Aphasia Exam 2 – Non-Fluent Aphasia Tx – Flashcards

term 1

term 2

- Non-Fluent = halting verbal output - Incomplete ; syntactically simplified sentences - Reduced phrase length - Aud. Comp relatively intact

Adequate for everyday functioning - Difficulty comprehending complex non canonical sentences. (passive, object relative) *the girl caught the cat that the dog chased

- Aphasia batteries - Supplemental *word finding, analysis of productive lang., aud. comp. - Motor speech exam *AOS or Dysarthria

Discourse Level - nicholas ; brookshire - saffran - LARSP

The Northwest Assessment of Verbs ; Sentences

RET Modified version of RET CAAST MIT SPPA Mapping Therapy TUF --> Complexity account of Tx efficacy Gestural --> Ameri-Ind Code PACE Script Training

Purpose: to increase the length and information content of verbal responses. Rationale: overly structured treatment may inhibit a patient from using language creatively.

Picture Verbs Personal Recount - "tell me something you did yesterday" - no picture stimuli Procedures (tell me how you do the laundry)

- More empirical support than most aphasia tx - Used with diff. types of aphasia - Generalization across stimuli varies & data is limited

1. Present picture stimuli & elicit a response 2. Repeat patients production & reinforce 3. Ask a question to elicit an elaboration of the original response 4. Repeat & reinforce the new production; model combined productions (1+3) 5. Model combined productions & request a repetition 6. Reinforce repetition & model again

1. Present picture stimuli & elicit a response - model 2 response options (NP or VP) - model a 1-word response (request repetition) - use integral stimulation 2. Repeat patient's production ; reinforce 3. Ask a question to elicit an elaboration of the original response - model 2 word response options (NP or VP) - model a 1-word response (request repetition) - use integral stimulation 4. Repeat ; reinforce the new production; model combined productions (1+3) 5. Model combined production ; request a repetition - if correct - 3 more productions - if incorrect - use integral stimulation to elicit multiple productions 6. Remove picture for 5 seconds - request repetition of description - if correct - reinforce - if incorrect or partial response - model and use integral stimulation to elicit response

RET ; Semantic feature treatment = are only ones with generalization (what caroline says) All these tests and studies have good gains or we wouldn't use them for therapy. Its not the question as to whether or not they generalize

Purpose: Designed to simultaneously treat aphasia & apraxia of speech *Takes modified RET & pairs it w/ sound production treatment *Sound production treatment (SPT) targets articulatory/speech sound errors due to AOS - lots of research (developed by Wambaugh)

Doer Action Theme Other

1. SLP provides a verbal model of target word & requests repetition 2. SLP indicates the letters representing the target sound, requests participant attend to that sound, SLP provides another model & requests repetition 3. SLP says "watch me, listen to me, say it with me" and attempts simultaneous production for max of 3 times. 4. SLP provides articulatory placements cues appropriate to the sound production error & repeats production used in previous step 5. SLP presents next item Example - Target word is "Spider" - patient says "pider" --> you move into the steps

- CIU gains - some generalization - speech production gains

Purpose: Hierarchically organized treatment program designed to facilitate verbal language production with severe non-fluent patients through use of musical "INTONING" and HANDTAPPING Rationale: - R hemi capabilities may be drawn upon - PWA may be able to sing melodies/words of songs when incapable of speech Objective: - promote some recovery of language use - emphasis on semantic aspects of verbal utterances - syntax & articulation are secondary aspects

- instructor manual - DVD - 60 action picture cards - 100 forms sheets - $110

Good: - Non-fluent or severely restricted verbal output - relatively good aud. comp. - poor repetition - poor articulation ability - lesion in the L hemi Poor: Patients with: Wernickes, TCM, TCS, Global or Conduction aphasia

Stimuli: - on individuals basis - meaningful, high-prioprity utterances - lots of utterances to "rotate" - nothing too complex

One item is carried through as many of the 5 steps as possible before next item is introduced 1. humming - SLP hums melody w/ handtapping 2. unison singing - and tapping 3. unison with fading - 1/2 thru SLP fades out 4. immediate repetition - SLP intones & taps / patient does the same 5. response to a question - SLP intones question / patient responds with tap when criteria is met advance to intermediate

1. introducing the item 2. unison with fading 3. delayed repetition 4. response to a question when criteria is met advance to advanced

1. delayed response 2. introducing Sprechgesang - no sing, exaggerated stress & rhythm 3. Sprechgesang with fading 4. delayed spoken repetition 5. response to a question

Very popular / Most studied treatment Studies have looked at pre & post tx rather than verbal lang. output - meaning not much info about language generalization (not much gain) - ultimately, there is lots of repetition *melodic aspect or just repetition??

Purpose: To facilitate retrieval of specific grammatical constructions through systematic stimulation - target 8 SENTENCE TYPES arranged in a hierarchy of levels of difficulty

- Imperative intransitive - Imperative transitive - WH interrogative-what/who - WH interrogative-where/when - Declarative intransitive - Declarative transitive - Comparative - Yes-No question