2026/2027
Case history is vital to - ANS ✔✔diagnosis, assessment & treatment planning
. Areas in which information should be obtained in Case hx include - ANS ✔✔medical history,
education, vocation, leisure activities, family dynamics, prior level of function (important for
reimbursement), primary language & other languages spoken, & use of sensory aids, such as
glasses, hearing aids, or dentures.
Medical history information includes - ANS ✔✔date of onset (i.e., CVA, fall, accident, etc.)
onset date is very important . Why? - ANS ✔✔most do not benefit much after period of optimal
recovery has passed, which is usually between 1-9 months post incident. However, recovery
times vary from individual to individual & some reports of pts benefiting well after a year post.
Neuroimaging test results - ANS ✔✔should be reviewed to determine where lesion occurred &
useful to determine areas of deficit before PWA is evaluated bc aids in assessment planning
previous medical diagnoses and history is also useful. Why? - ANS ✔✔to determine any
contributing factors to language impairment
Education plays a role. Why? - ANS ✔✔more educated PWA is, higher likelihood of more
focalized language function; if lesion occupies this area, PWA's chance of recovery is reduced.
Vocation is also an important factor - ANS ✔✔those with more language-involved professions
may not be able to return to work following incident.
Area of leisure - ANS ✔✔For someone who is retired, this may become a huge area to focus on
in therapy.
,Family dynamics can also play a part - ANS ✔✔PWA will need active support system to help
with new challenges may now face. Important to determine if pt can still live alone or will need
some sort of daily or even round clock care, which many times comes from family members.
prior level of function - ANS ✔✔not a decline from previous level of function, many times, third
party payors will not reimburse for therapy as there is really no true goal
primary language is important to consider - ANS ✔✔it can have implications for treatment.
use of sensory aids should also be considered - ANS ✔✔may be very difficult for the patient to
see without glasses or to hear without hearing aids.
Behavioral observations should be made when interacting with the PWA. Why? - ANS ✔✔to
assess areas: level of alertness (LOA), response to testing, lability, level of awareness of the
deficits, perseveration, off-task behavior, and any behavior, which may affect testing results.
LOA is central to evaluation results and treatment implications. - ANS ✔✔If a PWA is not
responsive, true evaluation of language and cognitive abilities cannot be assessed, and the
patient may not be able to participate in therapy.
Lability - ANS ✔✔interfere with tx as it can be a definite behavioral hurdle to overcome as much
therapy time is wasted managing the emotional disturbance
LOA deficits - ANS ✔✔pts who are unaware of issues they face are less motivated to participate
in tx regimen
Behavior affecting test results - ANS ✔✔maybe memory, attention, neglect, etc.
, cognition areas to assess - ANS ✔✔attention, memory, orientation, impulsivity, & problem-
solving abilities (usually non-verbal).
Attention - ANS ✔✔several different forms, which include sustained, selective, divided, and
alternating.
Individuals cannot maintain a conversation without attentional focus.
Sustained attention - ANS ✔✔ability to focus on specific task for continuous amount of time
w/o becoming distracted; e.g. studying for exam, balancing checkbook or cooking meal.
Selective attention - ANS ✔✔ability to select from variety of stimuli & focus only on the 1 that is
desired. Example focus on conversation with friend/spouse/etc. at dinner in crowded restaurant
compared to all other activity.
Divided attention - ANS ✔✔ability to process 2 or more tasks/stimuli/demands at same time.
Example of divided attention is talking on the phone while also surfing the web or watching
television.
Alternating attention - ANS ✔✔used when alternating between 2 activities, such as reading a
recipe & cooking a meal
Atkinson-Shiffrin model of memory - ANS ✔✔most popular model for studying memory
Memory - ANS ✔✔contributing factor to language function.
many types: short-term memory (STM), Working memory (WM), sensory memory, long-term
memory,
Sensory memory - ANS ✔✔very short in duration and deals with the amount of time to
experience a sensory stimulus. It is either transferred to short term memory or eliminated.