Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adult Lang Disorders > Weeks 9-11 > Flashcards

Weeks 9-11 Flashcards

(81 cards)

Start Studying
1
Q

T/F damage is RH is often overlooked with respect to language and communicative competence

A

True

Symptoms tend to be more subtle with respect to communication

Mess obvious stroke symptoms → physicians (and families) are less likely to refer to SLP for cognitive-communication impairments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Extralinguistic impairments

A

Occurs with RH syndrome

Impairments in:
Pragmatics

Conversation cohesion

Linking sentences

Integrating verbal with nonverbal info

Understanding main idea

Standard aphasia batteries for linguistics won’t detect RH extralinguistic impairments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Linguistic impairments

A

Occurs with LH damage

Impairments in language structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is RH syndrome difficult to study or underdiagnosed

A

No specific “communication areas” → Might be large networks involved in RH communicative functions

No clear patterns for categorization

Pragmatic and cognitive competence on spectrum

Normal declines in communication with aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

RH damage %

A

~50% with RHD have impaired verbal communication

~80% with RHD in rehab units have cognitive and/or communication impairments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of cognitive impairments with RHD

A

Attention

Visuospatial perception

Learning

Memory

SLPs look at cognition/attention to help figure out comprehension breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F - RHD will affect pragmatic competence and discourse level communication MORE THAN word- and sentence- level processes

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of communication impairments with RHD

A

figurative/nonliteral language

Inference

discourse/pragmatics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

RHD is often diagnosed as…

A

cognitive -communicative disorder/impairment

Or

Cognitive-linguistic impairment/disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F

RHD can respond appropriately to indiect questions in naturalistic contexts

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F

RHD can directly and indirectly make requests, but often do not justify or provide explanation for request

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T/F

Fewer formulaic expression produced following RHD when compared with individual with LHD

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does RHD have difficulty with inferencing

A

When situation requires elaborative inferences

When situation has multiple potential interpretations

Difficulty with understanding nad interpreting humor, sarcasm, and emotions when different from their own emotion

Suppression-deficit hypothesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is suppression-deficit hypothesis

A

With RHD, can generate several interpretations, but reduced ability to suppress/inhibit less-likely interapations

E.g. cookie theft picture description task - may talk about the bushes rather than the action of the picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the discourse-level impairments in RHD

name 7

A

Egocentric

tangential/off-topic/irrelevant content

Difficulty maintaining conversation and linking utternances to overall topic

Disorganized narratives

Theory of mind breakdown: Reduced ability to ID/repair conversation breakdowns

Reduced ability to judge appropriateness of conversation

confabulations : when people say something untrue but not aware it’s untrue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to assess RHD

A

Informally test because most RHD tests are not sensitive enough to detect subtle changes in higher-level discourse

Informal test include: narrative, biography, conversation, story-retell, picture description —> responses will be “off” or irrelevant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Many RHD impairments are due to inability

A

False

Most impairments are due to inefficient processing NOT inability

Do well with straightforward tasks → taxiing system reveals inefficient processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RHD treatment

A

Understudied

Target metaphor comprehension → emphasizing use of context

Use contextual clues to facilitate comprehension

Patient uses self-cueing (internal) rather than clinician-cueing (external)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is aprosodia

A

RH injury; not aware of it

Difficulty in comprehension or use of prosody to signal linguistic boundaries, meaning of convey emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment for aprosodia

A

Focus on use of prosody to express emotion

Motoric aspects of prosody

Both found to be successful with generalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Left neglect vs left visual cut

A

Left neglect → doesn’t’ recognize left side needs attention

Left visual cut → Visual field is cut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does RHD affect attention

A

Attention: ability to focus on a stimulus and filter our other stimuli

Inability to focus on one thing

Reduced sustained attention and topic maintenance

Reduced alternating attention

Reduced divided attention b/e multiple tasks

Reduced selective attention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does reduced selective attention affect communication

A

Irrelevant content

Inability to shift topics appropriately

May also perseverate on one topic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

RHD: Nonlinguistic impairments: neglect

A

Failure to report, respond, orient, attend to stimuli on the left side of body despite within functional limit of motor/sensory function

