Lecture 14: Communication and Praxis

Question 1

what is dysarthria

Answer 1

lesions in CNS or PNS causing issues with muscles in the mouth

Question 2

can people with expressive aphasia draw and write

Answer 2

drawing would be intact, but writing would be impacted

Question 3

what type or aphasia might speak like this: Boy … cuh …. Cuh .. Cookie … girl … mama …. Kay … water … sinking….ice … ay … ch .. Ch… water … sinking … ee … Why?”

Answer 3

Brocas expressive

Question 4

what type of aphasia might talk like this:
“Had that beofre … chories … this guy is a messo …sheisokay. Hehasamesson …alloverhere. She is just stupid. Oh, what is that? That’s ju … those are nice, pretty … and that’s’ a mess and then goots. He’s pretty stupid. She is okay. She’s cute. This is inside… outside.”

Answer 4

wernicke’s (receptive)

Question 5

what is global aphasia

Answer 5

All language modalities are severely impaired (both aspects of aphasia)

Speech may be limited to:
Automaticisms (yes, social greetings & cursing!)

• Speech repetition may be limited to serial speech (counting or over learned material like prayers or lyrics)

Question 6

what is important to keep in mind when communicating with someone who has aphasia

Answer 6

Short direct sentences paired with explicit language

Question 7

what is the order of the two steps you must take when initiating a session with someone with aphasia

Answer 7

A. Ensure a reliable yes/no
“I would like to make sure we are understanding each other”.

B. Obtain consent
“Now that I understand you, I would like to explain what I plan to do today and ask you if we may continue.”

Question 8

what are the 3 components of praxis

Answer 8

ideation - an idea of what I would like to do

motor planning- how do I do this new thing

execution - actually doing it

Question 9

what are the 2 main types of apraxia

Answer 9

Ideational apraxia

Ideomotor apraxia

Question 9

what is apraxia

Answer 9

inability to complete planned motor acts with intact sensation, movement and coordination status

Question 10

what is ideational apraxia

Answer 10

“What would I like to do?”

Impaired object recognition and mental process connecting object name to completing the task

Question 11

what is commonly seen in those with ideational apraxia

Answer 11

Objects are used improperly

tasks completed in improper order

Question 12

what is ideomotor apraxia

Answer 12

Know what to do – trouble is with execution

Performance of task appears clumsy

Question 13

what is commonly seen in those with ideomotor apraxia

Answer 13

if movement is automatic, like covering the mouth to cough, its fine, but if the person is asked to cover their mouth, they will struggle to perform the movement

More spatial-temporal errors (timing, posture, speed, direction)

Question 14

in what order do you assess apraxia

Answer 14

1. Sensory/Perceptual System
2. Conceptual system (Ideation: “Idea of what I want to do”)
3. Production system (Motor planning: “How do I do the task”)

Question 15

what is constructional apraxia

Answer 15

Inability to combine or organize a task from the sum of its parts; difficulty articulating the parts to make the whole

Question 16

what issues are commonly seen with constructional apraxia

Answer 16

difficulty making a sandwich, setting a table, etc

difficulty propelling a wheelchair

Question 17

what is the cueing hierarchy with someone with apraxia

Answer 17

verbal cueing

physical cuing

feedback

Question 18

how do you navigate verbal cueing for the function of a task?

Answer 18

Determine level of awareness

1. Is client aware? Yes or No
   If no, draw awareness to issue
2. Provide minimal/just right level of assistance

Question 19

how do you navigate verbal cueing for awareness?

Answer 19

ask “hows it going?”
and determine next steps based off of response

Question 20

what to say when someone says things are going fine but they aren’t (poor awareness)

Answer 20

1. Does that look right to you?
2. What about this does not look correct?
3. Do you notice ___________?
4. This is not correct because…

Question 21

what to say when someone says they need help or things aren’t going well (good awareness)

Answer 21

1. What seems to be the trouble?
2. How can I help you?
3. Have you tried…..

Question 22

what is the order of physical cueing

Answer 22

1. Manual contact
   “Do you notice your left arm (touch) looks different than your right arm (touch)”

“I’d like you to stop what you are doing” (gently touch arm)

2. Task Simplification
   (de-clutter environment sensed give items only when required)
3. Hand over Hand

Question 23

who to manage feedbaclk upon completion of the task

Answer 23

1. How did that go? (Assess level of awareness)
2. Knowledge of results (basic)
3. Knowledge of performance (more advanced)

Question 24

what are the 3 kinds of awareness

Answer 24

Intellectual Awareness

Emergent awareness

Anticipatory Awareness

Question 25

what is intellectual awareness

Answer 25

The ability to understand, at some level, that a function is impaired, “knowing you have a problem”.

Question 26

what is emergent awareness

Answer 26

The ability to recognize a problem when it is actually happening.

Question 27

what is anticipatory awareness

Answer 27

The ability to anticipate that a problem will occur, as the result of a particular impairment and thus, being able to make plans to compensate

Question 28

what is perseveration

Answer 28

inability to shift from one concept to another OR

inability to change/cease a behaviour pattern one having started it

(repeatedly putting on or taking off clothes, shaving same spot)