treatment of aphasia Flashcards
(39 cards)
purpose of treatment
- facilitate brain-based recovery via restitutive approaches
- help compensate for language impairments via compensatory approaches
- support people psychologically and socially
- encourage fullest life participation
best level of complexity for treatment
- traditionally, begin at easy complexity and progressively build
- Complexity Account of Treatment Efficacy (CATE): using more complex stimuli/tasks may optimize recovery
list of general approaches to social and life participation
- Life Participation Approach to Aphasia (LPAA)
- Living with Aphasia: Framework for Outcome Measures (A-FROM) and ICF Models
- supported communication
Life Participation Approach to Aphasia (LPAA)
- puts life at the enter of decision making
- recognizes that communication problems affect interpersonal bonds and all aspects of life
Living With Aphasia: Framework for Outcome Measures (A-FROM) and ICF Models
- conceptualizes intervention outcomes based on ICF framework
- considers four interrelated life-affecting impacts of aphasia
supported communication
- philosophy and set of tenets and strategies
- welcomes anything that improves access to participation in community events
list of specific treatment methods of life participation models
- Total Communication Approaches
- Augmentative and Alternative Communication (AAC)
Total Communication Approaches
- encourage any means of communication to convey and receive information
- no particular modality is required
Augmentative and Alternative Communication (AAC)
- Participation Model of AAC helps to breakdown access and opportunity barriers to AAC use
- Visual Scene Displays (VSDs) are contextually rich pictures depicting situations relevant to person
partner and caregiver training
- Reciprocal Scaffolding: person with aphasia serves as expert or teacher, which empowers person with language disorder through a teaching role
- Communication Partner Scheme
list of compensatory treatment approaches
- Promoting Aphasic’s Communicative Effectiveness (PACE)
- Communicative Drawing Program (CDP)
- Back to Drawing Board (BDB)
- Visual Action Therapy (VAT)
Promoting Aphasic’s Communicative Effectiveness (PACE)
- compensatory approach
- works on communication goals t the level of conversation via any modality chosen by the speaker
- clinician and client are both speaker and listener at different points, take turns describing set of stimulus cards
- research continues to be needed
Communicative Drawing Program
- compensatory approach using drawing
- drawing is non-linguistic, facilitating word retrieval using right hemisphere
- teaches to draw in hierarchical steps
- research is needed for carefully controlled studies
Back to Drawing Board (BDB)
- intended for severe aphasia to promote alternate communication modality
- same principles as CDP
- learning how to draw humorous cartoon panels from memory
- research is limited
Visual Action Therapy (VAT)
- gesture-based non-vocal approach
- promotes symbolic gestures to communicate, working in a system of three phases
- research is little
list of specific approaches for expressive language therapy
- Constraint-Induced Language Therapy (CILD)
- Script Training
- Melodic Intonation Therapy (MIT)
- Voluntary Control of Involuntary Utterances (VCIU)
- Response Elaboration Training (RET)
- Treatment for Aphasic Perseveration (TAP)
Constraint-Induced Language Therapy (CILD)
- restitutive approach, as they’re restricted to only using impaired modalities
- requires intense practice utilizing only verbal expression
- tasks are focused on verbal expression with a cueing heirarchy
- research continues to be needed in milder cases and larger groups
Script Training
- client practices with personally relevant scripts generated with SLP
- impairment focused, but also fits within social-participation model
- repetitive practice of pre-established personally relevant scripts
- discuss goals, generate scripts, practice reading, give homework, practice in social context, practice with new partners
- research is limited with adequate sample sizes
Melodic Intonation Therapy (MIT)
- facilitates spoken language through exaggeration of prosody, pitch, stress
- taps into melodic and prosodic control of intact right hemisphere
- restitutive in fostering brain changes to enhance speech output, but also compensatory in person using melody to facilitate speech
- hierarchical steps for implementation and teaching of rhythm and process
- research shows positive outcomes, but quality of studies is weak
Voluntary Control of Involuntary Utterances (VCIU)
- to improve expressive output in those limited to automatic speech
- chaining automatic speech to be purposeful
- research is limited
Response Elaboration Training
- to increase length and improve content with nonfluent aphasias
- client is primary communicator with clinician cueing for more information, building upon utterances, and connecting utterances o the client
- reduced clinician control over stimuli
- no direct feedback on client’s utterances
- research is limited to mainly case studies
Treatment or Aphasic Perseveration (TAP)
- impairment-level approach designed for those with perseveration
- goal is to reduce perseveration and enhance naming
- research is poorly based
list of specific approaches for improving word finding and lexical processing
- Cueing Hierarchies for Treatment of Anomia
- Semantic Feature Analysis (SFA)
- Phonological Components Analysis (PCA)
- Verb Network Strengthening Treatment (VNeST)
- Verb as Core (VAC)
Cueing Hierarchies for Treatment of Anomia
- systematically presenting cues to optimize naming success
- research is strong for therapy, with limited generalization