Week One

Question 1

What is the differences between dementia and aphasia?

Answer 1

Dementia is a degenerative disease and will not get better.

Aphasia has to potential to improve, therefore the end goals are very different

Question 2

How is aphasia an acquired condition?

Answer 2

People are not born with aphasia but rather develop it later in life as a result of various causes, such as:

• Tumours
• Toxic substances
• Mengingitis
• Stroke
• TBI

Question 3

What does it the definition of aphasia mean by “selective impairment of language function”?

Answer 3

Aphasia is a selective impairment as it doesn’t effect everything all at once i.e., some people may still be able to comprehend written language

Aphasia is specific to LANGUAGE. For example people who cannot comprehend spoken language, it is the language part of it, not the hearing that is impaired.

Question 4

What areas of language can be effected by aphasia?

Answer 4

• Auditory comprehension
• Verbal Expression
• Reading
• Written expression
• Numbers

Question 5

How may auditory comprehension be effected for someone who has aphasia?

Answer 5

• Difficulties understanding conversations in groups, TV, Telephone
• Understanding normal or fast speech
• Following simple or complex commands
• Unable to answer simple yes or no questions
• Understanding gestures

Question 6

True or False: Auditory comprehension is affected to some degree in almost every person with aphasia

Answer 6

True

Question 7

True or False: Almost all people with aphasia will have some difficulties retrieving words

Answer 7

True

Question 8

How may verbal expression be affected with someone who has aphasia?

Answer 8

• Retrieving names of items
• Expressing complex ideas
• Producing complex sentences
• Using grammatical function words
• Only able to say a few words
• Difficulties expressing self using words, gestures or drawings
• Unable to say words but can use common gestures

Question 9

How may reading be effected with someone who has aphasia?

Answer 9

• Reading and understanding signs, single words, sentences, paragraphs or long complex novels
• Understanding grammatical words in sentences
• Reading aloud while being able to understand some simple written words and sentences

Question 10

How may writing be affected in someone who has aphasia?

Answer 10

• Writing numbers, letters, single words to name things, sentences, paragraphs or text
• Writing grammatical words in sentences

Question 11

How may numbers be affected in someone who has aphasia?

Answer 11

• Reading a clock
• Reading a thermostat
• Using microwave

Question 12

What is the arcuate fasciculus?

Answer 12

• Fibre tract connecting Broca’s and Wernicke’s area
• Communication between the two areas necessary for language function

Question 13

What is the occurrence of stroke related aphasia?

Answer 13

About 1/3 of people who have a stroke have aphasia at discharge

Question 14

What are the key coursework frameworks?

Answer 14

• Cultural safety
• EBP
• ICF
• Australian aphasia rehabilitation pathway and international best practise recommendations for aphasia

Question 15

Describe cultural safety

Answer 15

A process of reflection on one’s own cultural identity and recognises the impact this may have in practice

Question 16

The three aspects of EBP?

Answer 16

• Client/patient/caregiver perspectives
• External scientific evidence
• Clinical expertise

Question 17

True or False: After a 1 year post stoke, there can be no improvements made in aphasia?

Answer 17

False, you can still see improvement even years after stroke

Question 18

Is there a difference in outcomes depending on when treatment is initiated in the post stroke period?

Answer 18

Yes.

• Treatment initiated in the acute stage
• medium-large treatment effect
  *double effect of spontaneous recovery
• Treatment initiated in the more chronic stage
  *small-medium treatment effect

Question 19

What is neuroplasticity?

Answer 19

The brain’s capacity to change

Question 20

What is the difference between neurophysiological recovery and compensation?

Answer 20

Neurophysiological recovery
-function restoration within area of cortex initially lost after injury e.g., swelling in the brain goes down after a stroke and speech is restored

Neurophysiological compensation
- different neural tissue takes over functions lost after injury

*recovery may be spontaneous or due to rehabilitation

Question 21

What is the difference between behavioural recovery and compensation?

Answer 21

Behavioural Recovery
- Capacity to preform previously impaired task in same manner as before injury

Behavioural compensation
-Use of a new strategy to preform impaired task

Question 22

What are some prognostic (foretelling) factors of recovery?

Answer 22

• Aphasia etiology
  *Haemorrhage better than ischemia (in hemorrhage, things are often displaced)
• Lesion size
• Timing
• Aphasia type
  *harder for those with severe comprehension problems as they can’t process what you’re saying/instructions

Question 23

Adaptive neural plasticity vs. Maladaptive neural plasticity

Answer 23

Adaptive Neural plasticity
- What we want to achieve
- Better recovery
-Recruitment of perilesional areas in left hemisphere

Maladaptive neural plasticity
-poorer recovery
- Recruitment of right-hemispheric areas homologous to damaged areas

*However efficient rerouting may include both perilesional and contralateral brain areas

Question 24

What are the 10 neuroscience principles?

Answer 24

1. Use it or lose it
2. Use it and improve it
3. Specificity
4. Repetition matters
5. Intensity matters
6. Time matters
7. Salience matters
8. Age matters
9. Transference
10. Interference

*all of these can be applied across the ICF