding

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25
Q

What are 3 other words for ‘holding information’ in regards to memory?

A

Consolidation
Storage
Maintenance

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26
Q

What are 4 other words for ‘re-accessing information’ in regards to memory?

A

Retrieval
Recall
Recognition
Manipulation

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27
Q

What are the 2 broad types of memory?

A

Working memory: short + limited
Long term memory (explicit): long + unlimited

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28
Q

What was working memory originally referred to as?

A

Short-term store/ short-term memory
- storage depot
- length of maintenance rehearsal determined likelihood of LT storage

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29
Q

How was working memory reconceptualised by Baddeley?

A

More emphasis on the nature of the processing mechanisms, than the time in ‘storage depot’

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30
Q

What is the contemporary construct of working memory?

A

Dynamic, active system that serves both maintenance + manipulation functions
Operates in multiple sensory-perception modalities

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31
Q

What is maintenance, in regards to working memory?

A

Mentally holding info for brief periods after the actual stimulus presentation is over

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32
Q

What is manipulation in regards to working memory?

A

Performing a mental operation on the info over and about maintenance
- takes more concentration, less instantaneous

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33
Q

What is Baddeley’s more recent model of working memory?

A
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34
Q

What is the phonological store/loop?

A

Speech based
Storage buffer

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35
Q

What is the visuospatial sketchpad?

A

Visuospatially based
Storage buffer

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36
Q

What is the central executive?

A

Modality free
Attention-like
Resource allocator
Linked to subsystems
Modality free

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37
Q

What is the episodic buffer?

A

Diverse information
Demanding of central executive
Holds, integrates, binds

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38
Q

What is explicit, declarative, long-term memory?

A

Revealed when performance requires conscious recollection of previous experiences

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39
Q

What are 2 important subtypes of LT memory?

A

Semantic: facts
Episodic: events over time

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40
Q

What are other subtypes of LT memory?

A

Defined by modality (eg: verbal vs spatial)
Defined by operation (eg: source memory, meta cognitive knowledge of when something entered memory)

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41
Q

How does explicit LT memory link to communication?

A

Stored information necessary for speech, language, literacy, social interaction

Eg: naming/identifying, recalling verbal sequences

  • this involves a large capacity and LT storage
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42
Q

What is an example of a working memory assessment that involves speech and language?

A

Digit span immediate recall *forward & backwards tasks)

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43
Q

What is an example of a LT memory assessment that involves speech and language?

A

Word list / sentence / story recall after a longer interval (minutes, hours)

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44
Q

What is an example of a working memory and LT memory assessment that involves speech and language?

A

Verbal fluency tasks (eg: name as many animals as you can in 1 min)
- uses LTM to access stored items
- uses WM to monitor spoken items, and not repeat them

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45
Q

What is perception?

A

The elaboration + interpretation of a sensory stimulus based on knowledge

Eg: may hear sounds, but perceive speech

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46
Q

How are stimuli and cognitive processes involved in information processing?

A
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47
Q

What is attention?

A

The prioritisation of external/internal stimuli
Describes various behaviours + cognitive processes + states of being

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48
Q

What are the 2 concepts relating to attention?

A

Physical orientation: overt attention
Cognitive resource allocation: covert attention

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49
Q

What is physical orientation in relation to attention?

A

Moving as needed to put the sensory system within gathering range of the stimulus

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50
Q

What is cognitive resource allocation in relation to attention?

A

Filtering stimuli from sensory-perceptual input so certain elements are available for further processing
Diverting focus between cognitive processes to prioritise
Sustaining concentration over time

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51
Q

What is inattentional blindness, as investigated by Simons and Chabris?

A

Filtering in visual attention
- ppts asked to watch video and count number of ball passes between those in white shirts

  • most reported number of ball passes from those in white shirts
  • none reported number of ball passes from those in black shirts
  • few reported seeing the gorilla
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52
Q

What is the lab experiment studying filtering auditory input?

A

Dichotomy listening technique + shadowing: one message to left ear, one to right ear

  • listener repeated one message whilst both presented
  • little recall from non-shadowed message

Initial belief that only the attended message was processed from sensory-perceptual input into memory
BUT experience improved recall of non-shadowed message (attention is a plastic, dynamic system)

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53
Q

Which test is used to measure attention?

A

Stroop tests
- speeded reading (fastest)
- speeded colour naming
- speeded ink colour identification (slowest)

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54
Q

What part of cognitive processing does overt physical orientation affect?

A

Sensory reception

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55
Q

What part of cognitive processing does covert filtering affect?

A

Perception

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56
Q

What part of cognitive processing does covert prioritising/diverting affect?

