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Aphasia > Test #1 > Flashcards

Test #1 Flashcards

0
Q

What does the propositional definition of aphasia say?

A

an affected person can’t formulate goal directed utterances, can’t convey intent

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1
Q

When was the majority of Paul Broca’s work done?

A

1860s

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2
Q

What do the cognitive theorists of aphasia believe?

A

there is some intellectual problems with aphasia

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3
Q

What do localizationist theorists say about aphasia?

A

affected individuals have difficulty naming and disassociation between a label and a concept

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4
Q

What does the concrete-abstract definition of aphasia say?

A

abstract language is more propositional and that is the deficit in aphasia

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5
Q

What does the uni-dimensional theory of aphasia say?

A

aphasia is a single disorder, you don’t differentiate between different types of aphasia

  • all modalities of language are impaired to some extent
  • should find the relative strengths within the language system to rebuild the weaknesses
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6
Q

What does the multi-dimensional theory of aphasia say?

A
  • there is differential diagnosis

- different types of aphasia based on the site of lesion and the clients behaviors

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7
Q

What does the microgenetic theory of aphasia say?

A

lesions in certain areas lead to specific deficits

-the older you are, the more localized your functions are

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8
Q

What does the thought process theory of aphasia say?

A

there is an impairment in semantic expression due to a deficit in thought processes

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9
Q

What does the psycholinguistic theory of aphasia say?

A

separates aspects of language into cognitive (what we know about the world), linguistic (form and content), and communicative (pragmatics)
-aphasia causes a problem with the content, form, use, and knowledge about the world

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10
Q

What is the definition for aphasia used in class?

A

an acquired communication disorder caused by brain damage characterized by an impairment of language modalities (not a sensory, intellectual or psychological deficit)

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11
Q

Explain short term memory

A

might be the three items you need to pick up from the grocery store
-don’t need to commit that to long term memory

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12
Q

Explain long term memory

A

can be broken down into semantic memory and lexical memory

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13
Q

What is semantic memory

A

deals with concepts

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14
Q

What is lexical memory?

A

the labels that are applied to concepts

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15
Q

What MUST someone with have to be considered aphasic?

A

anomia

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16
Q

What kinds of things will people with aphasia do to indicate that they know a concept?

A
  • gesture
  • point
  • circumlocute
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17
Q

What is working memory?

A

a subset of short term memory

-almost like a rehearsal space; helps you manipulate the concepts that are present so you can infer meaning

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18
Q

What is episodic memory?

A

memory for episodes (what you did that day, or something longterm that is more memorable)
-can be short term or long term

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19
Q

What is procedural memory?

A

memory for sequences or how to do things

i.e. how to make a peanut butter and jelly sandwich

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20
Q

What is topographic memory?

A

memory of how things relate in space

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21
Q

How do we formulate things?

A
  • first concepts
  • then propositions
  • then schemata (schemata ties propositions together with with procedural and episodic memory
  • finally incorporate all schemata to create a schema
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22
Q

What is a paraphasia?

A

when someone substitutes a word for a related word

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23
Q

What is agnosia?

A

lack of recognition from a certain sensory modality

i.e. not recognizing that sirens mean there is an emergency

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24
Q

What does apraxia cause problems with?

A

sequencing and motor planning

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25
Q

What does apraxia often co-occur with

A

aphasia

-especially non fluent aphasias

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26
Q

How many words per utterances does a non fluent aphasia have?

A

1-3 words on average

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27
Q

is apraxia related to more anterior or posterior lesions of the brain?

A

anterior lesions

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28
Q

What are some symptoms of apraxia of speech?

A
  • poor programming/sequencing of speech

- oral groping

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29
Q

What kind of tasks are easier for patients with apraxia?

A

automatic tasks

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30
Q

What kind of impairment is dementia?

A

intellectual

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31
Q

What does dementia impair first, language or cognition?

A

cognition, then it affects language

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32
Q

What is primary progressive aphasia?

A

the midway diagnosis between dementia and aphasia

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33
Q

What generally happens with primary progressive aphasia?

A

starts like an aphasia, but overtime where most aphasias recover, the person will decline overtime and their cognition will later be affected as well

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34
Q

What is right hemisphere disorder or non dominant hemisphere disorder?

A

when there is a stroke or injury to the right/non dominant side of the brain that causes pragmatic and attention issues

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35
Q

What percentage of left handed people will have language in their left hemispheres?

A

60-70%

meaning the other 40-60% will have language in their right hemispheres

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36
Q

What is the number one symptoms of aphasia?