Occurs in 80% of RHD patients

Attentional impairment → attention is on right side only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Assessments for neglect
scanning /canceling tasks → line bisetion task Drawing → draw a clock at 10 o’clock reading/writing
26
Types of neglect ``` Personal Peripersonal Extrapersonal Viewer-centered object-centered ```
Personal → neglects the left half of body → not shaving left side of face Peripersonal → neglects half of space within arm’s length such as not eating food on left side of plate or not finding remote on left side of bed Extrapersonal → neglect half of space beyond arm’s reach, not noticing a window or tv or visitor Viewer-centered: neglects left side of space defined by patient’s midline; left side will move as patient turns head Object-centered: neglects left side of an object, regardless of where it is placed; neglecting left side of photo even if the entire photo is place in right visual field
27
Treatments for neglect
Scanning tasks have limited generalization External stimulation→ left-neck vibrations → reduced severity several days post tx Presenting stimuli spanning the midline Voluntary movement of attention by having patient ID items on left and right sides of pages Training patient to activity manipulate object in space
28
RHD impairments in higher-level processing
50% of RHD patient in rehab Effects on communication like: organizing/sequencing, reasoning (implied meaning and theory of mind), problem solving (reduced ability to repair conversation)
29
RHD treatment for cognitive deficits
No specific protocol but can use other strategies like treatment for RH TBI Compensatory strategies are too specific and RHD may have difficulty with abstract thinking, reason so don’t know when to use strategy appropriately More beneficial to train habitual use (using it all of the time) of strategy to facilitate overcoming deficits
30
What is anosognosia
Lack of awareness of deficits or reduced awareness of deficits Co-occurs with neglect May need increase of supervision
31
Diagnosis criteria for major neurocognitive disorder (dementia)
Significant cognitive decline Substantial impairment in cognitive performance Cognitive deficits interfere with independence in everyday activities Must specify: with or without behavioral disturbance
32
Diagnosis criteria for mild neurocognitive disorder (dementia)
modest cognitive decline modest impairment in cognitive performance Cognitive deficits do not interfere with independence in everyday activities Must specify: with or without behavioral disturbance
33
What is mild cognitive impairment
Used for people who do not meet criteria for neurocognitive disorder (dementia)
34
T/F: dementia is due to sudden/acute onset
False More likely due to gradual onset of symptoms at a time rather than sudden/acute onset Dementia progressively gets worse
35
Describe short term memory
Involves encoding processes, temporary storage of limited capacity
36
Describe long term memory
Retrieval processes, permanent storage of unlimited capacity
37
Long term memory - declarative
Explicit Person’s knowledge base, conscious awareness Type of memories that go away
38
Long term memory - nondeclarative
Implicit Person’s knowledge of skills and action patterns. Unconscious awareness More likely to maintain and remember
39
t/f Postmortem examination for definitive diagnosis
TRUE
40
t/f When diagnosing dementia, physicians look for neural changes in combination with cognitive/behavioral changes
TRUE
41
Describe CT of dementia
Wide sulci cortical atrophy Enlarged ventricles
42
Huntington’s Disease atrohpy
More atrophy in deeper parts of brain
43
fMRI of dementia
Reduced blood flow in areas involved in memory and cognitive like hippocampus
44
PET for dementia
Reduced glucose metabolism in areas associated with memory and cognition
45
Postmortem studies of dementia
Required for definitive diagnosis Reduction in brain volume Decrease in neurons
46
Where do neural changes occur for - parkinson’s disease Lewy body dementia frontotemporal
PD = substantia nigra Lewy body = Lewy bodies in coritcal and subcortial regions Frontotemporal = pick bodies
47
Why is it good to diagnosis dementia before onset of symptoms
Stop disease progression Minimize disease severity Reverse disease symptoms
48
Greatest cause of dementia
Alzheimer’s Disease 60-70% of all dementia cases Anti-inflammatory meds protective against AD
49
Hallmarks of AD
Memory loss is hallmark of AD Early disease: working memory is intact but see semantic memory loss secondary to imparied storage or retrieval Progressive disease: loss of recent past first Retain childhood memories for longer time **Procedural memory and formulaic language preserved**
50
Alzhiemers Disease: effects on Language and Communication
Word find issues Comprehension of formulaic expressions like idioms are poor but production of conversational formulaic language preserved Use of vague terms like thing or stuff Discourse decent on surface level like good syntax and phonology but difficult maintain topics and conversation cohesion Late stage: ambiguous speech and incoherent mumblings and repetition
51
AD can occur with/without behavioral disturbance (non-communicative behaviors)
90% of patients have behavioral disturbance Personality changes Delusions Manic mood Sleep disturbances Sundowning Pacing/wandering
52
Describe Vascular Dementia
Differeiented based on artecioscerotic changes in blood supply to brain 2nd most common cause Abrupt onset of cognitive symptoms in a fluctuating but progressive course Early: memory loss, personality changes, excessive dysfunction Deficits depend on where in the brain the affected blood vessels are located
53
Frontotemporal dementia: primary progressive aphasia
Gradual loss of language function in the context of relatively well-preserved memory until the advanced stages Fluent or nonfluent Gradual onset and decline in language-specifc functions Acute awareness of deficits unlike other types of dementia Primary effects left frontal and temporal lobe language areas
54
Lewy body dementia
build up for protein deposits neurons Similar to PD → tremors, rigid Worse than AD → verbal fluency impairment and psychomotor slowing Similar to AD → episodic memory impairment and language disturbance
55