A

Memory + other higher order cognitive functions

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57
Q

What is executive function at a basic level?

A

Means by which behavioural options are selected: highest activation = selected

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58
Q

What other system does executive function link to, according to Norman & Shallice?

A

Supervisory attentional system
- willed action for complex decision making

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59
Q

What is the formal definition for executive function?

A

Neuropsychological mechanisms

Enable rapid construction + evaluation of hypothetical social futures, while weighing immediate versus delayed outcomes

Simulation of actions tested mentally for consequences before response is selected

60
Q

What is a more practical definition of executive function?

A

Doing what must be done to solve problems / achieve goals

61
Q

What does executive function incorporate aspects of to organise + regulate purposeful behaviour?

A

Attention
Memory
Planning
Reasoning
Problem solving

62
Q

What 4 things does executive function include?

A

Initiating intentional/daily behaviour
Planning behavioural routines to accomplish intentions
Maintaining + regulating goal-directed behaviour
Monitoring + modifying behaviour in response to situational variables

63
Q

What are 4 important concepts related to executive function?

A

Inhibit responses appropriately
Use working memory (in relation to hindsight + foresight)
Regulate + control behaviour
Flexibility

64
Q

Which lobe of the brain play a role in executive function?

A

Frontal lobes, particularly prefrontal cortex
note: personality + social understanding also interact with executive function

65
Q

What is the term for impairments to executive function / frontal lobe damage?

A

Dysexecutive syndrome

66
Q

What do people act like with less severe executive function impairment?

A

Carry out familiar, highly practised activities
Don’t do activities requiring planning / LT goals

67
Q

What is the concept of resource allocation relating to executive function?

A

Capacity + access of resources

  • more complex task = more resources
  • brain injury = lack resources

If resource demand > resource availability, mental operations slow/shut down/inefficient

68
Q

What is the Wisconsin card sorting task?

A

Participants sorts cards into categories according to the examiner’s feedback, with sorting principle changing after participant has deduced it

69
Q

Why may someone with poor executive function struggle with the Wisconsin card sorting task?

A

Requires
-working memory
- process of elimination/ t&e
- flexibility + responding to feedback
- perceptual processing
- attention

70
Q

What is the behavioural assessment of dysexecutive syndrome (BADS)? Wilson et al

A

6 subtests, majority timed
Scored + compared to norm

Also dysexecutive syndrome questionnaire (self + significant other rating), when things don’t go to plan
- discrepancies = patient lacks of insight / awareness

71
Q

What are the 6 subtests of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Rule shift cards (similar to Wisconsin)
Action program
Key search
Temporal judgement
Zoo map
Modified six elements

72
Q

What is the action program subtest of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Planning
- test-taker removes cork from narrow plastic tube while following a set of rules

73
Q

What is the key search subtest of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Planning + organisation
- test-taker plans strategy to find key in lost field

74
Q

What is the temporal judgement subtest of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Reasoning
- test-taker estimates length of everyday time intervals

75
Q

What is the zoo map subtest of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Planning
- test-taker plots route on map according to a set of rules

76
Q

What is the modified six elements test (SET) subtest of Wilson et al’s behavioural assessment of dysexecutive syndrome (BADS)?

A

Planning + organisation + self monitoring
- test-taker must divide available time among three tasks (picture naming, arithmetic, and dictation) while following a set of rules

77
Q

Why may not everyone with executive function difficulties struggle on formal, clinical assessment?

A

Controlled, quiet environment
Less demanding than real life: pressure, distractions, flexibility

78
Q

What is a more functional assessment of executive function?

A

Multiple errands test (MET) by Shallice & Burgess

79
Q

What is the multiple errands test (MET)?

A

‘Real world’ shopping task
Client has written instructions/rules
Self rating scale pre/post task for efficiency

80
Q

How is the multiple errands test (MET) scored?

A

Joint assessment: SLT + OT
Post session, therapists score

81
Q

What are some examples of instructions in the multiple errands test (MET)?

A

Buy the following 6 things:
Find out the following information:
20 minutes into the task, meet me by the red post box outside boots and tell me the time

82
Q

What are some examples of rules in the multiple errands test (MET)?

A

Carry out task in any order
You have £10 but spend no more than £5
No shop should be entered unless to buy something
Don’t go back into a shop you have already been in
Tell the person observing you when you have finished

83
Q

What is the rationale for using the multiple errands test (MET)?

A

Less structured/controlled environment

Gives observational data for skills not observed in clinical situations (eg: unforeseen circumstances)

Additional qualitative + observational evidence

84
Q

When are changes in adult brain anatomy and function detected?

