Treatment Flashcards
approaches to aphasia treatment
- impairment-based
- consequences approach
Impairment based approach to aphasia tx
- goal: provide treatment for aspects of language that are impaired
- uses models of normal language and cognitive processing to determine deficits, and treatment is prescribed to ameliorate them
- improve language ability and help patient reclaim as much as possible of the underlying damaged capacities
Consequences approach
- functional, social, participation, psychosocial approach
- goal: reduce consequences or impact of aphasia on a persons life
Strategies of aphasia therapy
- restoration
- reconstitution
- compensation
restoration
focus on the underlying cause/deficit
-example: if you cant use the GPC route, treatment should work to improve GPC skills)
reconstitution
- if you cant improve the underlying skill, use intact abilities to accomplish the same hting
- example: if patient cant use GPC route, stregnthen the whole-word reading route
compensation
-bypass the impairment and focus directly on intact skills or doing the task another way (maybe using nonverbal means)
Steps in aphasia therapy
- specify areas to be targeted
- specify a tx strategy/approach
- specify a treatment hierarchy
- decide how to implement the hierarchy
Group Treatment
- provides psychosocial support for PWA
- doesnt replace individual therapy, may not provide as strong linguistic benefits
- but provides benefits for “self-acceptance, personal growth, autonomy, positive relationships, enviornemntal independent, purpose in life (ryff & singer)
- groups should be naturalistic and pragmatic
- types: psychosocial, support, sicrouse/current event, book club, verbal expression, reading groups, writing groups, leisure groups
-evidence:
Bollinger, Musson, & Holland: found that 3 hours/week of group tx for 40 weeks revealed significant improvement on CADL and PICa measures
- may also be good for TBI!
- Ruff and Neimann: TBI pts showed reduction in depression after treatment
Tx of reading:
ORLA (Cherney)-reading and reading comp
For pure dyslexia: multiple oral readings; cross modality cueing; brief exposure (letter by letter reading not possible)
surface dyslexia: strengthen GPCs?
Tx of Writing
CART (beeson)
ACT (Beeson)
-both good for nonfluent aphasia
-both work to increase PGC and GOL (so strengthens for both types of dysgraphia)
Tx for verbal expression/language production
- CIAT (pulvermuller et al.)
- MIT (Sparks, Helm, Albert)
- TUFS (Jacobs and Thompson)- sentence level production
- ORLA (cherney)
- VNEST (Edmonds)
- SPPA (Helm-Estabrook)
- Mappping Therapy for Sentence Production (Schartz et al)
- Script Training (Holland)
Tx for Sentence Comprehension
- TWA (de-blocking?) Helm-Estabrook, Fitzpatrick
- TUFS (Thompson et al)
- Mapping therapy for sentence comp (Schartz el al)
Tx for naming
SFA (Boyle & Coelho)
Complexity/Typicality approahc to naming tx (Kiran & Thompson)
PCA (Leonard, Rochon, & Laird)
PACE (Davis)
Rationale for frequency of tc
(Robey)
-treatment during acute period is 2x more effective, but still get gains during post-acute/chronic stage
-need at least 2 hours/week to make a difference
(Bhogal)
-Intense treatment (8.8 hours/week) over short time is more effective then less ver a longer period
