Acquired language Disorders - PowerPoint Presentation

Slide1

Acquired language Disorders

aphasia…and

important 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

Common causes of aphasia

CVATBItumorsinfectionsepilepsyOver 1,000,000 individuals with the US have aphasia- National Aphasia Association

describing aphasia

Hegde (1998); Brookshire (1997)

v

arious

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

General 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

the WHO ICF

Functioning and Disabilitybody functions and structuresactivity and participationContextual Factorsenvironmental factorspersonal factors

Treatment 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 function

skills

based/compensatory

approaches – activity/participation

approaches that train a new skill/behavior -or- alternative method for

communicating

participation focused approaches – participation

approaches focused on improved community participation and quality of life

TReatment examples

Anagram and copy Treatment (ACT)

WHO ICF

:

activity/participation

client profile

:

clients with little to no writing, but who show abilities with writing letters and letter identification; ability to complete

homework

target

:

independent writing of functional single words for everyday

communication

rationale

: repeated exposure to words through

solving anagrams and

copying improves representation of single words in the lexicon (thereby increasing access)

ACT

Protocol:

measurement

in

session data:

in SOAP note, report independent writing of target words

if not independent, ability to write word in step 4 of protocol

still take data on anagram and

anagram+foil

steps in order to note any trends

outcome measure:

independent writing of target words in everyday conversation; self and SO reports of increased understanding, reduced frustration,

etc

may incorporate logs, rating scales, GAS

response elaboration training (RET)

WHO ICF:

impairment

client

profile

:

individuals with reduced oral expression; variety

of aphasia profiles and severities

target

: oral discourse



increased content units and length of utterance

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

RET

Protocol: uses simple line drawingsimportant: use modified RET (mRET) for clients with significant apraxia

measurement

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 measure: increased MLU in everyday conversation; measure of impact (e.g., questionnaire, GAS)