Adult Language Test 3
Space Retrieval Training (SRT)
-"a method of learning and retaining information by recalling information over increasingly longer periods of time"- for DEMENTIA -goal: enhancing the accessibility of stored representations by repeatedly activating them and making a person aware of them -an error-less/error free learning method=when the individual is encouraged/praised for successes and not corrected or given negative feedback when he/she doesn't perform tasks correctly -said to target implicit memory (unconscious, involuntary) -facilitates cue-behavior associations (between verbal and auditory cues and face or object name associations) -demonstrates that it can help people with aphasia with word finding and finds that it is more efficient than a cueing hierarchy approach to naming -2 FORMS: 1) fixed-interval/uniform approach=time between trials remains constant; said to transfer information into long-term storage 2) randomized-interval/adjusted approach=time between trials is adjusted according to the individual's performance; said to enhance long-term retention (delay between trials in increased when the client is successful in responding correctly to the question) *most common form used* -treatment effects can also be obtained over the phone
Living with Aphasia: Framework for Outcome Measurement (A-FROM)
-a means of conceptualizing the outcomes of intervention for people with aphasia based largely on the ICF -attends to 4 life-affecting impacts from aphasia: 1) language and related processing 2) participation 3) personal factors, identity, and feelings 4) the environment -it is the clinician's responsibility to modify the environmental barriers to life participation and enhance communication support -individual differences are paramount in all considerations
Savvy Caregiver Program (SCP)
-a packaged program focused on mediating caregiver stress through improved interactions with people who have DEMENTIA -formal and informal caregivers may receive training and trainers may be certified to train others -training content includes: background info about dementia, notions of control, goal setting, means of managing daily care and behavior, self-care, and decision-making strategies -components: in-person workshops, internet-based training, caregiver manual, a DVD, and an online workbook -has both benefits and drawbacks (page 469)
locus of control
-a person's own view of what and/or who has shaped the events in his/her life, and of what and/or who has the power to shape his/her circumstances -if we understand a person's locus of control, then we will be better at extending empathy
FOCUSED
-a set of strategies for enhancing communication with people who have DEMENTIA -recommended for use in real-life contextualized communication and are intended to be the basis for training of caregivers, family, health care professionals, and volunteers (six 2 hour modules) -F: face to face -O: orientation (repeating key words, repeat sentences exactly, give ind time to comprehend what you say) -C: continuity (same topic of conversation for as long as possible) -U: unsticking (suggest the word the ind is looking for) -S: structure (structure the questions to give the ind a simple choice to respond with, providing 2 options at a time) -E: exchange (keep normal exchange of ideas we find in conversation; begin with pleasant, normal topics, asking easy questions) -D: direct (keep sentences short, simple, direct, using specific and concrete nouns, rather than pronouns) -goals: to promote the best quality of interactions with people who have dementia and thus enhance quality of life for the person with dementia as well as all involved in such interactions -simple approach to training with hands-on practice with each strategy; may lead to greater satisfaction of trained personnel in communicating meaningfully with people who have dementia -in addition to hands-on practice, there is caregiver support in recognition of the added burden of communication on the part of the caregivers
The Breakfast Club
-a social approach used in a long-term care context in which social participation of people with DEMENTIA and MCI is encouraged during a multisensory activity; includes adaptations to individual preferences, needs, strengths/weaknesses, and challenges -for people with dementia and MCI who are at risk for social isolation and who have reduced opportunities for social interaction -not needed to be completed in a linear fashion
Promoting Aphasics Communicative Effectiveness (PACE)
-activities/participation based tx -compensatory tx -multimodal tx/total communication approach -an intervention method developed to foster pragmatic skills during conversation in which new information is conveyed and in which the client and clinician exchange roles as sender and receiver (does not constitute actual conversation) -developed for people with APHASIA, but can be applied to other populations -principles: equal participation (equal turns sending and receiving messages), new information (stimulus described is not seen by the receiver, which ensures true information exchange), free choice of modalities, and natural feedback (consists simply of clinician's or client's responses regarding whether message was successfully sent or received) -improve person's conversational skills with ANY modality -opposite of CILT -very natural and honest; you aren't the teacher; you are sharing information equally -gives empowerment to family members and friends to aid in establishing collections of meaningful stimuli IMPLEMENTATION: -clinician and client take turns describing what is depicted on a set of stimulus cards, and the other person not describing will have to guess what is being described with natural feedback; the clinician should expand on the client's utterances to acknowledge the successful components of their message -a scale from 0 to 5 may be applied
Supported Conversation for Adults with Aphasia (SCA)
-activities/participation based tx -compensatory tx -partner approach/supported communication intervention -a philosophy and set of tenets and strategies implemented throughout social intervention with people who have communication disorders, involving anything that improves access to or participation in communication, events, or activities -may involve ANY modality -communicative success results from: 1) skill of person with aphasia 2) skill of conversational partner 3) availability of appropriate resources -SCA techniques 1) spoken utterances (natural tone, natural prosody, slightly slower rate of speech, simple statements/questions, chunk info into phrases, emphasize key words with loudness and pitch) 2) gestural supports ("layer" gestures with spoken utterances, use appropriate eye gaze, body orientation, point to relevant pics when talking, use symbolic gestures) 3) graphemic supports (written key words, bold font with white background, avoid "clutter" on page, simple syntax for sentences) 4) pictographic supports (line drawings representing key concepts, grouping of pictographs within "topics"/categories) 5) verification (check to make sure YOU understood the intention of the person with aphasia 6) physical materials (paper, bold colored marker, pen/pencil)
Visual Action Therapy (VAT)
-activities/participation based tx -compensatory tx (sometimes considered restitutive) -multimodal tx -a gesture-based nonvocal method to promote the use of symbolic gestures in people with GLOBAL APHASIA -principle: people with severe language impairments often retain symbolic abilities that underlie language use -training specific gestures (usually one handed; very basic) -promotes the use of SYMBOLIC gestures to communicate when language expression is severely impaired -train caregivers and staff as well IMPLEMENTATION: -all types use the same materials (objects, line drawings of those objects, and pictures of those objects) 1) assemble 15 objects, line drawings, and pics 2) have client match pics to objects 3) as you show each object, have client use gestures to demonstrate how object is used 4) show group of objects, gesture how one of them is used, model gestures with each object 5) ask client to choose object that goes with your gesture 6) model gesture without the object in sight 7) have client request an object using only a gesture -0, .5, and 1 scale
Augmentative and Alternative Communication (AAC)
-activities/participation based tx -multimodal tx -aided (belong outside their body is helping them) vs. unaided (something that belongs to the body-eye gaze, blinking) -no tech: pencil and paper, gestures -low tech: core board, ipad, other technology -high tech: speech generating devices, ipads (depends)
Interactional Aphasiology
-activities/participation based tx -pragmatic tx -it is an alternative service delivery approach -focuses on how social interaction is effectively established, negotiated, and sustained -it is an authentic remediation of conversation abilities (gesturing, body orientation, initiating, turn taking, eye contact, topic maintenance)
Reciprocal Scaffolding
-activities/participation based tx -the pt is providing the scaffolding to the clinician -used in very natural communication setting (conversation) -person with aphasia takes role of teacher/expert and the clinician becomes the novice -the novice (clinician) provides language modeling and feedback during naturalistic interactions while the expert (person with aphasia) teaches -the novice may have greater language abilities, but does not know as much about the content to be learned
Script Training
-activities/participation based tx -impairment focused/restitutive -person with APHASIA (with limited expressive language) and clinician plan a personally relevant conversational script -can be monologue (can be predictive; them telling a story) or dialogue (can't always predict what they are going to say) -goal: to produce relatively fluent speech and natural language production in socially meaningful contexts
Stimulation-Facilitation Approach to Language Treatment
-aka Schuell's stimulation approach: a unidemensional view of aphasia from her recognition of the interdependence of all aspects of language, receptive and expressive, from phonology to pragmatics (interconnectivity among brain structures) -restitutive tx -from an appreciation of the functional interconnectivity among brain structures involved in language -method of "strong, controlled and intensive auditory stimulation of the impaired auditory symbol system" in people with aphasia -based on the fact that all people with aphasia tend to have at least some difficulty with auditory comprehension
Scary/Not Scary
-another executive function/self-regulation script
Ready/Not Ready
-another script -for returning to school/job -how can you show your body/mind is ready to work/learn -first taught explicitly, then implicitly
Problem Solving
-another script -say what the problem is and think of 5 solutions/reactions for each -reason through all of them and then choose the best answer
What About You?
-another script -theory of mind problems (egocentric) -the person turns it around in the conversation -this script helps the person attempt to think about the perspective of others
Big Deal/Little Deal
-another script -treat yourself like you would treat others -give yourself perspective
Video Assisted Speech Therapy (VAST)
-clinician videos their mouth, mostly the teeth -the pt watches the video and imitates the mouth movement exactly -can mime the mouth movements and speak out loud -really helps when it works
Communicative Drawing Program (CDP)
-compensatory tx -a treatment for people with SEVERE APHASIA who are limited in oral and written language expression that focuses on the use of drawing as a compensatory means of communication -principle: drawing is intrinsically nonlinguistic, so it may be useful even in people with severe aphasia; some have argued that drawing exploits use of the intact right hemisphere to facilitate word retrieval -focus on communicative effectiveness of the drawing over accuracy -challenge: focusing on accuracy of drawings as opposed to the communicative content conveyed; providing more detail than needed to convey a message results in inefficiency of communication IMPLEMENTATION: 1) have client identify and recognize categories of objects ("semantic-conceptual knowledge") 2) have client color 9 black and white line-drawn objects with specific colors, like with carrots and peas ("knowledge of object color properties") 3) have client trace around the contour of the black and white line drawings (recognize "outer configuration") 4) ask client to copy geometric shapes 5) have clients fill in the missing parts of a drawn object 6) show client a picture, take it away, and ask them to draw it ("stored representations") 7) name an object with which you have been working, ask client to draw it 8) give client a category name and ask them to draw an item from that category 9) ask client to draw as many items from that category as possible without any examples presented 10) ask client to draw 1, 2, and 3 paneled cartoons representing a story or joke (convey logical sequence)
Problem-Solving Approach
-compensatory tx -teaching the client with dysgraphia to implement strategies that help facilitate spelling -strategies include: partially correct responses, self-correction, making sound to letter correspondences, and using an electronic speller or tablet -principle: a focus on phoneme-to-grapheme conversion ideally helps the individual to improve spelling through repeated stimulation and corrective feedback
Back to the Drawing Board (BDB)
-compensatory tx/maintenance-based -a treatment program that focuses on the use of drawing as a means of compensatory communication for individuals for SEVERE APHASIA -much like CDP (based on the same principles), but developed before CDP -treatment outcomes may be indexed in terms of increased accuracy of drawings -family and friends are recommended to be included in training (with drawing and communication, and communication support in general) -progress is measured using the individual's drawings of "accidents of living" -goals may include: answering questions; requesting assistance, objects, or information; sharing information (all through drawing) IMPLEMENTATION: 1) provide 5 uncaptioned funny cartoon panels (start with single panels and then increase number) 2) show client the 1st one panel cartoon and then take it away; client must draw it from memory and it must be recognizable and contain humorous aspect 3) provide 2nd cartoon panel 4) once client successfully draws 3 of 5 single panel cartoons, introduce two panel cartoons 5) once they successfully draw 3 of 5 two panel, go to three panel cartoons
persistent depressive disorder
-component of chronic major depressive disorder -what had been previously called dysthymic disorder (chronic state of depression for most of the time over 2 years) -stroke survivors with aphasia tend to have a higher rate of depression than those without aphasia -regardless of whether or not they are depressed, many people with aphasia experience anxiety, stress, and worry associated with their self-perceptions of communicative inadequacy and anticipation of communicative failure
treatment intensity
-consideration of the number, frequency, and duration of treatment sessions
Computer-Based Treatments
-examples of software: -parrot software -bungalow software -brain train -brubaker on disk -microsoft word -ORLA -Morespeech and tactus therapy solutions: provides wide range of apps that generate activities related to a host of cognitive-linguistic abilities (one of the best-made by SLP)
Goal-Obstacle-Plan-Do-Review
-executive function/self-regulation script -teach person with TBI/cog deficit to approach tasks/activities with these steps -use visuals for some, have them number the steps so they can remember better -DO step is where most people with TBI get stuck -REVIEW step is one of the most important
Hard/Easy
-executive function/self-regulation script -when faced with a task, do they think it will be easy or hard? -targets self-talk and self-regulation
Transcranial Magnetic Stimulation (TMS)
-experimental tx -a technique involving magnetic coils placed on the scalp to stimulate or inhibit activation of targeted brain regions beneath the scalp via low-frequency magnetic pulses -uses a magnetic field to stimulate neurons to fire; electric currents are induced in brain tissue by rapidly-changing magnetic fields created by an electrical current passing through plastic-covered coils held against the head (delivered by a device about the size of a suitcase) -essentially painless, though some pts report a slight headache; most pts describe it as mildly annoying -it reduces diaschisis (inhibited functioning on site remote from site of lesion) thru activation of areas that are intact but have ceased to function normally -typically used before therapy session *like a pace maker for the brain
Transcranial Direct Current Stimulation (tDCS)
-experimental tx -a technique that involves delivering impulses of low-level electrical current through the scalp to stimulate the brain -a constant electric field induces a weak current that creates changes in the neuron's membrane and regulates its electrical activity -electric current does not cause the nerve to fire -patients do not experience pain -usually used during therapy session *like a pace maker for the brain
1. Proximal Limb VAT (PL VAT)
-focuses on the proximal limbs (closer to torso-arms and legs) and relates to gross motor skills (hitting desk with a gavel)
Attention Process Training (APT)
-for TBI survivors -a program designed to enhance focused, sustained, selective, alternating, and divided attention
Multiple Oral Reading (MOR) Protocol
-impairment based/restorative -reading tx -a restitutive, stimulation approach designed for people with APHASIA who have acquired reading impairments; involves repeated reading aloud of the same text -facilitates whole-word rather than letter-by-letter reading (fluency) -goal: increase reading rate while maintaining or improving accuracy (good for also improving fluency of reading) -principle: improve access to the graphemic input lexicon either directly or thru compensatory strategies -STEPS to Modified Version: 1. read passage (obtain wpm, errors) 2. have a mini lesson, highlight errors 3. read passage (marked) a 2nd time (obtain wpm, errors) 4. move on to another activity 5. read passage (clean) a 3rd time (obtain wpm, errors) 6. assign passage for homework
Verb as Core Treatment (VAC)
-impairment focused/restitutive -a treatment approach intended to improve expressive verb use and verb understanding as well as language performance in general in people with AGRAMMATIC APHASIA -verbs carry the greatest meaning about events conveyed in a sentence -principle: verbs carry critical meaning for communication and literally serve as the "core" of all sentences IMPLEMENTATION: 1) present verbs asking "who" and "what" questions to elicit a subject-verb response 2) add questions with "what", "when", "how", "where", and "why" to elicit a subject-action-object response *90% accuracy over 3 consecutive sessions to move to the next level
Voluntary Control of Involuntary Utterances (VCIU)
-impairment focused/restitutive tx -a treatment approach designed to improve expressive, propositional communication in people with SEVERE NONFLUENT APHASIA whose speech is limited to automatic production of few words -purpose: to stimulate use of propositional language in individuals who mainly use involuntary utterances but who are able to read and comprehend at least one word at a time -tx hopes that using correct automatic/involuntary utterances will facilitate production of voluntary utterances IMPLEMENTATION: 1) make list of all the words the client produces spontaneously and write them separately on cards 2) ask client to read each one 3) present pics of target words and ask client to name each one 4) have client practice at home 5) thru supported communication, encourage progress thru oral reading and confrontation naming to lead to use in natural conversation
Treatment of Aphasic Perseveration (TAP)
-impairment level/restitutive tx -a treatment approach for people with APHASIA who tend to perseverate on speech sounds, words, and utterances they have already said (paraphasias) -optimal candidates: people with aphasia who have at least moderately intact comprehension, good memory, and moderate to severe recurrent perseveration -principle: by helping people become more aware of their perseverations, we may help them suppress them IMPLEMENTATION: 1) establish baseline from percentage of words perseverated during confrontation naming portion of BDAE-3 2) explain to the client what perseveration is and give examples 3) engage in confrontation naming activity with 5 seconds between items (start easier and get harder) (use pics/objects that are personally relevant) 6) continue to draw attention to client's moments of perseveration; write incorrect utterances from client and then rip the sheet of paper in front of the client???
Verb Network Strengthening Treatment (VNeST)
-impairment-based/restitiutive/restorative -syntax treatment/word finding -a treatment method developed to improve word/VERB retrieval through enhanced activation of semantic and grammatical or relational aspects of verbs (verb network) -goal: helping the client generalize the ability to produce verbs within sentences and ideally to carry this over to discourse contexts -rationale: to use thematically related words to enhance production at the sentence level; thematic roles of verbs are emphasized (pick verbs with multiple thematic meanings (ex: play)) -client led to associate multiple possible agents (subject) and patients (object) with each target verb -agents go with the "who" cards and patients go with the "what" cards -STEPS: 1) baseline 2) stimulus selection and creation 3) generation of agent-patient pairs 4) wh- questions about agent-patient pairs 5) semantic judgments 6) generation of agent-patient pairs again
Word Retrieval Cueing Strategies (provided by clinician)
-impairment-based/restitutive -modeling -sentence completion -functional description (what it does) -description and demonstration of action -pairing an object or a picture with its printed name (matching task) -oral spelling (from clinician) -patient's spelling and writing -presentation of a sound (sound effect) -repeated trails (drilling) -direct deblocking (giving them the answer in multiple choice format) -indirect deblocking (not giving them the answer, but giving them related clues through synonyms, antonyms, paired items, intonation, semantic categories)
Gestural Facilitation of Naming
-impairment-based/restitutive -word finding tx -can be through sign language -really works well for nouns, some verbs/adjectives -just get the hands/arms moving while speaking (like in the video)
Response Elaboration Training (RET)
-impairment-based/restitutive -word finding tx -a treatment approach that focuses on increasing the length and improving the information content of ORAL language of people with Broca's or "nonfluent" APHASIA -goal: to improve word finding and increase the use of content words through a natural/conversational way -like extension and expansion (take what the client says and make it better) -client is seen as the PRIMARY communicator and client-initiated topics are encouraged -uses forward-chaining technique: clinician responds directly to anything the client says and models/reinforces longer utterances based on client's utterances -successful communication of novel ideas is encouraged rather than accuracy IMPLEMENTATION: 1) show stimulus pic depicting an everyday activity and elicit an initial verbal response about the pic 2) encourage the client to elaborate on whatever he/she is reminded of when looking at the pic (avoid having client describe pic or name objects) 3) respond to client's initial response and encourage client to extend the initial response 4) use "wh" questions and model sentences that combine client responses 5) don't directly correct client responses, but provide natural feedback
Oral Reading for Language in Aphasia (ORLA)
-impairment-based/restitutive/restorative -reading tx -a treatment method for people with DYSLEXIA (associated with any form and severity level of APHASIA), with the intent to foster recovery or relearning of reading comprehension through practice using phonological and semantic routes and associates feedback -principle: repetitive stimulation is intended to strengthen phonological and semantic routes for reading -incorporates connected speech rather than individual words to permit a more natural prosody when clients read out loud -computer software in newer forms of ORLA -can do it on the computer or with a person IMPLEMENTATION: 1) assemble reading materials based on reading level and length 2) start with 1st grade reading level, then 3rd grade, and then 6th grade 3) have the client read in unison with you, then have him/her read it alone (don't correct errors, but focus on modeling)
Melodic Intonation Therapy (MIT)
-impairment-based/restitutive/restorative -sometimes considered compensatory -a treatment method based on facilitating spoken language through the exaggeration of 3 elements of spoken language prosody: pitch, rhythm/tempo, and emphatic stress -goal: to draw on the prosodic features of language to facilitate verbal output -3 to 5 levels (elementary, intermediate, advanced, etc.) -levels usually begin with humming/intoning while tapping the patient's left hand, then move to unison singing/sprechgsang/unison with fading, then move to repetition (immediate or delayed), then move to response to a question -"sprechesang": "spoken song" refers to blend of speaking and singing; "utterance is lyrical but spoken rather than sung" -those who responded best to MIT had lesions in Broca's area, but not in the temporal lobe or right hemisphere -TIPS: 1. do not use a familiar tune 2. use high probability phrases (functional/applicable) 3. avoid consonant blends and clusters 4. imperatives before declaratives (and interrogatives) 5. criteria for passing to the next level: >90% accuracy for 5 consecutive sessions at previous level 6. pause for 6 seconds *some research results indicated activation of Broca's area and the left prefrontal cortex; these findings of left hemisphere reactivation called into question the thought that MIT leads to right hemispheric compensation *long syllable duration improved participant outcomes
Constraint-Induced Language Therapy (CILT)
-impairment-based/restitutive/restorative tx -aka constraint-induced APHASIA therapy (CIAT) -a treatment approach restricting the use of compensatory communication modalities and encouraging the use of communication modalities that are the most impaired (verbal output) -mostly used with people with Broca's/"nonfluent" APHASIA -key principles: 1. Massed Practice (group tx 2-4 hrs per day for 10 consecutive days or 5 days for 2 weeks) 2. Constraint (avoid gestures, drawing, writing) 3. Forced (communicate only by talking) -challenge: little consistency across studies in terms of actual tx protocol (tx intensity and duration, also specific activities for participants
Semantic Feature Analysis (SFA)
-impairment-based/restitutive; can also be compensatory -word finding tx -a treatment approach targeting word-finding abilities, involving focused associations with the meanings of words -especially designed for people with dysnomia, or ANOMIC APHASIA -goal: to enhance naming abilities by improving access to semantic networks *by activating the semantic network surrounding the target word, the target word maybe activated above its threshold, thereby facilitating word retrieval -has also been used to enhance naming of actions (verbs) too, but mostly nouns -use in group tx contexts may actually facilitate carryover to the discourse level -STEPS: 1) ax the patient's word retrieval processes through confrontation naming tasks (baseline of lexical retrieval) 2) consider the patient's potential for word retrieval and self-cueing strategies ----semantic self-cueing (semantic feature chart-carrot example); ask for the target word's semantic group, use, action, properties, location, and association ("reminds me of...") ----partial grapheme or phonological information (graphemic organizer) ----phonemic self-cueing/relay words (an achor word that helps them retrieve other words; they begin a word they know "Bethany" and then "bathtub" comes out because of the same initial phoneme) ----absurd visual images for proper nouns (Bellair Baptist Church example)
Anagram and Copy Treatment (ACT)
-impairment-based/restitutive?????? -writing tx -an approach for people with DYSLEXIA based on the notion that repeated recall and practice strengthens the graphemic representation of words (especially helpful if person has limited oral language or speech output- BROCA'S or APRAXIA) -goal: to develop a corpus of functional words that can be used to communicate, as a supplement to spoken or gestural communication -principle: manipulating anagram letters is easier than writing letters -STEPS: 1. present picture representing word and ask pt to write the word OR ask pt to write word to dictation 2. if correct, go to next word; if incorrect: ---present scrambled letter tiles and ask pt to arrange letters to spell the target word ---if correct, ask pt to copy the correct spelling 3 times ---if incorrect, clinician arranges letters correctly and pt copies it 3 times 3. present letter tiles PLUS 2 foil letters (1 vowel, 1 consonant) 4. cover all instances of target word (tile letters and written words) -goal criteria: write word correctly 3 times without any cues
3. Bucco-facial VAT (B/F VAT)
-incorporates facial gestures (drinking from straw) -people with severely restricted verbal output but relatively good auditory skills are best candidates
treatment dosage
-intensity of treatment over a specified period of time
Montessori Programming
-intervention methods, initially developed for use with children in educational environments, adapted for use wit adults who have DEMENTIA (highly adaptable approach) -goals: enhanced activation of intact intellectual and communicative activities and improved compensatory strategies through various activities -"first-in/last out" model of cognitive loss: theory that the functional abilities learned earliest in life are those most likely to be preserved in people with dementia -this program/approach said to complement intervention goals of improved independence, self-esteem, positive affect, and participation in social roles and activities -emphasis on intact abilities, use of supported communication, multimodal sensory stimulation, environmental accommodations, ecologically valid and personally relevant and concrete stimuli, supported and contextualized cueing, positive feedback, repetition, minimal reliance on episodic and working memory
hyperbaric oxygen therapy (HBOT)
-involves immersing an individual in a sealed tank while raising the atmospheric pressure so that oxygen is forced into his/her bodily tissues at a rate up to 3 times greater than under normal air pressure -thought to reduce effects of stroke and vascular dementia by supplying more oxygen to the brain to reperfuse the damaged tissue and decrease negative outcomes -research has not concluded it is a viable option for treating effects of stroke and dementia -associated with some risk of adverse effects
2. Distal Limb VAT (DL VAT)
-involves the distal limbs (farther from torso-fingers and toes) and relates to fine motor skills (dialing telephone) -people with severe deficits in expression but intact comprehension of speech and written language are the best candidates
Chapey's "cognitive stimulation" approach
-language treatment is considered to benefit from foci on cognitive operations such as memory, convergent and divergent thinking, and evaluation -use problem solving during discourse
compassion
-like empathy, but has the connotation of shared feeling, not just understanding; is also linked to a sincere desire to provide support and help
internal locus of control
-one's sense of having the power and the ability to do something about one's situation
PWA
-persons/people with aphasia
life coaching/wellness coaching
-professional means of helping people develop clear vision of what is most important and empowering them toward wellness and maximizing their personal potential -holistically focused, less formal -focuses on what can be done in the present and the future
counseling
-professional, goal based collaborative process toward fostering mental health and wellness by encouraging changes in ways of thinking, feeling, and behaving -delves into past experiences to improve the present and future -counseling by the SLP soon after the stroke or brain injury is usually the first counseling that a patient or family receives -the most immediate needs tend to be for information, reassurance, and hope -always have information on hand about aphasia groups, websites, and social media that the patient and family can get involved with
aphasia mentoring programs
-programs in which people with aphasia serve as mentors to students in clinical education programs in the health sciences -people with aphasia share their knowledge about what it is like living with aphasia and what they have learned as consumers of clinical services related to neurological disorders
Life Participation Model of AAC
-provides a framework for proactively considering and implementing means of enhancing communication in people with complex and severe communication disorders -STEPS: 1) assessment of participation preferences and needs 2) assessment of barriers to communication access and barriers to communication opportunities 3) trying out various AAC options 4) implementing promising forms of AAC 5) continuously assessing and providing supports of AAC use 6) modifying recommendations about forms of AAC use as appropriate
Life Participation Approach to Aphasia (LPAA)
-puts the life concerns of people with aphasia at the center of decision making -also applies to all people with acquired neurogenic communication disorders -recognizes the complexity of communication in real-life contexts and that impairment-based tx strategies are only meaningful and effective when they are grounded in what is relevant, meaningful, and important in the lives of the people we serve -considers holistically the many factors that influence lifelong coping with aphasia
mechanisms of brain changes underlying recovery
-reduction of edema -reperfusion -resolution of diaschisis -neuronal regeneration (dendritic branching and collateral sprouting) -long-term potentiation (LTP) (increased strength of nerve impulses) -unmasking of preexisting pathways -cortical reorganization (can be seen thru neuroimaging)
Phonological Components Analysis (PCA)
-restitutive tx -an impairment-focused approach for the remediation of of naming deficits in people with APHASIA, with a focus on the phonological aspects of target words -ideally, PCA leads to client to independently generate phonological cues when having difficulty -use of pic cues incorporates a semantic aspect to the naming task, so that phonological activation can interact with semantic activation to facilitate naming IMPLEMENTATION: 1) use confrontation naming task to determine which words client has trouble naming (baseline) 2) like SFA, place pic at center of chart and ask client to name it, then ask them to name 5 components related to the word (phonologically) --what does it rhyme with? what's the first sound? what other words start with this sound? number of syllables? 3) for each component, if client cannot response spontaneously, ask him/her to choose from list of answers 4) after reviewing phonological components, ask client to say the word that goes with the pic
Copy and Recall Treatment (CART)
-restitutive/restorative/impairment focused tx -writing tx -an impairment-focused stimulation method that entails repeated writing practice through a progression of single-word writing tasks -goal: to develop a corpus of functional single words that can be used to communicate, as a supplement of spoken or gestural communication -good candidates: have good visual recognition abilities and the ability to write letters (graphomotor abilities) -rationale: repeated attempts to accurately spell target words assist in activating the word's graphemic representations -consider short before long words and normal spelling before irregular spelling *it is important to activate associated word meanings while copying these words down -STEPS: 1. establish a homework notebook (6 days a week); ask pt to identify some target words he/she would like to be able to write/say 2. clinician writes target word of an depicted items 3. ask pt to copy word; if correct, demonstrate how pt should cover all instances of the word and try to write the word from "memory" 4. after writing the word, the pt should check what he/she wrote against what the clinician wrote to check accuracy; then cover all instances and write the word again; repeat this step until goal is met -goal accuracy: correctly write word 3 times without any written models *CART and ACT work in tandum
external locus of control
-sense that other forces, such as God, luck, fate, and other people (family, friends, professionals) determine what will happen
Pharmacological Experimental Tx
-tPA (tissue plasminagen activator): has to be given within 4 and a half hours after stroke, clot busting drug -Piracetum: VERY experimental; used for muscle contraction; an antihypoxic/antiarhythmic; helps the heart be more rhythmic, increasing oxygenation to the brain; appears to increase communication between hemispheres to help with aphasia; given between 1 week and 1 year after stroke
Cognitive Approach to Improving Auditory Comprehension (CAIAC)
-tasks of "attention" and "conceptual knowledge" said to help everyday cognition and communication from single word to discourse level -tx involves: 1) abstract design cancellation tasks 2) variety of pattern-copying tasks 3) symbols trail tasks; drawing of lines between symbols within given category 4) "odd-man out" tasks; what does not belong? 5) tasks requiring sorting of images by size and weight
empathy
-the ability to see the world from another person's point of view; it involves tuning into another's emotional state, desires, and sense of need -empathetic responding involves listening and reflecting with true concern about a person's feelings and perceived needs
Complexity Account of Treatment Efficacy (CATE)
-using more complex stimuli and tasks at the start of treatment, optimizing recovery by recruiting more intact neural networks and enhancing their interconnections through behavioral intervention -essentially, starting with the atypical, more abstract stimuli which will in turn generalize to more common stimuli
toastmaster programs
-worldwide clubs that provide means of developing communication and leadership skills; people with language disorders prepare, practice, and deliver speeches to one another