A

anomia (word finding problems)

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37
Q

What kind of memory will someone with aphasia have?

A

semantic memory

lexical memory is impaired

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38
Q

What is circumlocuting?

A

talking around the word and providing semantic information

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39
Q

What types of paraphasia are there?

A
  • literal/phonemic paraphasia
  • verbal paraphasia
  • unrelated paraphasia
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40
Q

What is phonemic paraphasia?

A

phoneme substitute within the work

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41
Q

When are you more likely to recognize your error/deficits, an anterior or posterior lesion?

A

anterior lesion

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42
Q

What is verbal paraphasia?

A

substitute a word with a related word

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43
Q

What is unrelated paraphasia?

A

a real word is substituted, but it isn’t related to the context

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44
Q

Are you more likely to hear paraphasias with lesions more anterior or posterior?

A

posterior (because they are more fluent)

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45
Q

What is a neologism?

A

a totally made up word

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46
Q

What is it called when someone uses one neologism after another?

A

jargon/word salad

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47
Q

What is “press for speech”?

A

when a patient isn’t able to monitor when to stop speaking

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48
Q

What is the rule of thumb for phonemic paraphasias?

A

if 50% or more of the target phonemes are there, it’s phonemic paraphasia

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49
Q

What is agrammatism/telegraphic speech?

A

when you leave grammatical markers out and content/function words are left in

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50
Q

What kind of lesion do you tend to hear telegraphic speech in?

A

anterior lesions or Broca’s aphasia

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51
Q

What is a stereotypy?

A

when one person says one word or phrase a lot

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52
Q

What kind of stereotypys are there?

A

dictionary form and non dictionary

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53
Q

What are some comprehension characteristics of aphasia?

A
  • better understand shorter utterances
  • better comprehension of nouns
  • may exhibit slow rise time
  • noise build up
  • intermittent imperception
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54
Q

What is noise build up?

A
  • point of overload

- patient may be comprehending for a while but eventually hit a point of overload and won’t comprehend beyond that point

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55
Q

What is intermittent imperception?

A
  • shutter effect

- similar to noise build up, but will intermittently comprehend

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56
Q

What are written symptoms of aphasia?

A
  • agraphia
  • paragraphia
  • jargongraphia
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57
Q

What is agraphia?

A

written errors; tend to mirror spoken/verbal errors and vice versa

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58
Q

What is paragraphia?

A

written equivalent of paraphasia

59
Q

what is jargongraphia?

A

written equivalent of jargon

-string of neologims

60
Q

What is perseveration?

A

when a patient continues to go back to the same things

61
Q

What is the difference between perseveration and sterotypy?

A
  • stereptype=the only thing the patient can say

- perseveration=patient may have more words but continue to go back to the same topic or words

62
Q

Is a person with anterior lesions likely to realize their deficits?

A

yes

63
Q

Is a person with a posterior lesion likely to realize their deficits?

A

no

64
Q

What does it mean to get a client in set?

A

get them prepared for an activity

i.e. model, or thoroughly explain directions

65
Q

What is the first thing needed to do when diagnosing aphasia?

A

confirm the presence of anomia

66
Q

What are ways to test naming?

A
  • confrontation naming
  • generative/categorical naming
  • phonemic naming
  • story retell
  • describe a procedural sequence
67
Q

How do you assess fluency?

A

take the patient’s three longest utterances and average them

68
Q

How many average words must a person have per utterance to be considered fluent?

A

9 or more

69
Q

How many average words per utterance does a person need to have to be considered non fluent

A

5 or less

70
Q

How many average words per utterance is considered borderline fluent?

A

6-8 words

71
Q

What ar the best ways to assess fluency?

A
  • ask open ended questions
  • wh- questions
  • picture description
  • ask about an emotional topic
72
Q

How can you assess auditory comprehension?

A
  • yes/no questions
  • pointing tasks
  • following directions
  • comprehension of narratives
73
Q

What is Broca’s aphasia?

A

a non fluent, effortful, and agrammatic type of language production

74
Q

What are some symptoms of Broca’s aphasia?

A
  • telegraphic speech
  • difficulty initiating speech
  • preserved auditory comprehension
  • impaired repetition
  • impaired naming
75
Q

Where is the lesion in Broca’s aphasia?

A

inferior frontal gyrus of the frontal lobe (broca’s area)

76
Q

Do patients with Broca’s aphasia tend to recognize their deficits?

A

yes

77
Q

What are some comorbidities of Broca’s aphasia?

