Chapter 2 Aphasia Flashcards

Question

Stroke causes

Answer 1

Most victims of a stroke are middle age and beyond  Risk of stroke increases with:  *Smoking, alcohol use, poor diet, lack of exercise, high blood pressure, high cholesterol, diabetes, obesity, previous strokes  First signs  *Loss of consciousness, headache, weak/immobile limbs, slurred speech  One third will die from a stroke or soon after  Those that survive may need services after acute care stay

Answer 2

*Word substitutions, neologisms, and often verbose verbal output  *Often posterior lesions in the left hemisphere  *Wernicke’s Aphasia  *Anomic Aphasia  *Conduction Aphasia  *Transcortical Sensory Aphasia  *Subcortical Aphasia

Answer 3

Poor Auditory Comprehension  Impaired repetition skill  Intact grammatical structures  Severe word finding problems  Poor visual comprehension  Seldom are paralyzed because damage is not in motor area  Rapid rate of speech with normal prosodic features and good articulation  Incessant, effortlessly produced, flowing speech with normal phrase length  Empty speech  Writing problems  Verbal paraphasias and neologisms  Reading comprehension problems  Circumlocutions  Reduced ability to comprehend the speech of others  Speech often lacks content  Have a hard time monitoring themselves  Generally poor communication in spite of fluent speech  Good articulation

Answer 4

Damage at the convergence of the parietal- temporal-occipital cortex  Fluent spontaneous speech marred by word retrieval difficulties  Mild to moderate auditory comprehension problems  Severe anomia in both speech and writing  When a word is furnished-patient usually recognizes it immediately  Intact repetition  Normal oral reading skills and good reading comprehension  Unimpaired articulation

Answer 5

Caused by lesions in the region between the Broca’s and Wernicke’s area.  Disproportionate impairment in repetition  Paraphasic speech  Marked word-finding difficulties  Empty speech  Reading and Writing are usually good  Good syntax, prosody, and articulation  Auditory comprehension ranges from mild to moderate  Naming deficits ranges from mild to severe

Answer 6

 Lesion in the temporo-parietal region  Rarest of the fluent aphasias  Good repetition skills but poor comprehension of repeated words  Normal automatic speech (counting)  Paraphasic and empty speech  Echolalia of grammatically incorrect forms  Difficulty in pointing, obeying commands, or answering yes/no questions  Good reading outloud but poor comprehension of material read  Writing problems that parallel those in expressive speech.  Impaired auditory comprehension of spoken language  Severe naming problems

Answer 7

Caused by lesions in the basal ganglia and surrounding structures  Intact repetition skills  Word-finding problems  Articulation problems  Semantic paraphasia  Normal comprehension for routine conversation; may be defective for complex material  Fluent speech, which may include some pauses and hesitations  Prosodic problems  Relatively preserved writing skills

Answer 8

Damage in the Posterior-Inferior Frontal Gyrus of the Left Hemisphere  Nonfluent, effortful, slow, halting and uneven speech  Misarticulated or distorted sounds  Agrammatic or telegraphic speech  Impaired repetition of words and sentences  Impaired naming  Better auditory comprehension of spoken language  Poor oral reading and poor comprehension of material read  Monotonous speech  Apraxia of speech  Dysarthria  Writing Problems  Limited word output, short phrases and sentences  Telegraphic speech

Answer 9

Lesions in the anterior superior or frontal lobe  Initial speechlessness  Echolalia and Perseveration  Absent or reduced spontaneous speech  Nonfluent, paraphasic, agrammatic, and telegraphic speech  Intact repetition skill  Slow difficult reading outloud  Good comprehension of simple conversations  Seriously disturbed writing  Unfinished sentences

Answer 10

Extensive lesions affecting all language areas  Most severe form of nonfluent aphasia  Profound impaired language skills  Greatly reduced fluency  Impaired repetition  Impaired reading and writing  Auditory comprehension limited to single words  Impaired naming  Perseveration

Answer 11

 Some aphasias may affect primarily one modality  Alexia with Agraphia-Reading with writing impairment  Alexia without Agraphia-Reading impairment  Pure Agraphia- Severe writing disorder  Pure Word deafness-Lack of auditory comprehension with error free spontaneous speech  Crossed Aphasis-Aphasia accompanying right hemisphere damage.

