Stroke
Non-fluent aphasia are the result of damage to which portions of the brain?
frontal and dorsal
Name the 2 main things hyolaryngeal excursion does during the swallow.
epiglottic retroflexion
UES opening
Name all the intrinsic laryngeal nerves and their function
LCA- adduct
interarytenoid- adduct
PCA- abduct
CT- increase pitch
TA- decrease pitch
3 year old child has profound hearing loss and was given hearing aids. HAs are providing little benefit and the child has speech and language delay. What would you recommend?
Cochlear impants
What is the dialectical differences we would expect to see for AAE in phonetics and morphosyntax?
Natalie- answers
WAB-R bedside version
BDAE-3 bedside version
Bedside evaluation and screening test (BEST-2)
Patient referred for swallow study who is fatiguing easily during meals. He is 65 years old and suffered from a stroke 2 years ago. He is alert and able to follow commands. He also has complaints of GERD. Which instrumental assessment would you use and why?
FEES-
no time constraints
can see secretions (GERD spilling over)
will not be agitated
can see height of swallow
Patient presents with a unilateral vocal fold cyst. Describe the likely stroboscopic findings and CAPE-V characteristics.
(hint- location, appearance, mucosal wave, amplitude, symmetry, phase closure)
Unilateral vocal fold lesion on mid-membranous portion of true vocal fold. Sessile and smooth/opaque. Findings reveal decreased mucosal wave and amplitude on affected vocal fold, asymmetry, and primarily open phase closure. CAPE-V reveals roughness and decreased pitch. Functional impact is glottic insufficiency and reduced VF pliability.
What is core vocab?
fringe vocab?
generic vocab used across situations
situation-specific vocab used for additional communication needs
PPVT-4 scores:
standard score: 77
95% confidence interval: 71-83
Percentile: 6
Interpret the test results for the parent.
¡Alex achieved a standard score of 77 (mean = 100 +/- 15) which is between one and two deviations below the mean. The 95% confidence interval means that 95% of the time that Alex is tested, he will score in the range of 71-83. The standard score corresponds to a percentile of 6, indicating that Alex scored as well as or better than 6% of the children included in the standardization sample of this test, and 94% performed better. Alex’s performance is below the average range and therapy is recommended.
Name one activity/participation-level assessment.
Communication Activities of daily Living (CADL-2)
Functional assessment of communication skills for adults (ASHA-FACS)
Quality of communication life scale (ASHA-QCL)
Communication effectiveness index (CETI)
WHO- Quality of life- BREF
Assessment for living with Aphasia (ALA-2)
Patient has unilateral vocal fold paralysis. What postural technique will you try during swallow study? Why?
head rotation to the weak side. Intact vocal fold can make contact with the weak vocal fold to close airway efficiently.
Patient has adductory vocal fold paralysis. what will glottic closure look like?
Patient has presbycusis. What glottic closure will they have?
incomplete
spindle-shape
What type of hearing aids would you recommend for an active 5 year old boy? Why?
behind-the-ear
2 large components, will not fall out easily, won't get lost.
name the late 8 sounds
/ʃ, s, θ, ð, ɹ, z, l, ʒ/
Patient presents with non-fluent speech, good auditory comprehension, and poor repetition. The aphasia type is ___________.
Broca's
Name at least one rehabilitative strategy you could use for someone with decreased hyolaryngeal excursion.
Shaker
effortful pitch glide
chin tuck against resistance
jaw opening against resistance
60 year old patient presents with tremor-like vocal quality and is unable to shout, but can phonate at falsetto. What is the likely diagnosis?
Spasmodic
dysphonia
What AAC display would you recommend for a 6 year old child whose teacher wants the child to improve upon syntax and sentence formation?
semantic-syntactic grid display
Fitzgerald key
soup -> [tup]
fate -> [peɪt]
Farm -> [fɑɚm]
sun -> [sɅn]
What process is being used?
assimilation
Name one aphasia treatment to help improve word finding and make a goal
Semantic feature analysis
Verb network strengthening treatment (VNest)
What does research suggest about the benefits/risks of an oral diet versus a non-oral means of nutrition for this patient?
23 year old female singer had bilateral vocal folds surgically removed. She was referred to you for post-op voice therapy. What treatments would you use and why?
hygienic- eliminate or modify inappropriate behaviors
physiologic- VFE and RVT- strengthen and coordinate laryngeal musculature
Why is it important for children with HL to receive intervention as soon as possible?
0-3 years is most critical period of speech and language development. Inability to access sound will result in delays.