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Aphasia > Aphasia treatment > Flashcards

Aphasia treatment Flashcards

1
Q

What are 2 considerations for setting treatment goals

A

-Clients personal priorities
-Reasonable expectations based on client’s performance and knowlegde/experience

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2
Q

Why are client priorities important in treatment?

A

-Increased tx progess
-Increased tx satisfaction
-Aphasia threatens their roles and autonomy: so give them information and seek their input
-The greatest impairment may not be the most salient, make sure it is what the client wants to work on

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3
Q

What components of the clients performance influence tx expectations

A

-individuals neurologic, cognitive, metacognitive, and language profile

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4
Q

What 3 key information pieces obtained from assessment help to determine reasonable tx expectations

A

-What the client can do independently (tx reinforcer)
-What the client can do with support (tx targets)
-What the client can’t do

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5
Q

5 components of treatment goals

A
  1. Reflect the individuals personal priorities
  2. Written in operational language, easily understood by others
  3. Easily measurable for clear and objective determination and report of treatment response
  4. Logical and practical progression from STG to LTG
  5. Emphasize the communication activity
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6
Q

What is progress monitoring

A

Continuously evaluating and revising of goals as appropriate
Assessment is an ongoing process

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7
Q

3 reasons for documentation of treatment services

A
  1. pragmatically more important than therapy
  2. Proves services took place (if not documented, it didnt happen)
  3. Shows expertise- explains and justifies reasoning for services and activities
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8
Q

ASHA Documentation guidelines

A
  1. Use terminology reflecting technical knowledge
  2. Indicate rational/function, type, and complexity of activity
  3. Report objective (quantitative data) showing progress towards measureable goal
  4. Explain any modifications and give reasoning
  5. Specify feedback and/or training and client response
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9
Q

How may group tx be beneficial at the individual level

A

sense of family support
Feeling understood
Community
learn from others
Socialization

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10
Q

How may group tx be non-beneficial at the individual level

A

May lead to being discouraged
Less individualized
Less structure
individuals may not benefit as much
Less attention to individual
Inconsistent attendance

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11
Q

How may group tx be non-beneficial at the healthcare level

A

Meeting insurance requirements
Third party payer
Communication is targeted indirectly

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12
Q

Cons of group therapy

A

Harder to take data
Finding a common activity for alls interests
Inclusion of all participants
Creating equal opportunity for everyone
Less structure

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13
Q

Considerations for composing group therapy

A

Etiology
Symptomology
Severity
Age
Gender
Family in groups (good and bad)
Standards for participation
Pragmatic skills
Social behaviors
Attendance
Dischanging

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14
Q

Tips for composing group therapy sessions

A

-Know patient and family members needs, abilities, etc.
-Get family members to fill out questionare about client
-Get a sense of pre-morbid level of funtioning
-Ignore undesireable behaviors and reinforce positve behaviors
-Redirect undesirable behaviors
-Praise any level of participation
-Acknowledge and validate frustrations

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15
Q

3 Types of group tx Programs

A
  1. Communication based
  2. Psychosocial based
  3. Transactional based
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16
Q

What are communication based group tx programs

A

Procedural discourse tasks
-Facilitate language in a social setting
-Improve narrative procedural discourse
-Improve content of narrative and procedural discourse
-Improve functional communication in selected roles

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17
Q

What are psychosocial based group tx programs

A

emphasis on a team
NOT individualized

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18
Q

What are transactional based group tx programs

A

Facilitate discharge planning for patient and movement from one setting to another
(rehab team to long-term care)
Leader: social worker or case worker

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19
Q

What would be examples of story based tx activities

A

Pictionary
Acting out scenarios
Guess that word
Show and tell
Charades

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20
Q

What would be examples of arts based activities

A

Building structures
Baking
Cooking
Directions
Planning
Blueprints

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21
Q

Considerations when selecting documentation instrument for group therapy

A

-Group tx goals and objectives
-Amount of time needed
-Frequency and duration of group tx
-Examiner skill
-State/company/billing insurance requirements

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22
Q

Examples of documentation

A

-Standardized tests
-Measures of quantifying verbal output (frequency of initiated conversation, response time, level of engagement, accuracy of message)
-Qualitative measures
-Psychosocial measures
-Task specific measures of information exchange
-Type of communication acts
-Satisfactory levels
-Communication acts profile (children)

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23
Q

Examples of qualitative information that can be measured in group tx

A

-degree of communication burden assumed by conversational partner
-communication modality
-Self ratings
-list of augmentative strategies used
-list of compensatory efforts used
-psychosocial measures

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24
Q

Examples of psychosocial measures

A

Mood scales
Well being scales
Affect balance scales
Interactive communication scales
Self ratings