Answer 12

May receive services for at least the first few months  Families are often frightened and confused  May exhibit perserveration, disinhibition, emotional problems  Course/extent of recovery difficult to predict  Spontaneous recovery  The earlier the treatment, the better the recovery  Loss of Language ability can lead to social isolation.

Answer 13

Assessment occurs in multiple phases as client recovers  Medical History  Interview with client and family  Oral Peripheral Examination  Hearing Testing  Direct Speech and Language Testing  Counseling is ongoing Formal testing postponed until patient is stable  Address  *Overall communication skills  *Expressive language  *Receptive language  *All modalities across all aspects of language  Standardized tests are available  Observation/interpretation of client behavior Definitive diagnosis difficult early on  SLP  *Identifies changes in language performance and behavior  *Genetic history and health information  *Observation in different environments  *A few language tests exist  * Scales can be used for rating loss  *Aphasia assessments can be used.

Answer 14

 Aphasia Language Performance Scales (ALPS)  Sklar Aphasia Scale (SAS)  Bedside Evaluation and Screening TestSecond Edition (BEST-2)

Answer 15

The Boston Diagnostic Aphasia Examination  The Western Aphasia Battery  The Minnesota Test for Differential Diagnosis of Aphasia  The PORCH Index of Communicative Ability  Bilingual Aphasia Test

Answer 16

Functional Communication Profile  Communicative Abilities in Daily Living  The Communicative Effectiveness Index  Functional Assessment of Communication Skills for Adults  Reading Comprehension Battery for Aphasia

Answer 17

 1. Severity of disorder  2. Classification  3. Strengths and Weaknesses  4. Competence of test- accountability  5. #’s to tell other professionals-data to report  6. Changes-want to show if patient gets better  7. Watch patient take test-what strategies are they using  8. To plan treatment  9. We use tests because they are there.  10. Provide Information and Answer Questions

Answer 18

Assessment of:  *Repetition Skills  *Naming Skills  *Auditory Comprehension of Spoken Language  *Comprehension of single words  *Comprehension of sentences and paragraphs  *Reading Skills  *Writing Skills  *Gestures and Pantomime  *Automated Speech and Singing

Answer 19

 A GOOD ASSESSMENT LEADS TO GOOD THERAPY!!!!  THE OVERALL GOAL OF INTERVENTION IS TO AID IN THE RECOVERY OF LANGUAGE AND TO PROVIDE STRATEGIES TO COMPENSATE OF PERSISTENT LANGUAGE DEFICITS. Determine by assessment and client/family needs  Cross Modality generalization  Conversational techniques  “Bridging” between hemispheres  Multimodality stimulation  AAC  Neural plasticity  Involve family members

Answer 20

 Group of deficits resulting from right cerebral hemisphere injury  Characteristics  *Neglect information from left side  Unrealistic denial  Impaired judgment and self-monitoring  Lack of motivation  Inattention

Answer 21

 Cognitive deficits result in communication problems  Linguistic deficits  *Pragmatics most impaired  *Incorrect Interpretations  *Misinterpret contextual information  *Understanding may be concrete  *Difficulty with naming, writing, repetition  Paralinguistic deficits  *Aprosodia

Answer 22

Visual scanning and tracking  Auditory and visual comprehension  Direction following  Response to Emotion  Naming and Describing  Writing  Observation is essential for pragmatics  Portions of aphasia batteries, standardized measures for RHD, and nonstandardized measures.

Answer 23

 Visual and auditory recognition  Respond appropriately in conversation  Track increasingly complex information  Use time restraints  Sequencing and explaining actions  Synthesize skills within conversation  Target nonlinguistic markers.

