Ch. 12: Right Hemisphere Syndrome (RHS)

Question 1

Define Right Hemisphere Syndrome (RHS)

Answer 1

o symptoms associated with right hemisphere damage (RHD), or right brain injury (RBI). It may be associated with any neurological etiology, such as stroke, traumatic brain injury (TBI), tumors, or infectious processes, and the resultant damage may be located in any part of the right hemisphere.

Question 2

Identify how RHS affects communication

Answer 2

o primarily in the area of cognitive-communicative or cognitive-linguistic impairments

Question 3

Expressive and receptive challenges of RHS

Answer 3

 Lack of perspective regarding another person’s feelings or point of view (theory of mind)
 Codeswitching deficits
 Inattentiveness
 Poor turn taking, frequent interruptions during conversation
 Poor eye contact
 Problems making use of contextual cues

Question 4

Receptive challenges of RHS

Answer 4

 Problems interpreting themes, morals, main ideas
 Problems with making inferences
 Tendency toward literal interpretation of figurative language (difficulty with idioms, indirect requests, sarcasm)
 Difficulty shifting topics
 Difficulty interpreting facial expressions
 Difficulty interpreting humor
 Receptive aprosodia

Question 5

Expressive challenges in RHS

Answer 5

 Poor topic maintenance, relevance, discourse cohesion, organization of content, use of macrostructure, main ideas, and themes
 Inefficient expression, inappropriate level of detail
 Frequent tangential comments
 Flat affect or inappropriate emotional expression
 Dysprosody
 Limited initiation of conversations
 Reduced use of facial expressions to convey emotion and meaning
 Disinhibition of inappropriate language and humor
 Confabulation
 Hypoaffectivity
 Hyperaffectivity
 Expressive aprosodia

Question 6

Attention problems in RHS

Answer 6

 Anosognosia
 Hemispatial (left) neglect
 Problems with vigilance, orientation, sustained attention, focused attention, selective attention, attention allocation, and alternating attention/attention switching

Question 7

Memory challenges (see also specific aspects of memory listed in Box 11–1)

Answer 7

 Verbal

 Nonverbal

Question 8

Executive function deficit Problems with RHS

Answer 8

	Reasoning
	Judgment
	Decision making
	Goal setting, planning, strategizing
	Self-monitoring, awareness of strengths and weaknesses
	Problem solving
	Organizing
	Sequencing

Question 9

Reading problems with RHS

Answer 9

 Visuospatial difficulties in interpreting letters and words
 Problems interpreting content, as noted for auditory comprehension

Question 10

Writing problems with RHS

Answer 10

 Visuospatial difficulties with writing or copying letters, words, ideographs, and symbols
 Problems with expression, as noted for discourse

Question 11

Visual-perceptual impairments with RHS

Answer 11

	Visual memory problems
	Prosopagnosia
	Visuo-constructive deficits
	Visuospatial disorientation
	Topographical disorientation

Question 12

Auditory-perceptual impairments with RHS

Answer 12

 Amusia
 Auditory agnosia
 Sound localization deficits

Question 13

Identify receptive language challenges

Answer 13

o Difficulty shifting topics

Question 14

Identify expressive language challenges

Answer 14

o Poor topic maintenance

Question 15

Identify cognitive challenges

Answer 15

o Problem solving
o Organizing
o Sequencing

Question 16

What is right hemisphere syndrome (RHS)?

Answer 16

o A constellation of symptoms associates with right hemisphere damage, or right brain injury.

Question 17

What is Hypoaffectivity:

Answer 17

o may be demonstrated as flat expression of emotion conveyed by reduces prosody and a lack of conversational or social initiative.

Question 18

What is Hyperaffectivity:

Answer 18

o may be evidenced as a degree of exuberance and incessant talking

Question 19

What is the Social cognition deficit hypothesis?

Answer 19

o the notion that right hemisphere networks are important for critical aspects of relating to others, such aa empathy, and understanding and responding to others’ perspectives.

Question 20

What is the Theory of mind?

Answer 20

o the ability to interpret, infer, and predict the thoughts, beliefs, feelings, and intentions of others and to differentiate the thoughts and perceptions of others from one’s own.

Question 21

What is the Cognitive resources hypothesis?

Answer 21

o The communication deficits seen in people with RHS are highly dependent on the degree of attention and working memory demands of a given communicative task. Deficits in linguistic performance are seen as being attributable to limited cognitive resources mediated by the right hemisphere, not to linguistic impairments per se.

Question 22

What is Figurative language:

Answer 22

o expressions that require abstraction to infer meaning that cannot be gained through literal interpretation.

Question 23

What is Inferencing:

Answer 23

o the act of making a logical conclusion about intended meaning based on what has been communicated.