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25
Q

3 types of communication acts

A
  1. Assertive: agreeing with others
  2. Responsive: answering others
  3. Imitative: copying others
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26
Q

8 specific intervention techniques

A
  1. multiple modality teaching
  2. Providing feedback
  3. check for comprehension
  4. Share the leadership role
  5. Scaffolding
  6. promote generalization
  7. compensatory
  8. Various communciation methods
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27
Q

Define communication

A

-Information exchange between listener and speaker
-Participants use meaningful mode of communication with set of symbols
-Feedback occurs, which makes the communication participation equal

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28
Q

Purpose of varying stimulation in tx

A

To add or decrease difficulty level
Want to minimize failures and maximize performance/success

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29
Q

Standardized test for measuring auditory verbal comprehension

A

Token test

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30
Q

Standardized test for measuring naming

A

Boston naming test

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31
Q

Standardized test for measuring reading

A
  1. Gray Oral Reading Test
  2. Reading Comprehension Battery for Aphasia
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32
Q

Standardized test for measuring language

A
  1. Western Battery Aphasia
  2. Boston Diagnostic Aphasia Examination
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33
Q

Standardized test for measuring writing

A

None that measure only writing

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34
Q

Standardized test for measuring repetition

A

None that measure only repetition

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35
Q

4 biomedical approaches for aphasia

A
  1. Pharmacotherapy
  2. Transcranial Magnetic stimulation
  3. Stem cell transplantation
  4. Nerve cell stimulation
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36
Q

Biomedical approaches help to understand?

A

The neural basis of language

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37
Q

Define pharmacotherapy for aphasia

A

Manipulation of the brains neurotransmitters (chemical substances that allow electrical messages to be sent from one nerve cell to another)

38
Q

List some of the neurotransmitters shown to be effective for pharmacotherapy

A
  1. Dopamine
  2. Acetylcholine/Cholinergic
  3. Amphetamines
  4. Bromocriptine
  5. Dopaminergic
  6. GABA
39
Q

GABA and cholinergic have been shown to be effective with what type of aphasia?

A

Fluent aphasia

40
Q

Amphetamines, Bromocriptine, and dopaminergic have been studied in what type of aphasia?

A

Nonfluent aphasia
(only amphetamines and bromocriptine are effective)

41
Q

Pharmacotherapy have been shown to be effective for?

A

Mild to moderate aphasia, but not severe aphasia

(evidence from not well-designed studies- case studies)

42
Q

What is transcranial magnetic stimulation

A

Noninvasive procedure using magnetic fields to create electrical currents in discrete brain areas
This increases or decreases the excitability of neurons in the affected area that lasts beyond the duration of the stimulus itself

43
Q

Differentiate between slow and fast runs of magnetic stimuli

A

Slow runs decrease cortical excitability

Fast runs increase cortical excitability

44
Q

What are some compensatory/alternative approaches to Aphasia Tx

A

Yoga
Meditation
Mindfulness meditation
Nature based therapy approaches

45
Q

What are the 3 nature based therapies

A
  1. Horticultural therapy
  2. ANimal assisted therapy
  3. Natural environment therapy
46
Q

What did the times say about meditation? Why

A

Meditation should be treated more seriously like medication because it can be beneficial to a variety of areas:
Depression
Anxiety
Cognitive functions
Immune function
Stress
Sleep
Cancer
Self-compassion

47
Q

Mindfulness meditation targets what

A

Divided attention
Increased attention and awareness
Improved relaxation
Increases cortical thickness

48
Q

Physiologic and cognitive benefits shown with mindfulness meditation

A
  1. Physiologic- increase parasympathetic (calming) activity & decrease sympathetic activity (fight or flight)
  2. Cognitive- attention benefits
49
Q

What compensatory/alternative approach has been shown to have bio-psychosocial benefits in stroke survivors

A

Yoga

50
Q

Yoga has had what 3 effects in stroke survivors

A
  1. Improved language abilities (spontaneous sleep and fluency naming)
  2. Improved visual attention (reaction time, perceptual tracking, and simple/alternate sequencing)
  3. Decreased levels of anxiety and depression
51
Q

Describe horticulture therapy

A

Therapeutic effects of cultivating plants

52
Q

What is animal assisted therapy

A

Use of animals to individuals improve:
socially
emotionally
cognitive functioning motivation

53
Q

What is natural environmental therapy

A

Exposure to natural environment can improve patients experience and health outcomes

Aimed at improving healing, reducing medicine use, shorten hospitalization, and decrease anxiety/stress

54
Q

What is agnosia?