A

From 20 years

85
Q

What are the changes in adult brain anatomy and function?

A

Loss in neuronal number + size
Decreased volume of cortical grey matter
Reduction in efficiency of cellular functions
Damage is cumulative

86
Q

When does IQ peak and drop?

A

Peaks at 25
Falls rapidly after 65

87
Q

What is the variability amongst cognitive aging in adults?

A

Individual differences in when it starts and how it progresses; acceleration of neural aging can occur any time (eg: early onset)

88
Q

What is brain aging and plasticity like in adults?

A

Ability to repair + regenerate after damage is limited
But synaptic connections among neurons do continue to reorganise, largely in response to environmental conditions
- myelination in some areas of cortical white matter continues through 40s
- olfactory bulb + hippocampus neuronal addition/ replacement

89
Q

How does performance on world knowledge change throughout adult life span?

A

Preserved
- tested via vocabulary measures

90
Q

How does performance on working memory, long time memory, and processing speed change throughout adult life span?

A

Declines with increased age
- tested via digit symbol measures

91
Q

How do sensory abilities change with age?

A

Hearing sensitivity declines, affects most healthy adults >70
Central + peripheral vison declines
- dual sensory decline may also occur

92
Q

How do sensory changes directly affect the ability to perceive + cognitively process information above and beyond the level of visibility/audibility?

A

More cognitive resources needed to decode degraded sensory stimuli
Leaves fewer cognitive resources for encoding + rehearsal

93
Q

Why may sensory changes not directly affect the ability to perceive + cognitively process information above and beyond the level of visibility/audibility?

A

Form of compensation may not work for highly complex stimuli / be sustainable LT
Correcting may improve function, but not necessarily maintain improvement in cognition

94
Q

How does cognitive change with age in healthy adults occur in regards to working memory?

A

↓ WM span (buffers + stores)
↓ attentional inhibition, reduced ability to suppress irrelevant info (central executive)

95
Q

How is verbal fluency related to WM and LTM?

A

LTM to access stored items
WM to monitor spoken items and not repeat

96
Q

How does cognitive change with age in healthy adults occur in regards to long term memory?

A

Difficulty with retrieval
More frequent tip-of-the-tongue, but can be accurate with longer retrieval time
Knowing event occured, but not when/how

  • some experientially based measures improve/remain intact for longer (eg: vocab)
97
Q

What is covert attention?

A

Aspects closer to perceptual filtering level + capacity limits of system
Aspects closer to cognitive prioritising level

98
Q

How does covert attention at the perceptual filter / capacity limit level change with age?

A

Reduced attentional inhibition of irrelevant/competing info, often due to prolonged access to irrelevant info
- like a slower refresh rate

99
Q

How does covert attention at the cognitive prioritising level change with age?

A

Parallel-processing cognitive more difficult: dual-task interference
Slower/less accurate performance = dual task cost

100
Q

What is cognitive change with age in adults associated with?

A

Environmental factors across the lifespan, linked to early life
Biological factors
Wider context: social + cultural + economic
Which brain systems & associated cognitive functions are involved (eg: frontal lobe late to develop, sensitive to early change)

101
Q

How is sex linked to dementia?

A

Alzheimer’s more common in women

102
Q

Which type of intelligence is highest in early adulthood?

A

Fluid intelligence

103
Q

Which type of intelligence is highest in age adulthood?

A

Crystallised intelligence

104
Q

What is cognitive reserve?

A

Latent pool of neural resources that allow a person to show good cognitive function in face of existing neuropathological burden

105
Q

How is cognitive reserve built to preserve cognitive function?

A

Physical and enviornmental means…
- health/fitness
- education/learning
- social interaction

106
Q

How is mild cognitive impairment improved?

A

Training in memory exercises

107
Q

What is traumatic brain injury (TBI)?

A

Trauma to the head from an outside force + subsequent complications which can follow and further damage brain

108
Q

How can TBI occur?

A

Road traffic accident
Assult
Fall

109
Q

What are some of the complications associated with TBI?

A

Lack of O2
Rising pressure + swelling in brain

110
Q

According to Nguyen et al, what is the incidence rate of TBI?

A

349 / 100,000

111
Q

Of the people with TBI, which proportion have mild vs moderate-severe?

A

Mild = 68%
Moderate-severe = 32%

112
Q

Why are men more likely to have TBI than women?

A

Professions
Motorcycles
Risk seeking behaviours driven by testosterone

113
Q

What are the prime age groups for TBI and why?

A

15-24: driving, risk taking
>75: more falls, esp in winter

114
Q

What are the different types of TBI?

