7 - Non-Standardized Aphasia Assessment + Aphasia Prognosis

Question 1

Do most aphasia patients change severity ranking due to treatment?

Answer 1

No but they can make functional progress

Question 2

Those with mild aphasia struggle mostly with ____________.

Answer 2

Word finding difficulties

Question 3

What is fluency like in Broca’s Aphasia?

Comprehension?

Repetition?

Answer 3

Poor

Good

Poor(ish)

Question 4

What is fluency like in Wernicke’s Aphasia?

Comprehension?

Repetition?

Answer 4

Good

Poor

Poor

Question 5

What six areas can we assess during an informal assessment?

Answer 5

Comprehension

Expression

Reading

Writing

Cognition

Pragmatics

Question 6

What four things can we ask the patient to write to test their writing ability during an informal assessment?

Answer 6

Name

Address

Telephone

Contact

Question 7

What are we looking when assessing cognition during an informal assessment?

(3)

Answer 7

Attention

Memory

Regulation

Question 8

What kind of environment should we test comprehension in during an informal assessment?

Answer 8

A quiet setting free of distractions

Question 9

What is an Aphasia Prognosis?

Answer 9

An educated, best estimate of where the patient will be in a specific time period (1 month, 6 months, 1 year, etc.)

Question 10

What do patients want to learn when they ask about their prognosis?

Answer 10

When they will get better

Question 11

What FIM score is associated with a higher likelihood of functional improvement after a stroke?

Answer 11

60+

Functional Independent Measure

Question 12

What is the most common type of stroke in the acute phase?

Answer 12

Global

Question 13

Aphasia _________ in first year post-stoke.

Answer 13

Improves in general

Question 14

___% of patients experience complete recovery by one year.

Answer 14

40%

Don’t tell patients this

Question 15

When does aphasia recover the FASTEST?

Answer 15

First 3 months

Question 16

When does the GREATEST amount of aphasia recover occur?

Answer 16

First 6 months

Question 17

When does aphasia recovery tend to slow down?

Answer 17

After 12 months

Question 18

When do most aphasia types often resolve to less severe forms?

Answer 18

Within 12 months

Question 19

___% of patients have residual impairments at 12 months.

Answer 19

61%

Question 20

_______ and ______ of recovery may be different across language domains.

Answer 20

Degree

Rate

Question 21

What is often QUICK to recover?

Answer 21

Repetition

Question 22

What is often SLOWER to recover?

2

Answer 22

Naming

Fluency

Question 23

Where is more improvement noted in aphasia patients: Auditory Comprehension or Language Production?

Answer 23

Auditory Comprehension

Question 24

Where is more improvement noted in aphasia patients: Oral Expression or Written Expression?

Answer 24

Oral Expression

Question 25

What is the most important predictor of aphasia recovery?

Answer 25

Initial aphasia/stroke severity

Question 26

What are the second most important predictor of aphasia recovery? (4)

Answer 26

Number of lesions (worse with multiple) Size of lesion Location of lesion Type of aphasia

Question 27

What are weak predictors of aphasia recovery? | 4

Answer 27

Age Handedness Education Intelligence

Question 28

What medical conditions are predictors of aphasia recovery? | 2

Answer 28

Physical dependence Other diseases

Question 29

What psychological conditions are predictors of aphasia recovery? (3)

Answer 29

Depression Enthusiasm Motivation

Question 30

What lifestyle conditions are predictors of aphasia recovery? (3)

Answer 30

Family support Unlimited professional support Unlimited financial support

Question 31

What personal decisions might predict aphasia recovery? What do we need to ascertain? (2)

Answer 31

Refusal of treatment // Cognitive status Does/can patient understand the consequences?

Question 32

Greater initial severity of aphasia is associated with ___________.

Answer 32

Poorer outcome

Question 33

The size of the lesion causing patient's aphasia has __________ on recovery.

Answer 33

Negative influence

Question 34

Damage to what cortical area affects memory? What role does this play on recovery?

Answer 34

Temporal Always bad for recovery

Question 35

Persistent non-fluency is associated with lesions in ___________ and ____________.

