ALI 1: Intro

Question 1

What’s aphasia?

Answer 1

APHASIA = acquired language impairment, caused by organic damage to the brain. Affects the ability to understand language (including talking, writing, and non-verbal comm.)

PWA can have difficulty acquiring new terms and retaining understanding => problem expl. what aphasia is => poor public awareness.

Question 2

Epidemiology and Causes

Answer 2

Caused by damage to brain; corticol – grey matter; sub-corticol – white matter.

Most common cause of aphasia is strokes (ischaemic – clot in brain which causes cell death, haemorrhage – brain aneurysm bursts or weakened vessel leaks.. blood builds and causes swelling + pressure). 1/3 of ppl w strokes have aphasia.

Other causes: head injury, brain tumours or infections, neurosurgery, progressive neurological disorders.

Question 3

In regards to PWA needs, what themes and aims lead to better outcomes??

Answer 3

5 themes identified =leds=> good prognosis (Grohn and Brooke et al.)

1. Needing to do things – sense of control and purpose; leads to independence
2. Social support and relationships – friends, family etc.
3. Rehabilitation – recovery, therapy, lifestyle changes
4. Adaptation and adjustment – use of strategies
5. Positive outlook – hope, determination.

Cruice et al. looked at QoL and aphasia – older pwA. What +++ and — to QoL?
• Core: activities, verbal communication, people and body functioning
• Other: stroke (type??), mobility, outlook (positive?), independence, home, health

Worral and Linda et al. looked at people’s personal therapy goals post-stroke:
•	Returning to pre-stroke life
•	Communicating needs, social, expr emotions
•	Access to info on aphasia, stroked etc
•	Relevant and long SaLT
•	Control and independence at home
•	Dignity and respect
•	Social, leisure and work
•	Altruism and contributing to society
•	Physical functioning and health

Question 4

Recovery - types of changed post stroke

Answer 4

Brain injury following stroke can lead to primary (changes occur in few days – quickly recover/stabalise) and secondary (long term and continuing functional changes).

Question 5

Prognosis – Acute Stage

Answer 5

Key prognostic factors:

1. Initial severity of aphasia
2. Stroke lesion/site and size
3. Speech and language therapy

a. Robey – 3mo post recovery of treated ind twice as extensive vs no trx.
b. Intensive therapy (2hr/week) = better outco.

Question 6

What leads to a better prognosis post brain injury?

Answer 6

Single CVA and lesion
Unilateral
Small area of damage
Cortical (surface wound)
Damage ant. location 
Good overall health
Short time post receiving therapy + willingness to learn

Question 7

What leads to a worse prognosis post BI?

Answer 7

Multiple
Bilateral
Large
Sub-corticol; deep and extensive
Damage to parietal 
Poor health and sensory deficits

Question 8

According to RCSLT, aims of therapy??

Answer 8

RCSLT – therapy should focus on: participation, improving language functioning, comp strats, skill of CP partner, group therapy, computer sup thx.

AIMS:
• Maximising remaining abilities + compensate, learn alt methods
• Restore language as much possible
• Coach relevant ppl in PWAs life

Question 9

Family + therapy

Answer 9

Exp w aphasia is shaped by environment. Therapy aims for families to:

• Understand aphasia and new ways they can comm.
• Adapt communication for PWA
• Support ppl in trx

Question 10

Approaches to practise

Answer 10

• Lang focus (impairment) => psycholinguistic, localisation (stimulation)
• Comm focus (activity) => functional, pragmatic
• Participation focus
• Psychological focus..