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THAS 102 > THAS 102 FINAL REVIEW > Flashcards

THAS 102 FINAL REVIEW Flashcards

1
Q

What is Aphasia?

A

Impaired language retrieval, recognition and comprehension

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2
Q

What is dysphasia?

A

Difficulty swallowing.

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3
Q

What is dysarthria?

A

Difficulty speaking because speech muscles are weak

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4
Q

What is apraxia?

A

Affects the coordination of muscles used for speech

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5
Q

What is anomia?

A

Difficulty finding words.

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6
Q

What is alexia?

A

Deficits in reading comprehension.

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7
Q

What is agraphia?

A

Impairments in the ability to write.

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8
Q

What is hemiplegia?

A

Paralysis to one side of the body

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9
Q

What is hemiparesis?

A

Weakness one one side of the body

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10
Q

What is neologism?

A

Made up words

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11
Q

What is echopraxia?

A

Repeated actions

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12
Q

What is copropraxia?

A

Obscene gestures

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13
Q

What is paraphasias? And the two subtypes?

A

Paraphasias - word substitutions
Phonemic paraphasias - sub or transpositions of a sound (ex tofa for sofa)
Semantic paraphasias - sub of one word for another (ex apple for orange)

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14
Q

What is circumlocations?

A

Talking around a word that cannot be retrieved

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15
Q

What is jargon?

A

Meaningless/irrelevant speech with typical intonation

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16
Q

What is telegraphic speech?

A

Phrases and sentences made of mostly nouns and verbs and omits small function words

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17
Q

What is pragmatic?

A

Use and contexts, aka taking turns in conversation and how to look beyond the literal meaning of words and utterances

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18
Q

What is syntax?

A

The rules that govern the English language (ex the boy kicked the ball, we are almost late for school because we missed the bus)

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19
Q

What is semantics?

A

The relationship between words and how different people can draw different meanings from that aka how we derive meaning (ex crash = car accident, stock market or attending a party without invite)

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20
Q

What is the wernicke’s area?

A
  • used for recognizing and interpreting incoming spoken language and the formulation and monitoring of our own speech and language
  • located in the left temporal lobe (receives info from the primary auditory cortex)
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21
Q

What is the Broca’s area for?

A
  • plays a primary role in programming the motor movement for speech production
  • located just behind the portion of the motor cortex that controls the lips and tongue.
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22
Q

Apraxia vs dysarthria?

A

Apraxia - “islands of correct speech” they may say a word correctly once and then wrong the next time
Dysarthria - muscle damage so you cannot make the sounds, they will make the same wrong sound every time.

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23
Q

What are the 3 critical elements of cognitive disabilities? (Aka dev delay, intellectual disability/delay)

A

1) significantly below-average intellectual functioning
2) concurrent related limitation in 2 or more adaptive skills (ex self care, decision making, learning)
3) manifests prior to 18
IQ is 70 or below (20-35 is severe)

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24
Q

What is adaptive behavior?

A
  • “life skills that develop as we grow” (ex asking permission, tying shoes)
  • adaptive functioning measures are important because IQ alone can’t predict general adaptation and IQ tests have biases
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25
Q

What are the deficits in adaptive behavior?

A

Major limitations in…
- academic learning
- personal independence
- social responsibility

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26
Q

What are the biological and environmental factors that can result in a cognitive delay?

A

Bio:
- genetic and chromosomal abnormalities (2 most common are DS and fragile x)
- infection during pregnancy/delivery complications
- brain disease (meningitis, encephalitis)

Enviro:
- TBI
- lead poisoning
- malnutrition

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27
Q

What are some developmental delays that come with CD?

A
  • delays in hitting milestones
  • infants with CD are less alert, have a weak sucking reflex and muscle tone
  • milestones like sitting, standing, walking, crawling, lang and communication skills are all significantly delayed
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28
Q

What are the types of Down syndrome?

