Treatment of Aphasia & Related Disorders Flashcards
Research has shown that it is effective if
treatment is delivered by qualified people
If content, timing, intensity, duration of treatment are appropriate for the patient
Appropriate measures are used to track performance
when should treatment begin
treatment should begin as early as possible, delaying it by 2 months may have negative impact
Spontaneous Recovery for occlusive stroke
4-8 weeks
Some patients may not be good candidates because of ..
lack of funding, mild impairments, too ill or too weak to undergo treatment
Irreversible Aphasia Syndrome
same as global aphasia
Poor prognosis for patients who remain globally aphasic one month post-onset
usually remain chronically globally aphasic
may not show enough improvements for third party funders
Goals of Treatment
Complete recovery is usually not a viable goal,
functional communication
Consideration of Treatment of Auditory comprehension
must be able to remember language long enough to interpret it and assign meaning
Sensory memory
lasts 1-2 seconds when incoming stimuli are briefly stored
short term memory
lasts longer than sensory memory-several minutes- but can be maintained by rehearsal. Remembering numbers or other sequences rely on short term memory.
long-term memory
has very large capacity-info decays slowly if at all. memories can become permanent memory at this stage.
working memory
similar to short term memory, sentence comprehension takes place. different from short term memory in that short term is static and on its way to long-term memory. working memory is where active mental processing is going on
Treatment of Auditory Comprehension
Treatment of Single-Word Comprehension
Typical treatment- an array of pictures/objects are displayed. patient is asked to point to one of them, carrier phrase is usually used to keep it simple for the patient to understand
Treatment of Auditory Comprehension
Treatment of Comprehension of Spoken Sentences
Answering y/n and open-ended questions
Following spoken directions
Sentence verification-pt listens to sentence and selects picture that matches the sentence
Task Switching activities
Treatment of Auditory Comprehension
Treatment of Discourse Comprehension
clinician reads aloud a discourse and patient answers questions about the information
Is discourse easier to understand than words in isolation?
True because discourse provides context
In treatment of discourse comprehension, patients can respond to..
y/n questions
sentence completion
open ended questions
retelling
Stimulus manipulations in treating discourse comprehension
familiarity length redundancy, cohesion and coherence salience directness
what is salience
main idea stands out, easy to identify using emphasis and elaboration and repetition
Surface Dyslexia
individuals have lost he ability to directly access words and meaning and must do indirect method. This causes difficulty in words irregularly, such as ‘through’ and ‘neighbor’. Direct route from printed stimulus to semantic representations is unavailable, so patient depends on indirect (grapheme to phoneme)
Do people with aphasia have better reading comprehension than auditory comprehension?
False, often their reading comprehension is worse than their auditory comprehension
To read we must be able to recognize words and attach meaning to words. This can be done in 3 ways
whole word recognition
phonemic analysis
word recognition by context
Phonemic analysis
reader divides words in letters or letter combinations to analyze first
Processes in Reading
Syntactic Analysis
Semantic Mapping
What is syntactic analysis?
determining relationships among words
What is Semantic Mapping?
relating the writer’s intended meaning to their own knowledge.
Deep Dyslexia
individuals have lost the ability to access the word and meanings indirectly and must rely on whole-word method. This may cause words that are similar to be confused. Grapheme to phoneme conversion is unavailable and the patient must depend on whole word reading. Uses semantically supportive context
Treating Neurogenic Reading Impairments
Teach the patient survival reading skills like reading mail, newspapers, etc. It varies on the what the patient sees as valuable
What to take into consideration when treating patients with mild to moderate reading impairments
Determine patients history of literacy
Determine reading capacity
Most material in daily life is at __ th grade level
5 or 6
Intervention for patients with deep dyslexia
Orally sound out words
Practice discriminating between words that are similar (college, cottage)
Practice completing the letters on words that are spelled regularly
Patients who can read at the sentence level, may do better with whole paragraphs than with sentences in isolation
true because the paragraph gives context
Webb suggests using reading passages that are at least 50 words long, as it takes that much to get context
False, 200 words
Facilitating Volitional Speech
sentence completion tasks
confrontational naming
word/phrase repetition
What is the most effective cue for confrontational naming?
Giving the first sound of a word has been shown to be the most effective cue
Treatment of Speech Production
3 Parts for enhancing Word Retrieval in Speech
Part 1- diagnosis, baseline, word list
Part 2- Strategy Development and Practice
Part 3- Stabilization and Generalization
Cues to give with Word-Retrieval Failure
1- First sound 2- sentence completion 3- rhyme 4- function/location 5- superordinate- its something you drink
Treatment of Speech Production
Sentence Production
Imitation drills Repetition-Elaboration drills Story Completion Question- answer drill Story elaboration Picture Story elaboration
Treatment of Speech Production
Connected speech
prompted story telling
picture description
Treatment of Speech Production
Procedural Discourse
ex: tell me how you make a sandwich, tell me how you get to the store
Writing requires
spelling visuomotor skills limb strength better syntax than in speaking more formality than in speaking
Treatment of Writing Impairments
Spelling, syntax and grammar are typically focused on
Advanced writing skills are not necessary, only survival writing skills are necessary
computers might make it easier
Group Activities for Aphasic Adults
family support groups
psychosocial groups
treatment groups
transition/community reintegration groups
Research shows group activities are effective
True, usually after individual treatment
recovery time for hemorrhagic strokes or TBI
recovery completed 3-6 months
