Know 4 ways aphasia can effect participation in everyday living
Changes in health, living situation, employment, community participation
What 4 functions of communication can aphasia effect?
Wants/needs, information transfer, social etiquette, social closeness in various settings of daily living and various speakers.
Partner dependent communicators
will not initiate communication
have expressive, receptive, and cognitive impairments
what to use with emerging communicators
use real objects for choices, pointing, agree/reject, concrete objects
contextual choice communicators
recognize symbols, partial awareness of predictable routines/topics, but no linguistic ability to initiate or add to convo
what to use with contextual choice communicators
pointing, giving choices for answers to limit answer set, ask questions through intonation/pointing, use symbols to increase participation (visual photos signs or highlight key points)
able to use symbols/strategies but need partner to initiate or prompt use of strategies
what to use with transitional communicator
use gestures, partial speech to ask/request/comment, use a low or high tech strategy to initiate in structured contexts, move toward more independent level
comprehend what is said, need AAC to prevent breakdowns, independent use of AAC
independent communicators may use:
stored messages, generative (will convey message independently but need aac intervention) or specific need only (only need aac in certain situations)
What are multimodal communication components persons with aphasia frequently use
Topic cards, role playing, tagging questions, written choice, spiral notebooks
Primary progressive aphasia affects
lose communication first, then have dementia symptoms...anomia will affect their language skills
cognitive decline, memory difficulties with transfering info from short term to long term. deficits in language and abstract thinking, judgement, exectutive functions
what to use for dementia
memory books to help with recognition/memory of meaningful topics, eliminating distractions while interacting, and chunking info
What are some effective strategies when communicating with someone who has PPA and Dementia?
Communication notebooks, cards with specific information, written choice techniques, labels on location around the home, multimedia biographies
methods to supplement language or speech impairments that occur after TBI
Communication boards, yes/no response, written communication, gestures, alphabet, portable voice amplification
intervention for Ranchos level 1,2,3
minimal/no formal assessment, identify changes in response patterns, get info from family about interests/pre-injury activities, shape responses into meaningful communication
intervention for Ranchos level 4,5
minimal/no formal assessment, identify residual capabilities, initial assessment to focus on seating and postural issues, determine if direct selection or scanning options, consider visual perceptual/acuity disturbances…intervention: compensate for attention/memory impairments, use messages to relate to wants, needs, info sharing, use small activity displays, written choice strategies, single switches
Intervention for ranchos level 6,7,8
assessment: have cognitive capability to be natural speaker, oriented, socially appropriate behaviors, AAC team id comm. Needs, barriers, capabilities, constraints to match technology, Intervention: augmented writing systems, system must be functional for patient in long term plan, use of letters, words, sentences. Be weary in changing system after patient has learned it (difficulty learning)
What is a secondary cause for communication impairments in acute medical settings?
Respiratory support can prohibit speech production
negative impact by oral interference in oral cavity so no articulation, tube passes thru vocal folds so no phonation
air does not pass through the vocal folds or oral cavity, so no phonation
What are some opportunity barriers in acute medical settings for use of AAC?
Patient may not get AAC referral, personnel may not use AAC with patient, SLP and professionals have little experience with AAC
What are 3 components to address when completing a Preliminary screening for patients in acute medical settings?
Determine capabilities, id natural comm. Signals, id yes/no signals, id comprehension and attention strategies.
What are communication options for people who have sufficient oral-motor/voice
electrolarynx (oral or neck type), passy muir valve on trach.
What are communication options for people who do not have sufficient oral-motor/voice
comm. Systems that use writing, direct selection, or scanning