Neuro Flashcards
According to the World Health Organization (WHO), a disability encompasses what?
- impairments
- activity liitations
- participation restrictions
Components of Language Processing
Phonological processing
Lexical-semantic processing
Morphosyntactic processing
Pragmatics and discourse processing
Phonological processing
- recognize and produce the phonemes in one’s language
- follow the rules for how sounds can be combined/sequenced
- suprasegmental processing - processing of intonation, stress, and pauses
2 subsystems of phonological processing
sequencing,
Suprasegmental aspect
Lexical-semantic processing
accessing meaning through language
Pragmatics and discourse processing
the ability to correctly interpret and use language based on the social/situational context
Components of Cognitive Processing
- attention
- memory
- executive functioning
Types of attention
Sustained attention
Focused or selective attention
Alternating Attention
Divided attention
Sustained attention,
sometimes called “vigilance”, refers to our ability to maintain our attention over time
Focused or selective attention
ability to direct attention towards a particular object or sensation while ignoring other competing objects
Alternating Attention
is attending to one task, attend to another and come back, like in cooking.
Divided attention
refers to the ability to attend to more than one activity or percept at a time
Sustained attention tasks
an exercise that requires listening for a target word or sequence on a tape and pressing a buzzer when the word is heard.
Selective attention tasks
any sustained attention task with a distractor in the background.
Visually, a clear transparent with shapes on it, ask a person to read a paragraph with this overlay of lines criss-crossing and distracting them visually.
Divided attention task
reading a paragraph for comprehension and simultaneously scanning for a word. So they have to count the number of “and”s and read for comprehension.
Long term memory
Memory held in permanent storage, available for retrieval at some time in the future.
Nondeclarative memory
routinized activites
Declarative
events, facts
Short term memory
Memory held in conscious awareness, and which is currently receiving attention
Working memory-
short term memory held in mind long enough to do some mental operation off it.
Stages of Memory
Encoding-
Storage
Retrieval/recall
Commonly described components of executive function
- planning
- organizing
- inhibition
- cognitive flexibility
- problem solving
- self-monitoring
Anomic paraphasia
f they require more than 5 seconds to find the word
Semantic paraphasia
-think word substitutions or sound substitutions.
Phonemic paraphasia
sound substitutions.
Anomic circumlocution-
talking around a word finding difficulty,
alos a compensatory strategy
Jargon
strings of neologisms.
Agrammitism
leaving out small grammatical words
Paragrammatism
errors of grammar
Popular Aphasia tests
WAB
BDAE
Dichotomous classification
Fluent vs. non-fluent aphasia
Connectionist classification system
- ssumes that subtypes of aphasia are due to disruption of specific brain regions or the connections between them
- kind we use
Aprosodia
- deficits in the production and comprehension of variations of pitch, duration, loudness, and pause time used to convey meaning and emotion
- RHD
What is the most common problem with RHD?
Why
attention
Attetnion -can impact other functions of the RH
What most likely predicts an individual to end up in a nursing home due to safety?
presence of neglect
TBI patients have more pronounced impairment of ________ vs ________, however, because head injuries can be unique, there are exceptions
cognition
language
Types of rating scales used post TBI
Glasgow
Ranchos Los
Classifications of head injuries
open
blast
closed
Open head injury -
when the skull is fractured or penetrated and the contents of the skull are visible
Blast damage
due to an explosion (like if afghanastan) putting pressure waves. Pressure waves act as a force.
Closed head injury
when the skull is not penetrated and brain is not exposed
Diffuse axonal shearing
microscopic damage to the axons in the brain due to high velocity rotation (movement) of the brain within the skull
Deficits of _________, _________, ________ and _______ are common after TBI and are often greater predictors of functional status (e.g. ability to live independently) than physical status.
perception
attention
memory
executive function
Dementia
Refers to cognitive, communication, and behavioral changes that occur in the context of a progressive medical/neurological condition
mild cognitive impairment
diagnosis given to individuals who have cognitive decline greater than would be expected for their age but whose symptoms are milder.
