Week Three

Question 1

What is the purpose in early phase/post stroke

Answer 1

• Receiving the right referrals
• Optimizing initial contact

Question 2

Overview of receiving the right referrals

Answer 2

• Early identification of stroke (F.A.S.T)
• Early identification of aphasia
• MDT meeting

Question 3

What are the goals of optimizing initial contact?

Answer 3

INITIAL ASSESSMENT
- Establish presence and severity of Aphasia (and other communication and swallowing disorders)
- Identify how to optimize communication with PWA
- Build trust
- Identify communication strengths and weaknesses

1. Information gathering
2. Initial observations
3. Screening (do they have aphasia, fluent/non, severity, informal/formal)
4. Identify communication strengths and weaknesses

INITIAL MANAGEMENT
1. Provide information for whānau
-Information about stroke, aphasia and other procedures
- What to expect
- Repeated follow up (shock, denial, overwhelmed)
- PWA friendly
- Individualized

2. Provide support for PWA and Whānau
   - PWA may have had done things (paying bills, health insurance, living arrangements)
   - Involve Whānau (ask them to keep track of what PWA says, create profile of PWA)
3. Ensure communication environment allows PWA to participate
   - Menus
   - Good lighting, no distractions, speak slow, give lots of time to respond

Question 4

What would an informal assessment want to include?

Answer 4

• Auditory comprehension (yes/no questions, point to the…)
• Spontaneous speech (ask about life)
• Verbal repetition
• Verbal naming (what is that?)
• Reading comprehension
• Written expression

Question 5

Benefits and disadvantages to informal screening?

Answer 5

Advantages
- Flexible
- Brief
- Also suitable for severely physically impaired Pts
- Provides enough info for quick preliminary diagnosis
- Provides direction for further assessment

Disadvantages
- non-standardised
- Content and administration varies from place to place
- Lack of consistency
- Subjective

Question 6

Standardized screening tests

Answer 6

• WAB-R (Western aphasia battery- revised)
• FAST (Frenchay Aphasia screening test)
• BEST (Bedside evaluation screening test)
• CDS (Communication disability screener)
• BRISBRANE (Brisbane evidence=based language test for acute stroke)
• IFCI-SAI (inpatient functional communication interview - screening, assessment & intervention)