Answer 24

Disruption in normal functioning caused by a blow or jolt to the head or penetrating injury  Leading Causes  *Falls (28%)  *Motor Vehicle Accidents(20%)  *Blows to the Head (19%)  *Assaults (11%)  1.4 million people sustain TBI annually  *Males sustain TBI more often than females. Affects orientation, memory, attention, reasoning/problem solving, executive function  Most disturbed language area is pragmatics  Deficits may also include  **Speech  **Voice  **Swallowing  **Psychosocial/personality changes  Severity related to initial levels of consciousness and post-traumatic amnesia

Answer 25

Most are young, results of vehicular accident  Several Stages of recovery  Initially, nonresponsive and requires full assistance  Gradually respond to stimuli and recognize some individuals  Confusion and Agitation  Inappropriate, incoherent, emotional language  Later, can remain alert and hold short conversation  Oriented to person and place, not time  Inappropriate, unaware, unrealistic, and uncooperative  In later stages of recovery, can initiate and carry out tasks  May consistently behave in a socially appropriate manner.  Periodic depression and irritability  Most will have lingering deficits, especially pragmatics

Answer 26

SLP  *Cognitive-communication abilities  *Swallowing  *Assessment varies with stages of recovery  *Few comprehensive tools  *Sampling essential for pragmatics

Answer 27

Cognitive Rehabilitation  *Restorative Approach  *Compensatory Approach  Early Stages  *Orientation, sensorimotor stimulation, recognition  Middle Stages  *Reduce confusion, improve memory and goal directed behavior  Late Stages  *Comprehension of complex information and directions, conversational and social skills

Answer 28

 Intellectual Decline due to neurological causes  *Additional deficits  *Poor reasoning/judgment, impaired abstract thinking, inability to attend to relevant information, personality changes  *Language functions most dependent on memory are affected  *Fewer than 15% of elderly experience dementia  *20% respond to treatment

Answer 29

CORTICAL DEMENTIA and SUBCORTICAL DEMENTIA

Answer 30

Visuospatial deficits, memory problems, judgment and abstract thinking disturbances, and language deficits in naming, reading and writing and auditory comprehension  *ALZHEIMER’S  *PICK’S

Answer 31

Deficits in memory, problem solving, language, neuromuscular control  *Multiple sclerosis  *AIDS-related encephalopathy  *Parkinson’s  *Huntington’s

Answer 32

 Cortical pathology  Affects 13% of those over 65  50% of those over 85  Affects primarily memory, language, or visuospatial skills  Cause unknown  Genetic and environmental  Presence of neurofilaments and plaques  Extensive damage to hippocampus and cortex

Answer 33

Mild dementia  Name recall difficulty, occasional disorientation, memory loss  Later stages  Paraphasia, delayed responding, reduced vocabulary and syntactic structure, pronoun confusion, topic digression, inability to shift/return to topic, reading/writing errors  Most severe form  Naming errors, generic terms, syntactic errors, minimal comprehension, jargon, echolalia, mutism

Answer 34

Often unaware or ignores early signs  No cures  Drug therapy may help  Early stages  Memory loss  As disease progresses, memory loss increases and vocabulary decreases  Most advanced stages  All intellectual functions are severely impaired  Almost all reside in nursing homes

Answer 35

 Definitive diagnosis difficult early on  SLP  Identifies changes in language performance and behavior  Genetic history and health information  Observation in different environments  A few language tests exist  Scales can be used for rating loss  Aphasia assessments can be used

Answer 36

Goal  Maintain client at highest level of functioning and help others maximize client’s participation  Emphasize intact abilities  Compensate for deficient abilities  Target memory or word retrieval  Coherent verbal responses  Longer, more complex utterances with memory aids  Stimulating cognitive processes plus pharmacological treatment is best

Chapter 2 Aphasia Flashcards

(60 cards)