aphasiaand important ideas about aphasia aphasia is a symbolic disruption is acquired involves any or all language modalities comprehension auditory reading signedvisual expression oral writing signedmanual ID: 774661
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Slide1
Acquired language Disorders
aphasia…and
Slide2important ideas about aphasia
aphasia…
…is a symbolic disruption
…is acquired
…involves any or all language modalities
comprehension: auditory, reading, signed/visual
expression: oral, writing, signed/manual
…is not a problem of sensation or intellect
Slide3Common causes of aphasia
CVATBItumorsinfectionsepilepsyOver 1,000,000 individuals with the US have aphasia- National Aphasia Association
Slide4describing aphasia
Hegde (1998); Brookshire (1997)
various impairments in any/all language modalities
the most commonly observed deficits are in naming and auditory processing
generally describe an the language profile as:
fluent/receptive;
nonfluent
/expressive; or
severe or global
Slide5General symptoms:
Impairments impacting language use include:
impaired auditory comprehension
anomia
: word retrieval/naming difficulty
paraphasias
: word or sound substitutions
agrammatism
: asyntactic production (or reduced syntax)
reading and writing disruptions
Slide6the WHO ICF
Functioning and Disabilitybody functions and structuresactivity and participationContextual Factorsenvironmental factorspersonal factors
Slide7Treatment and assessment - Linking the WHO ICF
restorative/process oriented approaches – impairment (body structure/function)approaches aimed at improving underlying motor or cognitive processes, resulting in generalized improvement in functionskills based/compensatory approaches – activity/participationapproaches that train a new skill/behavior -or- alternative method for communicatingparticipation focused approaches – participationapproaches focused on improved community participation and quality of life
except…
Slide8big picture
aphasia treatment targets the specific area of language or communication functioning impacted by aphasia
we do not treat by type of aphasia
the treatment should directly target the impacted area and/or your careful measurement shows the effect of treatment on the client’s stated goal
Slide9Treatment examples
Slide10CART – Copy and Recall Treatment
client profile
: individuals with lexical impairments in writing; unable to write single words reliably
target
: improved access to items in the written lexicon; improvement of trained words
dosage
: 1-2 times per week
rationale
: repeated copying of words retrains orthographic representations
CART protocol
this intervention can be in-session plus homework, or home program onlysession protocol - present picture; if they can not write the target:clinician hand writes word and client copies x 3clinician covers examples and client copies x 3; this step done three times
Clauson and Beeson, 2003
Slide12measurement
session data:
accurate written production of words without a model (independent on step 1)
reliable completion of homework
outcome measures:
increased use of trained words in everyday conversation/ communication contexts
increased perception of communication efficacy and/or QOL (self report/questionnaire; GAS)
Slide13response elaboration training (RET)
client profile
: individuals with reduced oral expression; variety of aphasia profiles and severities
target
: oral discourse
increased content units and length of utterance
dosage
: 2-3 times per week
rationale
: combining behavioral techniques of modeling and forward chaining with cognitive stimulation using loose training results in expanded oral expressive output
loose training - uses the client’s response as stimulus
Slide14RET
Protocol: uses simple line drawingsimportant: use modified RET (mRET) for clients with significant apraxia, or CAAST for clients with goals in both areas
Slide15measurement
in session data:
content: number of information units produced (steps 1 and 6) - may vary based on severity of client
possibly grammatical production: number of morphemes, nouns, verbs,
and modifiers
outcome measures:
increased MLU in language sample, everyday conversation
measure of impact (e.g., questionnaire, GAS)
Slide16