Guideaphasia.files.wordpress.com



Theories of AphasiaTradition Approach-localizationist View (if xRy, yRx, x=y)if you have information from Neuro anatomy, then you can predict the symptoms from the damage(e.g. hemorrhage in the frontal area, we can expect executive function and motor damage)However, we can usually expect damage to certain areas to have general symptoms.Anti-Tradition Approach-anti-localizationist view (if xRy, not (yRx), x(not=)y)if you have 1.-Anti-Localizationist argue against Localization because Localization don’t account for the subcortical regions.(e.g. frontal lobe damage can cause subcortical damage (basal ganglia), making our prediction less reliable.)2.-not considering subcortical regionsAnti-localizationist argue that every brain is different(e.g. lesion in similar area for 2 people, the symptoms will be different for each person)3.-every brain is different (same injury, but different symptoms)4-Anti-localizationist argue that there is no such thing as a textbook case.(e.g.Connectionist Model (telephone analog)What is CM? Information from one pathway to the next (telephone analogy)-e.g. if the patients attempts to answer question from clinician, the information must pass from the temporal lobe, parietal lobe, onto the frontal lobe and then back out.Anti-Connectionist argue that the model is too simple evidenced by Positron Emission Topography (PET) studies. The studies have found that there are multiple activation of the brain at the same time.Anti-Connectionist argue that language expression and comprehension is complex and we can not predict the pathways of the brain.Anti-connenctionist model (What is anti-CM?-multiple areas Darley & Schuell--Darley and Schuell claimed that aphasia is general language disorder that affect the language dominate hemisphere. Darley and Schuell believed that aphasia (CVA) affected these language components:1) auditory comprehension, 2) reading, 3) language expression, 4) writingLanguage dominate hemisphere characteristics(e.g. 99% right-hander are left hemisphere dominate for language.)(e.g. 70% left-handers are left hemisphere dominate for language.)(e.g. 30% left-handers are bilaterally dominate for language.)What are the implications for SLP, client and therapy?(client with CVA who is right-handed dominate must now use the left-hand)(client with CVA who is left-handed dominate may use the right or left-hand.)-Language Disorder (Goodglass and Kaplan-Goodglass and Kaplan claimed that aphasia is a general language disorder that affect the language dominate hemisphere and that aphasia affected other modalities of communication.(e.g. modalities: 1) gesturing, 2) drawing, 3) non-verbal responsesWhat did they change? Goodglass said that all modalities of communication will be effected (drawing)What are the 5 communication components that are affected by aphasia (damage)1) expressive language2) receptive language3) reading 4) writing5) mathRoberts Chapey-Roberta Chapey claimed that there is a close relationship between cognition and language.(e.g. if a client has a language deficits, then the client will have cognitive deficits.)-Special RelationshipWhat are the implications for the SLP? When the client has language deficits, cognitive assessment will be difficult using a standardized test. Why? If you have an auditory comprehension deficit, then the SLP will have trouble assessing cognitive deficits. Client with aphasia: .how can they drive. Classifying Aphasia: Why is this way is not good? Because it is not descriptive enough.-description of severity: how do we describe the severity? how do we determine the severity-time post onset: how long it has been from a CVA.-co-existing disorders: determining other aspect of the language system.Labeling aphasia (Kertesz, Goodglass and Kaplan)-made standardized assessment for aphasia1.expressive vs. receptive aphasia-how do we technically describe aphasiaClassification System-clinical researcher: by simply dividing aphasia into two large categories, the description is weak; not enough information.1. First division (is the aphasia expressive or receptive?)2. Second division (is the aphasia anomic?)if the aphasia is anomic, then can we determine if the anomic aphasia is semantic paraphasia or phonemic aphasia.3. Third division (is the aphasia fluent or non-fluent?)LCVA (left –CVA) rare cases of (Right-CVA)Are they anomic?-naming problemsTypes of anomia-verbal/semantic paraphasia (errors are within same catergory: it is a naming issue)(e.g. if I have a fork in my hand and I ask the client; what is it? and the client says it is a knife…no a spoon). the categories is utensils1. the client will use semantic category, but not name the exact item. Familiar categories for the client is furniture, vegetable.-give different examples know-literal/phonemic paraphasia (words are similar, but the sounds are transposed: it is a sound issue)definition: words are very similar, however sounds can be transposed or subsituted(e.g. Client says “I want to watch the /tewovision/’, the clinician can understand the word, but it is not exactly the word.”)Types of non-fluent aphasia.Criteria 1 (0-5 words in length that the client can produce)-global aphasia (clients are severely impaired)-Standardized Assessment with assess 4 components:1) expressive language (poor)2) receptive language (poor)3) motor aspect of repetition of speech (poor)4) naming (poor)What are the typical signs of global aphasia? A client with global aphasia will have difficulty communicating.