Chapter 18 (Review questions)
Differentiate between static assessment and dynamic assessment strategies for individuals with dementia.
Static assessment helps the clinician determine the client's current level of functioning, these assessment minimize contextual support and assess already learned products. On the other hand, dynamic assessment describes the type of procedure that determines a person's performance or potential at a given task with proper support and prompting.
Discuss the components of a thorough cognitive communication assessment for individuals with dementia.
1) Early identification of dementia and appropriate diagnosis 2) Identification of which neuropsychological capacities are impaired or spared 3) Prediction of skills most affected by the impairment 4) Establishing a baseline of cognitive functions prior the intervention 5) Use of dynamic assessment approaches and the evaluation of the effectiveness of those approaches per client
What are 3 cognitive screening tests appropriate for individuals with dementia?
1) Hachinski Ischemia Score - quick and precise means for clinicians to screen for vascular dementia. 2) Hearing screening - Behaviour associated with hearing loss often mimics that of persons with early signs of dementia. A hearing assessment would assess hearing levels and possibly assist in improving quality of life for individual if their hearing is improved. 3) Geriatric Depression Scale (GDS) - Depression is common among persons with dementia and may affect their motivation, willingness, and success of intervention plans. Screening is recommended.
Discuss three principles of interventions for people with dementia-associated cognitive communication disorders.
1) Treatment should focus on intact cognitive functions and reduce strain on those that are impaired. 2) Treatment should include stimuli that evokes positive emotion, action and fact memory, individualized to the client to increase meaningfulness and, in turn, effectiveness. 3) Treatment should focus on strengthening knowledge and capacities that that have the potential to improve. All treatment should be culturally and linguistically sensitive.
Define the dementia syndrome.
A syndrome characterized by acquired and persistent impairment of multiple cognitive domains that is severe enough to limit competence in activities of daily living, occupation, and social interaction. (affects language, attention, executive function, and visuospatial abilities)
What roles do SLPs have when working with individuals with dementia?
An SLP can play the following role when working with clients with dementia / at risk for dementia: 1) identification, through screening, of those who are at risk of developing dementia 2) assessment of cognitive communication disorders of of dementia using formal assessment tools 3) Intervention for cognitive communication disorders 4) Counseling for clients with dementia and their care givers 5) Collaboration with caregivers and person with dementia in order to develop and administer intervention plans for preserving cognitive communication skills 6) Case management of a comprehensive intervention plan 7) education , teaching and supervising future SLPs, family members, caregivers, other professionals, etc. 8) Advocacy for individuals with dementia 9)Research and advancement in the field of cognitive communication disorders
What is the effect of Alzheimer's disease on cognition?
Diminished cognitive function or mild cognitive impairment (MCI) could be an indicator of Alzheimer's Disease. Once a client has AD, cognitive functions such as attention, memory, and language are impaired to varying degrees.
What is one conceptual framework for developing interventions and measuring outcomes for individuals with dementia?
ICF - key framework for for measuring outcomes for people with dementia because is considers a person's impairment at the level of cognition, language and behaviour and its implications in a person's daily communication.
Explain language and communication deficits associated with Alzheimer's Disease.
Language expression: Persons with AD have difficulty initiating creative speech and generating novel language for the purpose of communication. Lack of desire to communicate. Written language is also impaired, demonstrating reduced complexity, although syntax is relatively well preserved. Language Comprehension: Oral comprehension is affected my diminished capacity for memory, however people with AD are often able to understand one-task instructions and respond appropriately to simple, direct and concrete questions.
Define mild cognitive impairment and discuss its relationship to Alzheimer's.
MCI is considered to precede Alzheimer's Disease in many cases. Identification of MCI and drug therapy can help to delay the onset of AD symptoms. Subsets of MCI have been linked to specific cognitive impairments. Studies show that adults diagnosed with MCI have a higher likelihood of developing AD or other forms of dementia within a five year period.
What are 2 intervention strategies to increase social communication opportunities for individuals with dementia?
REMINISCENCE THERAPY - Discussion of the past to help stimulate recall. Clients with AD often have ability to access memories and this discussion would allow them to connect with others in a meaningful way. MEMORY BOOKS - A book or wallet created to stimulate recall of personal information can be a strong conversation topic / motivator. Memory books contain pictures, words and phrases with relevant information to the client that stimulates memories.