Problems with dementia
- perceptual
- attention
- memory
- executive functions
- communication
Goals of assessment
Describe communication and cognitive strengths and weaknesses
Identify concomitant factors that may influence recovery and response to treatment
Establish goals
Determine prognosis for recovery and response to treatment
Identify problems
Sharing results with the patient and family, both ________ and in __________, are critical.
verbally
writing
What would be considered complicating conditions?
sensory deficits
perceptual problems
motoric impairments
pyschiatric disorders
Functional measures
assesses a person’s ability to successfully perform a function
Participation measures
assesses the number activities and the frequency with which patients participate in these activities.
Quality of life measures
- assesses feelings, attitudes, and beliefs related to one’s enjoyment of life.
- Measures satisfaction.
Most commonly used functional measure?
FTM
Functional measure better equipped for persons with communication disorders?
ASHA FACs
How are participation measures generally assessed?
observation
Primary TBI damage>
primary
diffuse
Secondary TBI damage
edema
infections
Assessments are influenced by the context
Setting (acute vs outpatient)
Patient/family complaint-MOST IMPORTANT
Question asked by the MD in the referral
poor prognostic indicators
- The more severe the aphasia the worse the prognosis
- Poor auditory comprehension
- Poor deficit awareness
T/F/
As a symptom, anomia is only seen in aphasia
false
T/F/
Based on the psycholinguistic model of language processing presented in this class, isolated damage to the semantic system will often result in different profiles of strengths and weakness in different modalities of language processing. E.g. mild verbal expression problems but severe auditory comprehension issues.
True
According to the psycholinguistic model of language processing, how many lexicons are there?
4
T/F
Most patients with a right homonymous hemianopsia will compensate for this visual defect and be able to adequately see test items.
true
One neurologically based motivation impairment is called
apathy
T/F
Quality of life measures do not focus on body functions (ICF model).
True
False
False
T/F
Both the Boston Diagnostic Aphasia Examination (BDAE) and the Comprehensive Aphasia Test (CAT) provides some means for beginning to identify which underlying psycholinguistic processes are impaired.
True
Briefly describe one method for treating awareness deficits.
- Ask a client how they think they will perform on a certain task.
- After they perform, have them reflect on how their performance was,
- Goal is to make them aware of deficits without telling them pointing them out.
We always want our treatments to “generalize” and we can think about generalization in different ways. List two levels of generalization.
- Generaizing at the stimulus level (different stimuli being used for the same target)
- generalizing at the setting level (practice a skill ina different setting).
A common cuing hierarchy during naming treatments is to start by giving a semantic cue, followed by a phonemic cue, and then repetition. In a naming treatment for a person with aphasia, how would you modify/change your cuing steps to make your treatment “more semantic”? You don’t need to list out the cues you would use, simply describe the general cuing approach.
Rather than moving to a phonmeic cue or repetition after my first semantic cue, continue to use different types of semantic cues.
example: If target was fork, start by saying it is silverware, then continue on to how it’s used and what you can do with it. I would also say “it’s ike a spoon,” giving the client different types of semantic cues that would hopefully direct them to naming the fork.
“Spaced retrieval
A method of committing information to memory
The kind of awareness that refers to having the basic understanding that one has a specific deficit is called
Intellectual awareness
Say 10 words to client, informing them that after delay, to repeat the words back to me. If client is unable to repeat more than a few words back , it suggests…..
difficulty either recalling or encoding.
Take the same ten words and write them on index cards, add ten more. Ask to identify which words were previously said. If the client does poorly it suggest what?
difficulty encoding.
Recognition does not require what?
recall
Spaced retrieval
identical to errorless learning except that the patient is asked to retain the information for progressively longer periods of time
Chaining techniques
technique which can he used to train patients to perform sequences of steps by means of procedural memory, in which each item is learned automatically, as an isolated unit, which is then mechanically linked with the items before and after.