A

1) Trisomy 21 (95%) - extra chromosome on the 21st pairing
2) Translocation pattern (2-3%)
3) mosaicism (2%)

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29
Q

What medical issues are there associated with Down syndrome?

A
  • heart malformation
  • intestinal problems
  • hearing loss and poor vision
  • smaller head; slanted eyes, small ears, flat nose bridge
  • hypotonia
  • teeth come in late
  • short fingers
    75% have conductive hearing loss (earwax + mid ear infection, low tone affects Eustachian tube)
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30
Q

What are the speech issues associated with Down syndrome?

A
  • high, narrow and arched palate
  • large adenoids affects nasal airflow which leads to mouth breathing
  • difficulty with tongue control
  • hypotonia = fine motor skill diff
  • when looking at mouth movement function, consider speed,strength and coordination
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31
Q

Articulation of DS

A

Reduced intelligibility due to
- delayed onset of speech
- vowel errors are common;alveolar sounds are more likely to be distorted
- structural differences + inconsistent error patterns

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32
Q

Language errors of someone with DS

A
  • sig lang impairments
  • exp lang more advanced than rec
  • visual learning skills are strong

Semantics: slower to develop, but vocab is a strength (very good at labeling objects)
Syntax: more impaired, challenges in learning to understand and use passives and pronouns
Pragmatics: strong ToM, may have issues with conversational behavior, differentiating facial emotions

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33
Q

Fluency and voice deficits in DS

A

Fluency - diff apparent in 30% of DS
Voice - quality problems, hyper/hypo nasality (can be due to structural differences) possible cleft/submucous palate

34
Q

Sensory + cognitive processing challenges on DS

A

Sensory:
- intolerance to certain sights/smells/sounds/textures/temp/colours
- clues there may be a sensory issue = gagging, inability to tell if they are full or hungry, lots of drool or messy eater

Cognitive:
- attention + verbal short term memory
- reasoning + problem solving

35
Q

What is Fragile X?

A
  • x-linked genetic disorder (males more affected than females)
  • results in cognitive, communicative, and behavior disorders
  • IQ tends to decrease with age
  • self injurious behavior, ADHD, anxiety and disciplinary problems are typical
  • many symptoms mirror autism, which may be based on sensory integration/processing issues
  • higher incidence of otitis media
  • due to long pinnas, extensive examination of hearing mechanism is encouraged
  • auditory-receptive memory and auditory processing skills are generally deficient
36
Q

Facial characteristics of fragile X

A
  • elongated faces/ears, prominent Jaw, flat bridge of nose
  • hypotonicity and joint dysfunction
  • vision difficulties
  • heart malformation
37
Q

Articulation, language and pragmatic associated with Fragile X

A

Articulation :
- associated with cognitive imapairment
- delayed articulation dev is common
- oral-motor diff
- dyspraxia apparent

Lang:
- affected by attention and sensory issues
- rec lang is a relative strength
- delayed in onset (may never develop)
- echolalia and preservation lang
- anomia and weak lang sequencing, organization and syntax

Pragmatics:
- weak nonverbal pragmatic skills; often inappropriate
- poor non verbal skills
- girls have a higher language skills
- dysfluencies

38
Q

What is FASD?

A
  • dev secondary disabilities
  • dis range from mild intellectual + behavioral issues to profound
  • most with FASD do not look different, can be misdiagnosed (ie ADHD, learning disabilities, anxiety etc)
  • primary disabilities = dis a child is born with
39
Q

Adverse outcomes/secondary disabilities associated with FASD

A

1) disrupted school experience with can include suspension, drop out etc (60%)
2) mental health issues (95%)
3) trouble with the law ( 60%)
4) inappropriate sexual behavior (52%)
5) high risk of being neglected/abused
6) being confined/housed in various public institutions (55%)
7) problems with employment (70%)
8) problems with parenting