Answer 35

Rolandic cortical areas Underlying white matter

Question 36

Sparing of ___________ is positive prognostic sign for recovery of non-fluent speech. This area is associated with ______ aphasia.

Answer 36

Lower Pre-Rolandic (face) area Broca's

Question 37

Sparing of ___________ is a positive prognostic sign for recovery of auditory comprehension. This area is associated with ______ aphasia.

Answer 37

Posterior-superior temporal lobe Wernicke's

Question 38

For best aphasia recovery outcome, _____ needs to be dominant initially but ________ needs to regain control.

Answer 38

Right hemisphere Left hemisphere

Question 39

What are the recovery odds if both hemispheres are involved?

Answer 39

Poor

Question 40

Compensatory right-hemisphere activity is inversely related to the _______________.

Answer 40

Restoration of the left-hemisphere language networks

Question 41

Comprehension in patients with Wernicke’s aphasia had a significantly higher greater median increase in their AQ than _______ and _______ at week 12 + 24 but less than ______ at week 24

Answer 41

Conduction Aphasia Anomia Global Aphasia

Question 42

Patients with ______ appear to have best prognosis for improvement in first year of stroke. Why? (2)

Answer 42

Broca’s Aphasia // Comprehension preserved Self-monitoring preserved

Question 43

The extent of improvement in patients with global aphasia is better than patients with _______. Why?

Answer 43

Wernicke’s aphasia // There's more room to improve

Question 44

Prognosis of post-stroke aphasia appears to depend, at least partially, on the __________.

Answer 44

Type of language impairment

Question 45

Patients with _______ had a better prognosis than those with Global and Wernicke’s Aphasia.

Answer 45

Broca’s Aphasia

Question 46

Lesions involving the _______ were seen to have worst overall scores and differed from controls

Answer 46

Medial-Temporal Gyrus

Question 47

Anterior portion of BA22 may be critical for comprehension of ___________.

Answer 47

Simple sentences

Question 48

In Laska et al.'s study, "Aphasia in acute stroke and relation to outcome" (2001), ___% had complete recovery, ___% continued to have significant aphasia, and ___% died.

Answer 48

~25% ~50% ~25%

Question 49

Were patients with non-fluent aphasias younger or older than patients with fluent aphasia?

Answer 49

Younger

Question 50

Did younger patients with aphasia show higher or lower degrees of recovery?

Answer 50

Higher

Question 51

What is a better predictor of aphasia recovery: fluency or CT results?

Answer 51

Fluency (better results with impaired fluency)

Question 52

When aphasia changes it typically progresses to a __________.

Answer 52

Milder form

Question 53

_______ is a common endpoint of aphasia evolution for both recovering fluent and non-fluent aphasias.

Answer 53

Anomic aphasia

Question 54

What aphasia types are associated with GOOD recovery? | 4

Answer 54

Anomic Conduction TCMA TCSA

Question 55

What aphasia types are associated with FAIR-GOOD recovery? | 2

Answer 55

Broca’s Some Wernicke’s

Question 56

What aphasia types are associated with FAIR-POOR recovery?

Answer 56

Wernicke’s

Question 57

What aphasia types are associated with POOR recovery?

Answer 57

Global

Question 58

What aphasia types are associated with FAST recovery? | 2

Answer 58

Conduction Wernicke’s

Question 59

What aphasia types are associated with INTERMEDIATE (moderate speed) recovery? (3)

Answer 59

Broca’s TCMA TCSA

Question 60

What aphasia types are associated with SLOW recovery? | 2

Answer 60

Anomic Global

Question 61

What information do we give for a prognosis? | 2

Answer 61

What is going to improve (aphasia, functional communication, etc.) When it is going to improve (2 weeks, 3 months, etc.)

Question 62

The question prognosis answers is will this patient with this __________ characterized by these _______ at given ___________ improve in communication functions given ____________ at ____________.

Answer 62

Specific syndrome Symptoms Levels of severity Specified treatments Specific points in time

Question 63

We should give patients hope but always err on the ___________.

Answer 63

Side of caution