Dementia can be secondary to these diseases
PD Huntington’s disease (onset younger in adulthood) HIV
56
Dementia evaluation - what is used Additional cognitive batteries are useful when evaluating for dementia
Screening tools good for assessing range of cognitive abilities but age and culture may affect scoring Mental status rating scales provide stages of disability **Mini Mental Status Exam (MMSE) looks at orientation, memory, visual-spatial, repetition; low score = most severe** Cognitive Batteries like Ross Information Processing Assessment - 2 (RIPA) Memory assessments like Wechsler Memory Scale-III
57
t/f BDAE and WAB can be used to evaluate language and communication in dementia
TRUE
58
When evaluating dementia- describe daily functional status
Has there been a change in functioning? Justifies need for therapy to improve interaction in social environments Test: CADL or ASHA FCMs (NOMS) Activities of Daily Living Instrumental Activities of Daily Living
59
T/F: ASHA NOMS level 1 - individual ability is independent NOMS tests functional level for dementia
False Level 1 is most severe - unable to speak in meaningful or familiar way
60
Dementia behavioral treatment - 3 strategies of Memory Treatment
Internal, external, environmental
61
Describe internal strategies for memory treatment for dementia
Internal: mild/normal aging declines → WOPR, mnemonic devices and visual association Spaced retrieval → recall info over time; relies on preservation of reading and procedural memory But these might be difficult for someone with dementia to know when to use strategies
62
Describe external strategies for memory treatment
External: Compensation → used when we know we won’t be changing person’s cognitive ability Environmental cues like written reminders, calendars Written information/pictures in “memory wallet” People with dementia benefit from external strategies
63
Describe environmental strategies for memory treatment
Environmental: Combo of internal and external strategies Special care units → reduced environmental complexity, low stimulating environment Social groups
64
t/f TBI is 30% of all injury-related deaths And falls are the leading cause of TBIs
TRUE Mostly kids and older adults over 65
65
Define TBI
Craniocerebral injury from blow from an external mechanical force causing temporary or permanent impairments in brain function The external force is what distinguishes TBI from stroke or infection
66
What is coup-contrcoup
Contusions on opposite sides of head ``` Coup = 1st point of impact Contrecoup = 2nd point of impact ``` Closed head injury associated with acceleration-deceleration movement About 50% of all TBIs
67
TBI: Primary damage vs secondary damage
Primary: Immediate effects Coup-contrecoup (primary/focal-secondary/diffuse) or penetrating wound (focal) Vascular injury Secondary: Affected post trauma Ischemia Increase in intracranial pressure
68
What is glasgow coma scale
15 point scale based on eye opening and verbal and motor responses The lower the score the more severe Verbal also incorporates cognitive Motor also incorporates attention
69
Describe loss of consciousness severity
0-30 min = mild 30-<24 hrs = moderate 24hrs + = severe Most qualitative with unclear boundaries
70
TBI prognosis
MRI/CT dhow depth of lesion associated with poorer outcomes (brain stem is most severe) GCS = lower the score, the poorer the outcome Duration of coma: severe disability “uniquely” with coma < 2weeks; positive recovery “unlikely” with coma >4weeks Basically, the lower the score, the deeper the damage and damage occurring both sides of brain = poorer outcoes
71
t/f The cause of the TBI does not predict outcome
TRUE
72
When compared with less dependent TBI patients, more dependent TBI patients at admission to rehab _____, _____, etc. at discharge
More dependent: - Make more progress - Remain more dependent - Slower rate of recovery Less dependent = Shorter distance to go = less progress
73
End goal for TBI rehabilitation
Community reintegration
74
t/f Common to all TBI survivors = reduced ability to pursue pre-injury career and leisure activities
True Secondary cognitive impairment: attn, memory, organizing, communication, reasoning. Inhibition Cognitive and communicative symptoms most likely the cause preventing patient to return to pre-injury QoL
75
Describe coma
State of unconsciousness, eyes closed, pt does not wake Results of persistent, severe diffuse injury to both cortex and subcortical regions like brainstem
76
TBI cognitive impairments may affect:
Orientation (frontal lobe implications) → AAO attention/concentration (thalamo-frontal pathways) Memory - LTM, STM, working Executive function Anosognosia **Behavioral like immature, egocentric, irritable and impulsive** Communication → issue with lang. USE
77
What is AAO
Awake alert orientation Cognitive rating for TBI ``` 1 = person 2 = person and place 3 = person place time 4 = person place time situation ```
78
What is minimally conscious state
Often transitional state reflecting improvement in consciousness Behavioral evidence of self or environments Ability to follow simple commands unlike PVS can’t follow commands Act of engaging in a response Intentional movements (not reflexive)
79
assessments for cognitive-comm impairment in TBI
Standardized tests paired with Naturalistic informal testing (ST should not occur in isolation) SLP scope: cognitive processes related to communicative behavior and language Guideline developed by Academy of Neurologic Comm dis and Sciences (ANCDS)
80
Interventions (with evidence) for cognitive-comm impairments in TBI
Attention training → stimulus-drill approaches make best generalizations External memory aids → not effective for mod-severe memory impairments (better for mild) Instructing people with acquired memory impairments; evidence that structuring introduction of and use of procedures improves strategy learning Self-monitoring → training strategies help to generalize Behavioral intervention → traditional contingency management and positive behavior interventions (or both together) are valid EBP options
81
Treating TBI - what’s important!
The roles of family/caregivers and educating on nature of TBI and educating them on strategies to use

Adult Lang Disorders (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions