RHD Therapy Flashcards
1
Q
Things to know about treating individuals with RHD
A
- Implusive behavior:
— nonverbal or verbal signals so wait a few seconds before responding
- Denial and Indifference:
— Often times, patients with RHD are unaware of their deficits.
- Videotaping sessions to give immediate feedback to the patient increases awareness.
2
Q
Therapy Strategies
A
- Left Neglect
- Attention
- Orientation
- Holistic, Gestalt-like stimuli
- Temporal ordrer- Sequencing
- Prosody
- Pragmatics
- Inferencing
- Emotions and Expressions
- Prosopagnosia
- Memory
- Figurative Language
- Visual Perception
- Reading and Writing
3
Q
Left Neglect Treatment with RHD
A
- Goal is to get patient to attend to left side of visual field and reinforce behavior
- Approach individual from left side and begin speaking, make contact if they don’t move toward you
- Place items on left side
- Include the left hand in therapy tasks
4
Q
Attention
A
- Sustained- The state of focusing on one stimulus to the exclusion of all other competing stimuli
- Selective -The ability to focus on the important/relevant stimuli in the presence of distracting stimuli
- Sustained- use puzzles, simple math problems, series of yes/no questions and other simple tasks
- Selective- Could have patient tap finger when clinician says a target number when a series of numbers are read aloud
- Frequently draw attention to treatment stimuli
5
Q
Orientation
A
- Involves frequent and systematic repetition of basic information about the patient, the events leading to hospitalization, and temporal and spatial facts relating to the current time, place, date, and time.
- Therapy relies on environmental prompts in living space, verbal orientation, information delivered by caregivers, and orientation drills
6
Q
Holistic, Gestalt-like stimuli
A
- Target main ideas vs. smaller details (cards, pictures, and short stories)
- Puzzle /object arrangements
- Recognizing commonalities and categories
7
Q
Temporal Order-Sequencing
A
- Work on activities that require sequencing
- Review schedule of events for the day
- Use sequencing cards/ worksheets
8
Q
Prosody
A
- Provide model sentence with emotional prosody
- Use cards identifying the target emotion and picture of facial expression
- Eventually make phone calls or go into natural settings for treatment to practice appropriate prosdy and pragmatics
9
Q
Pragmatics
A
- Give verbal cues to maintain eye contact
- Topic maintenance- simple to complex
- Turn taking with role playing
- It’s your turn- regulate smooth turn taking
- Show videos of conversations with people using appropriate and inappropriate pragmatic behaviors
- Train family members to prompt patient to attend to conversational partners on the left side
10
Q
Inferencing
A
- Treatment should focus on evaluating contextual cues, determining which ones are relevant and which aren’t, and integrating multiple cues to arrive at one most plausible interpretation
- Simple to complex
- Reading/auditory comprehension
—- patient reads or listens to story and makes inferences
—- must state contextual clues, identify words that lead to the inference
- Matching cardgame of situations and emotions
11
Q
Emotions & Expressions
A
- Label emotions
- Descriptions of vocal characteristics to convey emotions
12
Q
Prosopagnosia
A
- Focus on unique qualities of loved ones, other then their face (hair, height, clothing, perfume, voice ) that will help to identify that person
- VSD of patient’s loved ones and voices
13
Q
Memory
A
- Test STM while working on inferencing of short paragraph read aloud to them
- Make them recall their reading strategies
14
Q
Figurative Language
A
- Practice metaphors and idioms w/literal and figurative meanings
- Use of metaphors and idioms that are age-appropriate and relevant to the patient’s everyday life
- Have patient draw correct depiction of metaphor or idiom.
15
Q
Visual Perception
A
- Customize to patients age and interests
- On computer, dots appear on screen so patient must visually scan in all directions to find the next number