A
  • right hemiparesis
  • apraxia of speech
  • swallowing difficulties
78
Q

What is Wernicke’s aphasia?

A

a fluent aphasia with sometimes excessive verbal expressions that are full of paraphasias and neologisms

79
Q

Where is the lesion with Wernicke’s aphasia?

A

just under the sylvian fissure on the superior temporal gyrus (wernicke’s area)

80
Q

What are some symptoms of Wernicke’s aphasia?

A
  • fluent speech
  • meaningless speech
  • paraphasias
  • poor AC
  • poo repetition
81
Q

Do you see hemiparesis with Wernicke’s aphasia?

A

not usually

82
Q

What does it mean if Wernicke’s aphasia doesn’t improve and becomes chronic?

A

the lesion extends beyond Wernicke’s area (BA 22)

83
Q

What is often the most debilitating symptom of Wernicke’s aphasia?

A

poor auditory comprehension

84
Q

Which type of aphasia do you tend to hear a lot of press for speech?

A

Wernicke’s

85
Q

Which other type of aphasia is similar to wernicke’s aphasia with very poor repetition skills?

A

conduction aphasia

86
Q

Do patients with conduction aphasia have good or poor comprehension skills?

A

better comprehension skills compared to wernicke

87
Q

What are some symptoms of conduction aphasia?

A
  • paraphasias
  • anomia
  • sometimes patients recognize errors
  • fluent
88
Q

Where is the lesion for conduction aphasia?

A

in the left hemisphere usually around the supramarginal gyrus
(the bundle of fibers that connects wernicke’s and broca’s area)

89
Q

What does the bimodal distribution theory say?

A

that the patients level of fluency depends on where the lesion is on the arcuate fasciculus

90
Q

Do patients with conduction aphasia try and self correct?

A

sometimes

91
Q

What type of aphasia looks like Broca’s but with spared repetition?

A

transcortical motor (TCM)

92
Q

does TCM aphasia have a more anterior or posterior lesion?

A

anterior

93
Q

Where is the lesion for TCM aphasia?

A

around but spares broca’s areas

94
Q

What are some comorbidities of TCM aphasia?

A
  • transient incontinence
  • rigidity of the upper extremities
  • hemiparesis more in the leg than arm
  • problems initiating speech
  • may see bradykinesia
95
Q

What is bradykinesia?

A

slow movement

96
Q

What other type of aphasia looks like wernicke’s aphasia but with spared repetition?

A

transcortical sensory (TCS)

97
Q

Will a patient with TCS aphasia comprehend something they repeat?

A

no

98
Q

What kind of mediation is someone with transcortical sensory aphasia missing?

A

semantic mediation

99
Q

Where is the lesion for transcortical sensory aphasia?

A

surrounding but sparing wernicke’s area

100
Q

What other aphasia does mixed transcortical aphasia look like?

A

global aphasia

101
Q

what is the lesion like with mixed transcortical aphasia?

A

very large, but spares the perisylvian

102
Q

What aphasia has good repetition skills but all other areas are poor?

A

mixed transcortical aphasia

103
Q

What does palilalia mean?

A

compulsively repeating yourself

104
Q

What is a letter representation system?

A

what assigns a grapheme (written letter) to each word

105
Q

what is graphemic input lexicon?

A

what will recognize a string of letters by sight

106
Q

graphemic input lexicon has to go through what so you can comprehend a word?

A

semantic representation system

107
Q

explain the lexical semantic route

A

looks at the features of words

  • processed through letter representation system
  • then perceived graphemes go through the graphemic input lexicon
  • then the graphemic input lexicon goes through a semantic representation system so you can comprehend
  • if you read aloud you then assign a grapheme to a phoneme
108
Q

What is the non lexical route?

A

unfamiliar words don’t need semantic mediation

  • often go from grapheme to phoneme conversion
  • considered a sublexical route or phonological route
109
Q

does newer reading require more or less attention?

A

more attention

110
Q

Is reading a left hemisphere or right hemisphere process for most people?

A

left hemisphere proces

111
Q

Explain how reading involves all the lobes of the brain

A

occipital: vision
temporo-parietal and occipito-parietal: word identification
inferior frontal gyrus: semantic processing of words
-more anterior: semantic processing of words
-more posterior: phonologic processing of words

112
Q

what is surface dyslexia?

A

no access to meaning

-must sound it out

113
Q

Can someone with surface dyslexia read?

A

yes, but they probably aren’t comprehending it

114
Q

What is phonologic dyslexia?

