Neurogenic Final

Question 1

Evaluation is ongoing..

Answer 1

Can’t gather all info from 1 initial assessment. need to continually evaluate to see if they’re improving or if you need to make adjustments to therapy.

Question 2

AAC

Answer 2

Should attempt speech but if they can’t get point across/function with speech and are frustrated then can recommend AAC.

Question 3

Stimulation approach

Answer 3

most widely used. defines aphasia as an impairment that is regular and orderly, so therapy is regular and orderly.

Question 4

strengths of stimulation approach

Answer 4

structured so easy to get data and family can incorporate tasks based on this model at home.

Question 5

weaknesses of stimulation approach

Answer 5

only targets body function and its completely clinician controlled and a more passive form of therapy.

Question 6

cognitive neuropsychological approach

Answer 6

based on idea that aphasia is a cognitive problem that results in client’s inability to use language properly. determine cognitive underpinnings of language and treat or compensate for those.

Question 7

strengths of neuropsychological approach

Answer 7

identifies what’s impaired and what’s retained by hypothesis driven testing and allows a more clear identification of location of impairments.

Question 8

weaknesses of cognitive neuropsychological approach

Answer 8

model of function, not rehab and limited research to show generalization.

Question 9

neurolinguistic approach

Answer 9

views aphasia as a neurologically caused language disorder that can be described using linguistic concepts.

Question 10

strengths of neurolinguistic approach

Answer 10

better understanding of types of errors and focused therapy on sentence comprehension and production deficits.

Question 11

weaknesses of neurolinguistic approach

Answer 11

only looks at language aspects. does not consider importance of language in a pragmatic context or focus on communicative competence.

Question 12

psycho-social approach

Answer 12

client-centered approach. self worth, personality traits, and whats important to client, etc. realistic, functional training.

Question 13

strengths of psycho-social approach

Answer 13

comprehensive picture of how person is living with aphasia. functional and leads to carryover.

Question 14

weaknesses of psycho-social approach

Answer 14

difficult to measure and harder to plan and execute.

Question 15

prognosis

Answer 15

give a good prognosis for insurance companies. look at personal and environmental factors.

Question 16

families are hidden victims of aphasia

Answer 16

focus of therapy generally on aphasic person and spouses often experience disturbed marital relationships, social isolation, and minor psychiatric illnesses. spouses often feel guilted into giving up their hobbies and giving up having a life. families that are viewed as most supportive are often doing the worst mentally and emotionally because they’re sacrificing their own health for the aphasic family member.

Question 17

Promoting Aphasics’ Communicative Effectiveness (PACE)

Answer 17

Treatment designed to improve conversational skills using any modality to communicate messages. promotes active participation. Promotes compensatory strategies and good for patients who are easily frustrated.

Question 18

4 Principles of PACE

Answer 18

1. clinician and patient exchange new info
2. clinician and patient participate equally as senders and receivers of message.
3. patient has a free choice as to the communicative modes used to convey a message.
4. clinician’s feedback as a receiver is based on patient’s success in conveying the message.

Question 19

Constraint-induced language therapy (CILT)

Answer 19

Intense but good statistical results. patients must be in good enough health for 3 hours a day of therapy. Instead of compensatory strategies, only works on speech to “fix the problem.”

Question 20

3 principles of CILT

Answer 20

1. Mass practice.
2. Constraint of all modes of communication except speech.
3. Forced use of spoken language in relevant communication exchange.

Question 21

PACE vs. CILT

Answer 21

Depends on client. Try speech first, but don’t want to force to point of being so frustrated they don’t want to communicate. for patients that are easily frustrated, PACE would be better. Or could start with compensatory strategies and then back off.

Question 22

Discharge

Answer 22

best to tell them at beginning how long they’ll be in therapy and tell them that if they continue to practice strategies they’ll improve and that they didn’t hit a plateau. refer to it as “graduation” we’ve taught them what they need to know. family may think discharge means they can’t improve anymore.

Question 23

therapy outcomes

Answer 23

how client’s life is changed due to therapy. should start therapy with client’s end goal in mind. “what is it that you cannot do that you want to do?”

Question 24

Schuell approach

Answer 24

another name for stimulation approach. uses intensive auditory stimulation to maximize recognition of language. repetitive auditory stimuli, drill approach. each stimulus should elicit max responses.

Question 25

strengths of Schuell approach

Answer 25

structured, so easy to keep track of data/progress and family can incorporate tasks at home.

Question 26

weaknesses of Schuell approach

Answer 26

only targets body function and patterns of speech of aphasics aren't always that predictable. clinician controlled and more passive form of therapy.

Question 27

Aphasia ICF

Answer 27

environmental factors-communicative partners and places/settings where the client needs to communicate. personal factors-patient motivation, frustration level, can they self-correct, etc. body function-impairment at word level body structure-left hemisphere affected activity and participation-patient's capacity in clinic vs at home

Question 28

right hemisphere syndrome ICF

Answer 28

environmental factors-communication partners and settings personal factors-motivation, frustration, can they self-correct, are they lacking insight body function-impairment in prosody, discourse, theory of mind, etc activity and participation factors-home vs. clinic, ability to understand idioms, metaphors, etc. when given context

Question 29

when doctor says therapy won't help

Answer 29

improvement can be made at any stage or severity of aphasia. each person with aphasia is different and will have different abilities in speaking, reading, writing, using gestures, etc. as the person with aphasia improves, therapy is changed, so we really cannot say that neither mild nor severe will benefit from therapy. may just "not be ready for therapy yet"

Question 30

"mild aphasia"

Answer 30

may be able to have a conversation, but may have difficulty finding words or understanding complex conversations. therapy may be directed by patient and their goals.

Question 31

"severe aphasia"

Answer 31

provide strategies to understand/participate in conversation. teach how to communicate wants and needs