Question 24

What is the suppression deficit hypothesis

Answer 24

o suggests that people with RHS are typically able to generate multiple interpretations of words, sentences, and stories but have a harder time selecting a most plausible interpretation when given suggested interpretations to choose from.

Question 25

What is Discourse coherence:

Answer 25

o the tying together of content in a logical way to express ideas effectively and efficiently.

Question 26

What is Codeswitching:

Answer 26

o taking into account the person with whom one is speaking in considering appropriate adaptations of what is being expressed and how it is being expressed.

Question 27

What is Prosody:

Answer 27

o the intonation, stress, and rhythm of speech.

Question 28

What are Tonal languages:

Answer 28

o languages in which changes in tones change the literal meaning of a word.

Question 29

What is Dysprosodia/dysprosody:

Answer 29

o prosody deficits

Question 30

What is Prosopagnosia:

Answer 30

o difficulty recognizing familiar faces

Question 31

What is preservation:

Answer 31

o Tendency to repeat words or parts of words previously spoken that are not the target word
o Ex: saying ‘head’ for ‘face’

Question 32

What is Paraphasia:

Answer 32

o Words that are substituted for target words. Can be semantic or literal.

Question 33

What is Neologism:

Answer 33

o Refers to nonwords; literally, “new words”. This happens in Wernicke’s aphasia.
o Ex: saying “bring me a trunket”, instead of “bring me a drink”.

Question 34

What are Semantic Paraphasia?

Answer 34

o (Also called verbal or global paraphasia’s). It is the substitution of a real word for the targeted word. The words can be closely related or non-related. (I.e., mouth instead of teeth or door instead of microwave).

Question 35

What is phonemic paraphasia?

Answer 35

o Substitution of one or more sounds in the target word (also called literal paraphasia’s)
o Ex: saying ‘bady’ for ‘baby’
o Ex: saying ‘tegetable’ instead of ‘vegetable’

Question 36

Semantic Perseveration

Answer 36

A word semantically related to the intended response – words related to the names they replace
(e.g., repeating the word eye when a clinician points to their nose when told to name body parts)

Question 37

Lexical

Perseveration

Answer 37

A type of recurrent perseveration involving persistence in using the same word used in a previous response instead of an appropriate word.
Ex: The individual names the following items, colors, and letters correctly: feather, glove, yellow, brown, P, T, but then says “brown” when shown the letter H. The actual response is a word that was spoken previously and is not semantically related to the intended response.

Question 38

Phonemic Perseveration

Answer 38

The response that the individual says, has phonemic features in common with a previous word spoken and it is not semantically related to the previous response. Ex. Instead of saying “ear” when a clinician points to an ear, the patient says “hear”.

Question 39

Logorrhea

Answer 39

Spoken language that is overly abundant in light of a given communicative context, also called press of speech.

Question 40

Press of Speech

Answer 40

When an individual is continuing to speak even though everything they are saying is not being understood by others. The speaker does not participate in turn taking during conversations and they are also unaware and do not understand that what they are saying makes no sense to others listening.

Question 41

Anosognosia

Answer 41

When a person is unaware of his/her illness or deficit; denial of problems.

Question 42

Telegraphic

Answer 42

When a person with Broca’s aphasia only produces short and simple phrases like someone would back in the day when sending a telegraph. They only use words that are necessary to get their thought across.

Question 43

Dysnomia/

Anomia

Answer 43

Refers to difficulty with word finding. With anomia, the person often uses other words to get around their errors which allows them to still communicate their intended meaning.
Ex- Having a phone right in front of you but not being able to name it but understanding its function.

Question 44

Circumlocutions

Answer 44

When a person uses other words, other than the intended words to communicate what they want (e.g., “hand me the cutters” vs “hand me the scissors”) (Lindsey)-it is also using many words to describe something instead of using the actual word

Question 45

Catastrophic

Reaction

Answer 45

When a person has extreme frustration when struggling to communicate, uncharacteristic and they can’t control it

Question 46

Stereotypy

Answer 46

When a person repeats the same couple of words or non-words across situations, regardless of what they meant to say. Repeated use of a word or a nonword when communicated with no meaning.

Question 47

Conduit

d’approche

Answer 47

person attempting to repeat a verbal target over and over. Ex: say the word “ball” Response: “bah, baa, back, bale”

Question 48

Repetition

Answer 48

Task assigned to a person to copy what was said or written OR an act where the person during communication copies what was said or spoken before.

Question 49

Emotional

lability

Answer 49

An individual’s tendency to cry, swear, or demonstrate other emotions that are uncharacteristic of the individual’s typical response prior the stroke or brain injury.