A

person cannot read non words

-has difficulty with low frequency words

115
Q

What is deep dyslexia?

A

when a person exhibits semantic errors for the target

  • will not be able to read non words
  • will do better with high frequency words
116
Q

What kind of impairments will someone with deep dyslexia have?

A

grapheme to phoneme conversions

117
Q

what is pure alexia?

A
  • no co-occuring agraphia

- impaired access to graphemic input

118
Q

How do you look at assessment for dyslexia?

A
  • obtain literacy history
  • look at ability to inference from written material
  • look at various word frequencies
  • look at different regularities of spelling
  • look at different levels of concreteness
  • look at word lengths
119
Q

What do you look at in error type analysis?

A
  • visual confusions
  • semantic confusions
  • derivation errors
  • regulation errors
  • phoneme to grapheme conversion errors
120
Q

During paragraph reading with someone with alexia or dyslexia, how many words should you ignore before you start counting errors?

A

200

121
Q

What kind of paragraphs should you have someone with alexia/dyslexia read when assessing?

A
  • novel (new)

- strong in theme

122
Q

What things should you focus on in treatment with alexia?

A
  • focusing attention
  • lexical decision making
  • limiting letter by letter reading
  • survival reading
123
Q

What does agraphia often co-occur with?

A

aphasia

124
Q

What are some characteristics of agraphia?

A
  • paraphasias (written)
  • neologisms
  • agrammatism
125
Q

What are the three types of agraphia?

A
  • lexical (surface): doesn’t access semantic route well
  • phonologic: doesn’t access phonologic route well
  • deep agraphia: a little of both lexical and phonologic
126
Q

What are some treatment targets with agraphia?

A
  • assess ability to write automatic things
  • assess ability to copy
  • asses spelling and diction
  • written naming
  • written narrative
127
Q

What is CART?

A

copy and recall treatment

-pick 10 functional words and copy it over and over

128
Q

What are two screenings for aphasia?

A
  • Bedside Evaluation Screening Test (BEST)

- Aphasia Language Performance Scales (ALPS)

129
Q

Explain the ALPS

A
  • has 4 scales: listening, reading, speaking, and writing
  • provides graphs for progress
  • has a system of cueing to give 1/2 credit
  • each scale is out of 10 points
130
Q

What are some benefits of standardized aphasia tests?

A
  • provide norms
  • valid measure of performance
  • invariable adminstration
131
Q

What are some common comprehensive standardized test?

A
  • Boston Diagnostic Aphasia Examination-3 (BDAE-3)

- Western Aphasia Battery-Revised (WAB-R)

132
Q

What are some functional assessments?

A
  • Communication Activities of Daily Living-2 (CADL-2)

- Functional Assessment of Communication Skills (ASHA-FACS)

133
Q

What are some tests for severe/global aphasia?

A

Boston Assessment for Severe Aphasia

134
Q

What is one of the most standardized assessments out there?

A

Porch Index of Communication Abilities (PICA)

135
Q

What kind of scoring system does the PICA use?

A

multi-dimensional scoring system

136
Q

The PICA is considered to be the best prognostic test for aphasia if it is given when?

A

1-5 months post stroke (preferably in the first month)

137
Q

What kind of subtests does the PICA have?

A

the typical ones + pantomime and drawing

138
Q

What PICA score has really good predictive value?

A

the “peak mean difference” score
>500 = great prognosis
<200 = plateau, limited ability to change

139
Q

What does the HOAP score on the PICA provide?

A

the number where we think the client will end up 6 months post injury

140
Q

What are some things you want to assess in an informal beside eval?

A
  • conversation
  • discourse (phrase length, substantive/functor ratio, syntax, paraphasias)
  • auditory comprehension
  • naming
  • repetition
  • reading and writing
  • praxis
141
Q

What are some ways to assess auditory comprehension?

A
  • come up with 5 one-step, two-step, and three-step directions
  • yes/no questions
  • pointing tasks
  • money
142
Q

How can you assess naming?

A
  • confrontation naming (“what is that?”)
  • responsive naming (naming to description)
  • generative naming/word fluency (categories or phonemic fluency)
143
Q

How do you assess repetition?

A

start with single syllables and then moves to phrases

144
Q

How do you assess praxis?

A

use automatic lists

145
Q

Who is a cognitive eval done by?

A

a neuropsychologist or SLP or OT

146
Q

What should you include when obtaining a case history for cognitive eval?

A
  • premorbid cognitive level
  • considerations
  • neuropsychiatric behaviors (caused by brain damage)

Aphasia (3 decks)

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