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Aphasia Final
| Question | Answer |
|---|---|
| VA Cooperative Study (Wertz, 1981) | -Compared improvement of pts in group tx to improvement of pts in individual tx -Both groups improved beyond the spontaneous natural covery period -Both groups made significant improvement in lang skills -Individual tx --> better improvement w/ PICA |
| Recovery patterns in aphasia by type (Kertesz & McCabe, 1977) | -Anomic aphasias recover fully -Broca's & conductive aphasias --> best recovery rate -Wernicke's aphasics --> little recovery w/ jargon; better recover without jargon -Global aphasics --> poor recovery but evolution into different types |
| Prognostic factors (Basso, 1992) | -Age (young pts may do better than old pts) -Personality (pleasant & cooperative) -Initial severity -Sparing of critical cortical region |
| Extent of recovery (Basso, 1992) | -Good for pts with anomia and conduction aphasia -Fair for pts with Broca and Wernicke aphasia -Poor for pts with global aphasia |
| Rate of recovery (Basso, 1992) | -Fast for pts with conduction & Wernicke aphasia -Intermediate for pts with Broca -Slow for pts with anomia and global aphasia |
| Overview of factors contributing to recovery (10) | 1. Age; 2. Personality; 3. Motivation; 4. Severity; 5. Handedness; 6. Time post-onset; 7. Social milieu; 8. General health; 9. Lesion size; 10. Lesion nature |
| Bilingual recovery patterns (Paradis, 1977) | -50% of bilingual aphasic recover in a synergetic pattern (i.e., both languages recover; may be PARALLEL or DIFFERENTIAL) -27% selective recovery -6% successive recovery -4% antagonistic recovery |
| Ribot's and Pitre's rules | -Ribot's Rule --> L1 recovers first (rule of primacy) -Pitre's Rule --> language most used at time of the injury (rule of recency) |
| Purpose of aphasia assessment | To determine what functions are lost and which functions are still there |
| Differences in the assessment tests | Nature of the tests may be research (i.e., extended version of Boston) |
| Three types of validity for standardized tests | -Predictive validity (Does it distinguish between normal and disordered?) -Construct validity (Does performance on the test correlate with performance on another measure?) -Content validity (Do the test items test what the assessment claims to test?) |
| Types of rating scales (and related issues) | -Mild/moderate/severe --> Subjective -Pass/Fail --> Inadequatel not enough info -Descriptions --> Impractical; too time-intensive -Multidemensional --> BEST OPTION; but fewer options available |
| Ideal aphasia test attributes | -Minimizes the effects of intelligence/education to measure language -Discriminates between normals/pts with aphasia/dementia -Has internal consistency and comparability of scores |
| Severity Rating Scale | -Provides an estimate of the severity of impairment from 0 (No communication) to 5 (Normal comprehension/output) -Estimated based on interactions w/ pt (prompts: "Tell me about your family", "How did you get here today?", etc.) |
| Rating Scale Profile of Speech Characteristics | 7 aspects of speech are ranked by examiner: 1. articulatory agility; 2. Grammatical form; 3. Paraphasias in running speech; 4. Melodic line; 5. Phrase length; 6. Word-finding; 7. Repetition and auditory comprehension |
| NCCEA Test | Norms for all ages; Includes tactile naming; Uses Scrabble pieces for testing graphic ability; LIMITATION: does not include spontaneous speech |
| Minnesota | Lacks disorder types |
| PICA stands for... | Porch Index of Communicative Ability |
| Pros of PICA (4) | Multidimensional scoring (1-16 scale); Ideal for plotting recovery; Precise (high inter-rater and test-retest reliability); Uses 10 common objects for homogeneity |
| Cons of PICA | Certified training required; |
| 3 areas of PICA | Verbal; Gestural; Graphic |
| Philosophy of PICA | There is a central language processing capability but SEVERAL input/output modalities |
| PICA standardization sample | 280 LH damage; 100 bilateral damage |
| Pros of Token Test | Very short; Very sensitive to auditory comprehension deficits (pts who perform well on other aphasia tests may falter on this test) |
| CADL | Measures functional communicative ability in simulated activities (e.g., receptionist, shipping, doctor's office, driving, making phone calls) |
| Raven's Progressive Matrices | Assesses intelligence/reasoning with lower verbal load (right brain lesions, TBI) |
| Cognitive Linguistic Quick Test (Nancy Helm) | Symbol cancellation, symbol trains (Executive function, attention- ability to pay attention to some symbols and discard others) |
| Issues with aphasia assessment in children | Rapidly increasing skills in children; Language variability at a given age; Plasticity and compensatory adjustment |
| Social worker | In charge of post-discharge planning |
| SLP's role during acute phase | Prevention of regression; Family reorientation |
| SLP's role during chronic phase | Promotion of restitution; Family participation |
| Information processing deficit due to brain damage | Slow rise time, noise buil-up, retention deficit |
| Response delay | Greatest response increment occurs in 3-5 seconds, with most within 10 seconds. More responses with meaningful/novel stimuli and natural contexts |
| Language Teaching vs. Language Facilitation | Aphasia tx is not teaching, only facilitation; Teaching implies that language has been lost but aphasia only impairs the use of language |
| Pros of response charting | Easy; Brief; Visual feedback; Retention of stimuli; % conversion of scores; criteria for termination |
| Ways to promote generalization | MENTAL IMAGERY |
| Propositional density | Amount of info (i.e., proposition count) divided by the # of words; Tells you how meaningful the utterance is; May be able to predict dementia |
| ABA Tx | Treatment; Nontreatment phase (until target behavior is stable); Repeat tx phase |
| Multiple Baseline Tx | A single tx applied sequentially to multiple behaviors |
| Alternating Tx | Two txs given in a single day and repeated in different order for several days |
| Pro-Activation | Exposure to difficult to name objects interferes with the ability to name easy to name items; Easy to name items facilitates naming of difficult to name items (priming effect) |
| Naming Contexts | Open-ended conversation is most effective; Response to pictures is less effective; Naming from verbal description is least effective |
| Compensated activation | Post-stroke right hemisphere activation; but RH-processing is an inadequate processing route; so optimal recovery is right hemisphere giving up activation in favor of the left hemisphere |
| PACE | Promotes opportunities to practice natural communicative behaviors; cl and cln participate equally |
| Melodic Intonation Therapy | Singing uses right hemisphere; 3 different levels |
| Visual Action Therapy | Visual communication system (manipulative objects, drawings, video, etc.); for pts whose early tx has focused on AAC |
Created by:
aewerner
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