40
Q

Diagnostic criteria of FASD

A

1) craniofacial abnormalities = widely spaced eyes, flat thin upper lip, flat midface (less than 10% have visible differences)
2) prenatal + postnatal growth deficiency (low birth weight, lose weight over time not due to nutrition, low weight to height ratio. 70% have severe feeding problems, often “failure to thrive”)
3) CNS dysfunction (structural brain abnormalities including the partial or complete agenesis of corpus collasum. Neurogenic signs aka impaired fine motor skills, poor hand eye coordination. Brain malformation)

41
Q

Left Hemisphere vs Right hemisphere of brain

A

LH - logic, facts and rules
RH - sensory input + reactive

42
Q

Cognitive + behavioral problems of FASD

A
  • may have normal to high IQ but very low adaptive capacity (AQ, aka the inability to predict consequences of actions, poor judgment skills. 2/3 kids have significant behavioral and emotional disturbances)
43
Q

Articulation + language skills of someone with FASD

A

Artic:
- poor feeding skills early in life which doesn’t allow for normal movement patterns necessary for pre speech motions to develop)
- dyspraxia (affects movement and coordination)

Lang: often present with greater expressive language than they have (aka cocktail speech) and has dif with syntax, semantics and Pragmatics

Voice:
- resonance problems common (many have clefting, VP insufficiency, and craniofacial anomalies)
- hypernasality + nasal air emissions
- may be hoarse

44
Q

Tourette Syndrome

A
  • ~1/160 children (more boys than girls, diff to diagnose, typically between 6-8 yrs)
  • normal cognitive ability, maybe some learning disabilities

Speech:
- unusual prosody, tone accents and intensity of speech

Simple vocal tics: whistling,coughing
Complex vocal tics: linguistically meaningful utterances
Simple motor tics: eye blinking, shoulder shrugging
Complex motor tics: clapping, kissing, hopping

45
Q

Prader Willi Syndrome

A
  • occurs 1/8000 - 1/25000 live births
  • defect in chromosome 15
  • most common cause of genetic obesity (have polyphasia insatiable appetite) (60% have normal metabolism)
  • develops between 2-5 years
46
Q

Cognitive and physical deficits of prader willi syndrome

A

Cognitive:
- IQ 40-105 (average is 70)
- immature for age, displays incomplicance, diff with transitions, impulsivity and disinhibition

Physical:
- hypotonia
- short stature, small hands/feet, tapering on fingers and toes, distinct facial features, narrow palatial arch, underdeveloped chin and inadequate velopharyngeal closure.

47
Q

Speech issues of prader willi syndrome

A

Oral -Motor: severely reduced, low tone affected feeding in infancy, flaccid dysarthria notes (due to damage to the lower motor neurons)

Articulation: hypotonia and structural differences, speech onset can be delayed, mild to multiple articulation errors ( esp trouble lifting tongue to make alveolar phonemes)

Lang: both rec and exp lang delay, affected by cognitive function, reduced morphological and phonological, dif with comparatives and superlatives

Voice: hypotonia can result in excessive hypernasality and high pitched voice, nasal emissions and poor VP closure

Fluency: above average # of dysfluencies

48
Q

What is Articulation delays?

A

Articulation: ability to produce sound in sequence by moving the articulators
Articulation delays: refers to the difficulty making motor movements to produce speech sounds that should be achieved by their age

  • most artic delays are considered functional (ie the cause of differences in speech development from normal developing kids simply cannot be determined)
49
Q

What are phonological delays?

A

Phonology: system of sounds/sound patterns within a language
Phonological delays: refers to children applying phonological processing longer than necessary or applying atypical phonological patterns

*most phonological delays are considered functional (ie the cause of differences in speech development from normal developing kids simply cannot be determined)

50
Q

Functional vs organic disorders

A

In order to be classified as functional rather than organic disorder, kids should have
- normal physiological development
- normal functioning oral mechanism
- normal hearing
- no neurological problems relevant to speech production

51
Q

Types of simplification processes

A

1) syllable simplification (FCD, CCR, ICD, USD, Diminutization aka adding ‘ee’ at the end of a word, Reduplication aka soother becomes soosoo
2) sound substitutions (stopping, fronting, gliding)
3) sound assimilations (making one sound similar to another to simplifying the word aka gog for dog, prevocalic voicing)

52
Q

What processes is normal and not normal in a 3 year old?

A

By 3 they should be done with : USD, FCD, VF, PPV
After 3: CCR, Gliding, Stopping

53
Q

Symptoms of a phonological disorder

A

1) chronological mismatch (advanced patterns co-occur with ‘early processes)
2) variable use of processes
3) use of atypical processes (use of atypical processes, backing, glottal replacement)
4) small phonetic repertoire/inventory
5) systematic sound preference (aka “phoneme collapse”; child subs ‘t’ for all fricatives
6) reduces intelligibility

54
Q

What are the 2 divisions in the nervous system?

A

1) central nervous system CNS (includes the brain and spinal cord)
2) peripheral nervous system PNS (all associated nerves and sense organs including cranial + spinal nerves)

55
Q

What is the CNS’ role?

A

The brain is the central processor for incoming sensory information, mutual reasoning and outgoing motor commands.
The cells in certain regions perform different tasks such as processing sensory information, generating motor commands and nourishing + supporting the other nerve cells.

56
Q

What are the 3 major divisions in the brain?

A

1) cerebrum (divided into left and right hemisphere, it controls muscle function and also speech control, thoughts, emotions, reading, writing and learning)
2) cerebellum (responsible for coordinating movement and balance also known as the “little brain” plays a vital role in language and attention and can assist people with vision and eye movement)
3) brain stem (includes midbrain, pons, medulla oblongata, regulates breathing/swallowing/automatic body activities

57
Q

Facts about cerebrum

A

Cerebral cortex: expands brains surface area + # of nerve cells
Gray Matter: where processing + regulating of info occurs in CNS, found in cortex + some subcortical structures + basal ganglia and spinal cord
White Matter: myelinated neurons, specialize in transmitting info over relatively long distances within the body
Ridges = called a gyrus
Valley = called a sulcus (very deep sulcus is called a fissure)
** made up of two major divisions
Cerebral hemispheres
Basal ganglia (responsible for motor control, motor learning, executive function, behaviors and emotion)

58
Q

What are the types of strokes?

A

Ischemic (85%)
- blood clot the restricts blood flow to brain
- buildup of plaque involved in most ischemic strokes (fatty materials, calcium and scar tissue)
1) thrombotic - blood clot directly in artery in brain
2) embolic - clot that travels to brain from somewhere else in brain

Hemorrhagic (15%)
- uncontrolled bleeding in brain; interrupts normal flood flow in brain
- flooding in brain kills brain cells
1) subarachnoid hemorrhage - uncontrolled bleeding on the surface of the brain (between brain & skull)
2) intracerebral hemorrhage - an artery deep within brain ruptures

59
Q

What is a hemorrhage?

A
  • can be caused by structural problems with blood vessels in brain

Aneurysm: weakened area in blood vessel wall fills with blood and bulges, high BP or trauma can cause a rupture

AVM (arteriovenous malformation): malformation of brains blood vessels usually present at birth; cause artery walls to be weak

60
Q

What is a transient ischemic stroke (TIA)?

A
  • “mini stroke”
  • symptoms are similar to ischemic stroke, but go away within minutes or hours (less than 24 hours)
  • many people have a TIA without knowing it
61
Q

Different locations of strokes

A

1) left hemisphere
2) right hemisphere
3) cerebellar stroke (can cause abnormal reflexes of head + torso, coordination + balance problems, dizziness, nausea + vomitting
4) brain stem stroke (esp devastating, can result in paralysis on one or both sides of body aka “locked in syndrome” where you can only move eyes)

62
Q

Speech, language, swallowing and/or cognitive deficits of a stroke

A

Aphasia - impaired lang retrieval, recognition and competency (30% of stroke survivors)
Dysphasia - diff swallowing (55%)
Dysarthria - diff speaking bc speech muscles are weak (40%)
Apraxia - affects coordination of muscles used for speech (10%)

63
Q

What is aphasia? What are the causes of aphasia

A
  • left sided stroke “brain holding your words hostage”
  • most common cause is a cerebrovascular accident (CVA)

Causes:
- 85% stroke
- 15% brain injury, tumors, neuro conditions

Every client is different depending on
1) site of injury
2) severity of injury
3) uniqueness of injury

64
Q

What are the 2 classifications of aphasia?

A

Non-fluent aphasia: verbal expression is agrammatic, lacking in prosody, slow and effortful
- relative strength is comprehension
- typically frontal lobe injury, often comes with gross motor deficits
- Broca’s aphasia = main type of nonfluent aphasia
Fluent Aphasia:
- marked by fluent (though nonsensical) speech +impaired comprehension
- typically injury in temporal parietal region, therefore no gross motor deficits

65
Q

What is transcortical motor aphasia?

A
  • output similar to Broca’s but excellent imitation
  • little to no initiation of spontaneous speech (or writing)
  • present with telegraphic speech, agrammatism +anomia (also agraphia)
  • relatively intact comprehension
66
Q

What is global aphasia?

A
  • most severe
  • little to no exp or rec skills
  • results from damage to Broca’s and wernickes area
  • severe motor deficits (hemiplegia, severe dysarthria, apraxia, dysphagia)
67
Q

What is fluent aphasia?

A
  • wernicke’s area
  • main type of fluent aphasia
  • fluent but often meaningless (jargon)
  • imapired comp (both written and verbal)
  • unaware that what they are producing is incorrect

Characteristics
- circumlocations (talking around a word that can’t be retrieved)
- jargon (meaningless speech)
- neologisms (made up words)
- paraphasias (word sub that are found in some individuals with aphasia who may talk fluently + grammatically ‘
Phonetic paraphasias: sub or transportation of a sound (tofa for sofa)
Semantic paraphasias : sub of one word for another
- alexia
- agraphia
- anomia

68
Q

What is conduction aphasia?

A
  • relatively fluent speech and good lang comp
  • main imapairment is inability to repeat words or phrases
  • some have spoken lang impairments, paraphasias (often phonemic) and anomia
69
Q

What is anomic aphasia?

A

Significant word finding diff with otherwise fluent and grammatical speech ; good comp (writing may be poor)
Least severe aphasia

70
Q

Language functions assessed with aphasia and factors affecting prognosis

A

1) speech fluency (measured by length of utterances with 4 or more connected words indicating greater fluent speech ability)
2) syntax
3) naming (ability to use appropriate words + provide names when presented an object)
4) repetitions or imitative speech (ability to repeat back what is said
5) automatic speech
6) lang comp
7) reading and writing

Factors:
1) age (younger ones have greater levels of recovery)
2) lesions size (larger lesions typically cause more deficits + more diff to completely recover
3) lesions location ( more tissue damage + damage to wernickes area produce more persistent aphasia)
4) severity and type (global aphasia has poorest prognosis)

71
Q

What is an RHI?

A

Stroke, TBI, tumor, seizure, infection that damages right side of brain

72
Q

What are right hemisphere deficits?

A

-cognition and language (nonverbal) are affected
- language skills such as word and sentence processing are relatively unaffected
- there are lang issues but cognitive and perceptual issues are more typical

Cognitive:
- diff with memory (esp working mem), logic, reasoning, planning, sequencing, problem solving, inferencing, understanding sarcasm and humor, and ToM.

Perceptual and attentional deficits:
- neglect of left visual field (left side neglect)
- diff with facial recognition (prosopagnosia),denial of deficits, reduced sustained attention and selective attention
- trouble reading others emotions

73
Q

What is TBI trauma determined by?

A

1) primary damage ( ranging from large to small microscopic brain lesions caused by impact to the head)
2) secondary damage ( resulting from such factors as infection, oxygen deprivation, brain swelling (edema) which can lead to intracranial pressure)
Secondary issues include:M cerebral edema, traumatic hemorrhage and seizures.

(Open) Penetrating injuries:
- results when the scalp, skull and meninges are penetrated (ie gunshot wound)
- injuries tend to be relatively localized “focal” with regard to the size and the extend of the neurological damage

Closed head injuries:
- brain is jostled in skull yielding diffuse “nonfocal” neuro injuries
- primary damage are result of mechanical forces involving direct contact and inertia (similar to whiplash)

74
Q

Coup vs contracoup injury

A

Coup - injury at point of contact
Contracoup - injury at the opposite point of contact

75
Q

Organic speech disorders

A

Organic speech disorders:
Motor- (neurogenic) childhood apraxia of speech (CAS) and dysarthria

Structural - cleft lip and palate, craniofacial abnormalities

Perceptual/Sesnory:
- otitis media (infection of the middle ear, the air filled space behind the eardrum that contains the tiny vibrating bones of the ear)
- sensorineural hearing loss

76
Q

What is developmental apraxia of speech (DAS)

A

Speech disorder characterized by sensorimotor difficulties in planning,positioning and sequencing movements for the volitional production of speech
- children with DAS have more problems saying sounds syllables and words

Causes:
- no consistent explanation
- runs in families, higher incidence in males
- presumed to be a disorder of motor programming

77
Q

Cerebral Palsy

A
  • neuro motor disorder resulting from brain function abnormalities, non progressive
  • may result in weakness, paralysis, and in coordination

Types: categorized based on muscle tone, motor systems involved (hemiplegia)
Spastic CP: most common, caused by damage to the motor cortex
Athetoid CP: damage to basal ganglia, slow + invol movements
Ataxic CP: damage to cerebellum, disturbance in balance + coordination

78
Q

Types of apraxia

A

1) verbal apraxia - affects the initiation + execution of the movement patterns particular to speech
2) oral apraxia - apraxia of the mouth; oral often but not always with verbal
3) limb apraxia - associated with voluntary movements of the arms and legs (clients might be unable to wave goodbye for example)

79
Q

What is verbal apraxia?

A
  • sound sub, omissions, distortions, and addition all observed (most frequent sub and omission)
  • artic errors are more frequent on cons clusters
  • usually aware of errors
80
Q

What are dysarthrias?

A
  • group of neuromuscular impairments that may affect speech, range, direction, strength and timing of motor movement as a result of paralysis, weakness of discoordination of muscles
  • motor movement that were previously established may have been lost through that movement still exists
  • artic errors most commom
81
Q

Speech characteristics of dysarthria

A
  • depends on location of lesion in CNS or PNS
    Errors include
    Artic errors (imprecise artic)
    Resp issues (weakness in muscles)
    Laryngeal issues (weak adductors/abductors)
    Velopharyngeal issues (hyper/hyponasality)
    Prosody issues (rapid or slow speech)
82
Q

6 types of dysarthria

A

1) * flaccid (hypotonia resulting in weakness or paralysis of affected muscles)
2) spastic (hypertonic males movement difficult, slow speech with jerky imprecise artic)
3) ataxic (irregular or slow rythym of speech and pauses of speech or excessively equal stress on every syllable)
4) hyperkinetic ( involuntary movements affected respiratory, phonatory, articulatory structures impacting speech)
5) hypo kinetic (decrease or lack of appropriate movement)
6) mixed (spastic - flaccid)

THAS 102 (3 decks)

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