(e.g. a client with global aphasia can’t verbally communication through language, but can communicate non-verbally like when they recognize you, the client will smile; the client will look sad; the client will even question. But there is no verbal expression)Is there co-existing language disorder with global aphasia? -Yes, there is a high probability that the client will have dysarthria (weakness=slurring) and/or apraxia (motor planning).Where is the damage? 1. perisylvian region=area around the perisyvlain fissure (temporal. parietal lobe areas) 2. sub-cortical structures, 3. major lesion anterior and posterior to Broca’s area and Wernicke’s areaIs the damage so severe that the patient can not function?No, client with global aphasia will act like they are reading the morning paper.Client with global aphasia will have pragmatic skills. (e.g. client will smile at you appropriately and even laugh at a joke)Clients with global aphasia will have linguistic and language problems/difficulties(e.g. client who could only say “ka”; client had good prosody and good pragmatics, but difficult with language expression.)e.g. language difficulty: can be pragmatic, but not linguisticBroca’s aphasia and Transcortical aphasia are sisters with respect to tree structureClients with Broca’s aphasia have the following symptoms:1. anomia=naming (poor)2. receptive language=auditory comprehension (poor)3. motor aspect of repetition of speech (poor) 4. expressive language (?)5. abnormal prosody=monotoneIs there a co-existing disorder in clients with Broca’s aphasia? Yes, there is a high probability that there will be dysarthria and/or apraxia.Landmark for Broca’s aphasia is telegraphic speech.(e.g. client with Broca’s aphasia will not use articles, prepositions, and verb tenses. The client will usually produce only nouns and present-tense verbs)Standardized Assessment and Language sample is needed for Broca’s aphasia because we will need to do an analysis on the content words. What will add content to the language? What is necessary and what is not? Goal is to add content to the language(e.g. client will say “boy go home”…what are our goals?)Clients with transcortical’s aphasia have the following symptoms:1. anomia=naming (poor)2. receptive language=auditory comprehension (poor)3. motor aspect of repetition of speech (good) 4. expressive language (?)5. abnormal prosodyBroca: abnormal prosody, apraxia and/or dysarthria, telegraphic speech (broca produce noun and verbs) broca aphasia will have Where is the damage for Broca’s aphasia? Anti-localizationist approach1.posterior inferior frontal lobe =lower portion of the motor strip-broadmann’s 44a. anti-localizationist approach (surrounding areas of lower portion of the motor strip)Where is the damage for transcortical aphasia? (anti-localization)1.anterior superior to broca’s areas 2. subcortical regions within broca’s area What is commonly diagnosis: Global, Broca’s, Transcortical, but not mixed!broca or globalTypes of fluent aphasia (9+ words in length)1. Wernicke’s aphasia and transcortical sensory are sisters-neologism (made up words)-use words as it (LANDMARK)(e.g. client use a fake word as a real word)-jargon(e.g. client sound like they are saying something)-anomia (poor)-auditory comprehension (poor=impaired)-good articulation-motor aspect of repetition of speech (poor-wernickes, good transcortical)-good prosodyWhere is the damage in Wernicke’s aphasia?-auditory association cortex-posterior superior temporal lobe, injury to angular gyrus-lesion is far from the motor strip, so no motor problemsIs there co-existing disorders? No, the lesions are far from the motor strip and client will not have dysarthria.Where is the damage in Transcortical Sensory? anti-localization (TSM) vs. (TCM)1. auditory association cortex2. angular gyrus-same as Wernickes-differences in repeatingdamage (lesion)- auditory association cortex and the angular gyrus-agrument against localizationOther types of fluent aphasias (in the fluent aphasia: will see symptoms of semantic paraphasia and phonemic aphasia.Anomic fluent aphasia and Conduction fluent aphasia are sisters1. naming (poor)2. auditory comprehension (both good)3. motor aspect of repetition of speech (anomic=good, conduction=poor)(e.g. Client can’t think of the word, but if the clinician gives the word, the client will be able to repeat it (anomic, but not conduction)Where is the damage to anomic aphasia? anti-localization-damage: angular gyrus and the auditory association cortexWhat are the difference between anomic and conductionWhat is the damage of conduction fluent aphasia?-damage: angular gyrus and sylvian aphasia.Memories the sheet.Terms associated with aphasia-alexia-inability to reade.g. expressive abilities are the same as writing, and reading ability.-agraphia-inability to write-agrammatic-inability to use sentence strucute-circumlocution--crossed aphasia-right hemisphere dominate-perseveration-repeating over and over-sounds (phoneme) -words (no, no, no )-idea (topics)Confrontational naming: semantic paraphasiaphonemic paraphasiaWhy is this phonemic paraphasia: repeating of soundsvariables to look at: semantic paraphasia: neologism-others: Key is not to associatedunderstandingMemory 3Counting the length of the utterance-anomic aphasia (determine the severity…mild to severitysubcortical aphasia: borderline aphasia-verbal agility (repetition tasks0-non verbal agility basal ganglia, thalamus, subcortical damage-verbal agility (repetition tasks…difficulty repeating item)-non verbal agility (oral motor movements)-show symptoms of dysarthria-hemiplegia and hemiparesis-hypophonia (soft voice)KEY varbible is that they have variable performance…it varies inconsistentlyWhat type of changes can we make for this population?How do we determine the type of aphasia. How do we determine the severitydetermine the diagnosis ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download