A

Closed or open/penetrating
Focal or diffuse

115
Q

What is a closed TBI?

A

Brain injured, head exposed to forces
- fall
- car accident

116
Q

What is an open TBI?

A

Skull is breached/penetrated
- gunshot

117
Q

What is a focal TBI caused by?

A

Produced by external force, causing compression of tissue underneath skull at site of impact (coup) or tissue opposite (contre-coup)

118
Q

What is a diffuse TBI caused by?

A

Rapid acceleration + deceleration of head, widely distributed damage to axons

119
Q

What is the primary injury from TBI?

A

Immediate tissue damage due to direct impact (open/closed) eg: axonal shearing, haemorrhage

120
Q

What is the secondary injury from TBI?

A

Hypoxia in minutes post injury
Brain bruising / swelling / bleeding / blood clots → raised ICP in 24-48h

121
Q

How is the severity of TBI measured?

A

Duration of loss of consciousness (Glasgow Coma Scale)
Duration of post-traumatic amnesia

122
Q

What is post traumatic amnesia (PTA)?

A

Disorientation in time, place, and person and/or inability to remeber new experiences

123
Q

How does the Glasgow Coma Scale (GCS) work?

A

Mild = 13-15
Moderate = 9-12
Severe = ≤8

124
Q

How does attention present in an individual with TBI?

A

Short attention span
Distractible
Unable to multi task
Struggles with noise/busy

125
Q

How does memory/learning present in an individual with TBI?

A

Difficulty retrieving info
Forgetting things
Repeating requests
Word finding problems
Comprehension difficulties
Difficulty learning new things

126
Q

How does executive function present in an individual with TBI?

A

Difficulty…
- organising
- achieving goals
- problem solving
- making inferences
- flexiblity
- judgements/decisions considering consequences

127
Q

How does perception present in an individual with TBI?

A

Reduce spatial awareness
Clumsy
Misjudges movements
Neglecting one side

128
Q

How does behaviour/social interaction present in an individual with TBI?

A

Irritability
Aggression
Rude comments
Laughing inappropriately
Disinhibited
Inappropriate sexual behaviour
Paranoia
Personality changes

129
Q

What % have communication difficulties after TBI? What is this known as?

A

75%
Cognitive-linguistic deficits
Higher level language deficits
Social communication disorders

130
Q

What are the communication difficulties faced after TBI?

A

Language intact but pragmatics is poor → difficulties at level of interaction/discourse

May also have speech difficulties (eg: dysarthria, apraxia), swalloing difficulties

131
Q

What is the framework for cognitive-linguistic disorders

132
Q

How may those with cognitive-linguistic deficits have disorganised/confusing discourse?

A

Topic shift
Topic drift
Getting lost in less relevant detail, struggling to focus on bigger picture
Inappropriate quantity of info

133
Q

What is the impact of TBI on the person/family?

A

Unseen
Anxiety, mood disorders, fatigue
Communication difficulties affects relationships + education + employment
Reduced social activity/networks

134
Q

How does the employment rate change for those with a moderate-severe stroke?

A

80% pre-injury
55% 3 years after

135
Q

What are 3 different ways to assess communication for TBI?

A

Assess cognitive-linguistic function
Questionnaires for client/family
Functional assessment (MET, multidisciplinary)

136
Q

What are 6 different assessments for cognitive-linguistic function?

A

Mount Wilga
Measure of cog-ling abilities (MCLA)
Cog-ling quick test (CLQT)
Scales of cognitive ability for TBI (SCATBI)
Speed of comprehension test
Six elements test

137
Q

What is an example from the Mount Wilga test?

A

“What is ridiculous about these stories?”

138
Q

What does the cognitive-linguistic quick test (CLQT) test?

A

5 primary domains of cognition

139
Q

What does the Scales of Cognitive ability for TBI (SCATBI) test?

A

Scales assessing perception / orientation / organisation
Recall reasoning

140
Q

What does the Speed of comprehension test do?

A

Sentences are judged as sensible/non-sensible under time pressure

141
Q

What does the Six elements test have?

A

Written word finding component → word finding abilities in absence of time/organisational pressure

142
Q

What are some considerations when assessing communication?

A

Insight
Self-awareness
Self-monitoring
Artificial inflates performance

143
Q

What are some examples of questions from the La Trobe communication questionaire?

144
Q

What does rehab for TBI focus on?

A

Focus on functional communication: effective + independent
Interventions to improve discourse, social comm, QOL
Maybe specific/multiple cognitive processes

145
Q

What is considered in rehab for TBI?

A

Client + family goal centered
One2one vs group
Communication partner training
INCOG 2.0 guidelines