A

-Sensation without perception= sensory acuity being WNL, with inability to recognize/identify sensory stimuli
-Modality specific
-Rare

55
Q

Define visual agnosia

A

Failure to respond appropriately to visually presented stimuli

Visual sensory processing, language, and intellectual functioning are intact/preserved

56
Q

Define auditory agnosia

A

Problems with the recognition of sounds, while hearing acuity is 100& WNL

57
Q

Apperaceptive visual agnosia

A

Inability to match, draw, or point to objects

58
Q

Apperceptive visual agnosia deficits are possibly due to?

A

Simultanagnosia

59
Q

Lesion site associated with Apperceptive visual agnosia

A

Striate area- visual sensory area in occupital lobe

Peristriate area- areas surrounding striate areaa

60
Q

Define associative visual agnosia

A

Inability to identify objects
Able to copy (drawings) or match sample objects

61
Q

Associative visual agnosia is affected by what effect?

A

Stimulus abstraction
Line drawings < picture or objects

62
Q

4 types of associative visual agnosia

A

-Object agnosia
-Color agnosia
-Prosopagnosia
-Alexia

63
Q

What is object agnosia

A

Difficulty with object identification

64
Q

What is color agnosia

A

Inability to identify/differentiate between colors

65
Q

What is prosopagnosia

A

Face blindness
Inability to recognize familiar faces

They can recognize identifying characteristics of individuals (eye color, hair style, clothing, nose)

66
Q

What is alexia

A

Acquired reading disorder
Difficulty with letter identification

67
Q

2 types of alexia

A

Peripheral and central alexia

68
Q

which alexia type affects early stages of reading processes and includes difficulty with perceiving the wirtten word

A

Peripheral alexia

69
Q

What is central alexia

A

Affects later stages of reading process

Impairment in lexical and sublexical processing

70
Q

Pure word agnosia

A

Difficulty recognizing/understanding spoken words

Environmental (non-speech) sounds, reading, writing, and speaking abilities intact

71
Q

How would a person with auditory comprehension deficit may differ from pure word deafness during a repetition task

A

AC would be able to repetite the words even tho unable to comprehend the words

Pure word deafness would be able to perceive the sound, but not recognize it inorder to repeat

72
Q

When listening to music, what may pure word deafness hear

A

Melody
Without words

73
Q

What is auditory sound agnosia

A

Difficulty recognizing enviornmental sounds
Speech reception is normal

74
Q

What is cortical deafness

A

Inability to recognize any auditory sounds
All other language areas are unaffected

75
Q

Which type of auditory agnosia often report feeling deaf

A

Cortical deafness

76
Q

What is cortical auditory agnosia

A

A subset of cortical deafness
Able to recognize background noise, but unable to recognize auditory sounds

Feel like something is happening in the background

77
Q

What is amusia

A

Difficulty recognizing/discriminating characteristics of music, while being able to hear lyrics/words within a song

78
Q

What musical characteristics would someone with amusia not be able to discriminate

A

Pitch
Harmony
Timbre
Intensity
Rhythm

79
Q

What is agraphia

A

Acquired writing difficulty

80
Q

2 approaches to evaluating agnosia

A
  1. neurologic model- Agraphia is the core, and the other disorder is associated with agraphia
  2. Neuropsychological (Cognitive) approach- agraphia exists as a result of a processing deficit or peripheral deficit
81
Q

What is linguistic agraphia

A

A problem in processing results in writing deficit (agraphia)

82
Q

What is peripheral agraphia

A

Any peripheral (outside) deficit that results in a writing deficit

83
Q

What peripheral deficits could cause agraphia

A

-mobility issue (ALS, cerebral palsy, paralysis)
-Vision (blindness, visual neglect)
-Attention deficit

84
Q

When assessing agraphia, which writing level should writing be assessed?

A

Paragraph, sentence, and word level

85
Q

2 types of writing tasks used to assess agraphia

A
  1. spontaneous writing task
  2. Dictated stimuli writing task
86
Q

Instructing someone to write regular words, pseudowords, irregular words would be considered

A

Dictated stimuli task

87
Q

Give an example of a spontaneous writing task

A

-Write what you did yesterday
-Write a story about a past experience

88
Q

What is the best way to assess writing

A

Spontaneous writing task

89
Q

What are 2 approaches used in treating agraphia

A
  1. Phonological Treatment Approach
  2. Copy and recall treatment
90
Q

What is the phonological treatment approach for agraphia

A

Hierarchy to improve writing
- letter sound association
-key word
-picture identification
-copy key word

91
Q

What is CART

A

Retrains writing by looking at the word, progressing to spontaneous writing

92
Q

3 interactive treatments for agraphia

A
  1. Train phonological skills
  2. Lexical checks
  3. Electronic devices

Aphasia (4 decks)

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