Citations
Cite the Cookie Theft Picture
The Cookie Theft Picture from the Boston Diagnostic Aphasia Exam; Goodglass, Kaplan, & Barresi, 2001
Name prognostic indicators for aphasia
Age at onset, handedness, gender, IQ and ed level, language/s, personality, social and personal history, location of damage, extent of damage, etiology (eg., ischemic vs hemorrhagic stroke)
12 possible symptoms (or comorbid symptoms) of aphasia
1. anomia 2. circumlocutions 3. paraphasias 4. agrammatism 5. jargon 6. stereotypies 7. perseveration 8. paragraphias 9. apraxia 10. dysarthria 11. alexia/dyslexia 12 auditory agnosia
Describe PACE
1. PWA and partner exchange information
2. Each are equal partners
3. PWA has choice of modes of cmc - e.g., verbal, written, drawing, gesture
4. Partner provides feedback about success in communicating the message
What are confirmatory signs for flaccid dysarthria?
conf signs: atrophy, fasciculations, diminished or absent normal reflexes
Possible perceptual features: breathiness, hyper or hyponasality, audible inspiration, short phrases, monoloudness, monopitch, harsh voice
Cite the Life Interest & Value cards
Haley et al., 2010
What are four categories for Life Interest and Value Cards for goal setting?
Home and community
Creative and relaxing
Physical
Social
Name 3 types of perseveration
Stuck in set, recurrent, continuous
Describe script training
Create custom scripts for key daily routines
What are neuromuscular features, confirmatory signs, and distinct speech features of spastic dysarthria?
Neuromuscular: Spasticity, weakness, slowness, reduced range of motion
Distinctive speech features: slow rate, strained/strangled voice, slow and regular AMRs
Confirmatory signs: Hyperactive gag reflex, presence of abnormal reflexes, dysphagia, drooling, emotional lability
What are the components of a dysphagia interview?
Medical stability, respiratory status, mental status, are they NPO?, current reason for admission & for seeing you, medical history, physical exam, interview, maybe a QoL scale, oral care, bedside eval
What might be the appropriate treatment for severe dysphagia?
Possibly NPO
Name 3 types of paraphasias
Phonemic
Verbal
Semantic (a subtype of verbal)
Describe Motor Learning Guided treatment
practice a model with fading support and pauses between productions
What are neuromuscular features and speech features of ataxic dysarthria?
Neuromuscular: reduced tone (pendulousness, slowness of movement - starting, stopping, reaching target, irregular timing of movement, inaccurate direction of movement
Speech: irregular articulatory breakdowns, distorted vowels, excess and equal stress, irregular speech AMRs
Possible treatment - rigid rate control
What might be the appropriate treatment for mild dysphagia?
Slight change in diet
Cite Health Literacy: The Cornerstone of Patient Safety and describe some recommendations
Rao, 2007
1. Slow down 2. Use plain language 3. Use visuals 4. Limit the amount of information and repeat info 5. Use the teach back or show me methods 6. Create a shame free environment
Describe Treatment for Wernicke's Aphasia
Have client select a photo from 6 choices. If incorrect, take them through a hierarchy of reading comprehension, oral reading, oral repetition, auditory comprehension
What are the components of a motor speech exam?
1. History 2. Oral mech exam 3. Cranial nerve exam 4. Speech/voice production eval 5. Stress testing (if indicated) 6. Motor speech planning and programming - automatic vs voluntary speech tasks, and progressively more complex speech tasks
What are speech features of hypokinetic dysarthria?
Rushes of speech separated by pauses, monopitch and monoloudness, increasing rate, diminished stress pattern, harsh and breathy speech
Possible treatment - LVST for Parkinson's
What might be the appropriate treatment for moderate dysphagia?
Use of dysphagia techniques, diet modification, maybe supplemental nutrition
Name 3 types of jargon
Neologistic, semantic, phonemic
Describe Semantic Feature Analysis
to build confrontation naming skills for nouns -
Choose a noun, describe by group, use, action, association, location, and properties
What are some key features and possible treatments of apraxia
Impaired ability to plan or program sensory-motor commands: groping of articulators, difficulties initiating, vowel distortions, inconsistent errors, decreased accuracy as speech increases, false starts and restarts, attempts at self correction, disturbed prosody.
Treatment options include: integral stimulation, melodic intonation therapy, motor guided learning
What are features of hyperkinetic dysarthria?
Choreiform: prolonged silences, variable rate and variable stress
Dystonia: voice stoppages, inappropriate silences, strained/strangled voice, variable loudness and rate
possible treatment - breath control, easy onsets