APHASIA FINAL EXAM QUESTIONS AND ANSWERS | APHASIA FINAL STUDY
GUIDE 2026/2027
Cognitive symptoms - ANS ✔✔Growing evidence of cognitive impairments in aphasia (e.g.,
Baldo et al., 2015; Murray, 2012; 2017). • Even patients with mild stroke can have cognitive
impairments (Hommel et al., 2009). • Overlap of neural structures underlying cognition and
language. • Lesions that commonly result in aphasia can produce non-linguistic cognitive
deficits. • Can expect to see difficulties in one or more domains of non-linguistic cognition. •
Common cognitive problems seen in patients with aphasia: attention, memory, and EF. • Can
exaggerate language problems and impede aphasia recovery. M
attention problems - ANS ✔✔Varying degrees of attentional impairment in persons with
aphasia. • None, some, or all domains of attention may be affected. • Compared to individuals
without brain damage, people with aphasia may be less accurate and slower on attention tasks
evaluating (one or a combination of different types may be affected): • Sustained attention,
attention switching, focused attention, divided attention • May be easily distracted or be
impacted by noise or other distractors, problems with resource allocation. • These difficulties
might be seen in different modalities. • Can further impair language functions (e.g., auditory
comprehension, reading)
Neglect can also be seen in people with aphasia • Commonly associated with RH damage •
Approximately 15-65% of individuals with LH injury show right sided neglect. • Impaired
attention/inattention to information presented to the right side of the body. • Commonly seen
examples of neglect: • Not eating food on the right side of the plate • Failing to attend to
sounds presented to the right ear • Omitting words on the right side of a sentence, paragraph,
or page • Reading errors: television for telephone - *maybe the only sign of neglect
memory problems - ANS ✔✔Different aspects of memory may be vulnerable in aphasia. •
Damage in the frontal, temporal, and parietal regions • Short term and working memory
problems - more commonly seen in this population. • Particular problems with tasks that
involve short term/temporary storage and subsequent recall of verbal or visuospatial
information. • Reduced retention span could lead to language comprehension and production
deficits • Some people with aphasia might show long term memory issues • Retrieving verbal or
,visual information from long term memory might be problematic. • Maybe more common in
patients with anterior lesions. • Not much research in this area - findings remain inconclusive. •
Clinical evidence suggest problems in this area.
EF problems - ANS ✔✔Most common symptom after acute stroke • A variety of EF skills may be
compromised in persons with aphasia • Planning • Problem solving and reasoning •
Organization • Inhibition • Cognitive flexibility • Self monitoring - anosognosia • Discordant
findings regarding whether differences are seen based on aphasia type and severity. • May not
occur in all individuals with aphasia. • Associated with poorer language recovery, difficulty
learning compensatory strategies. • Can be a strength or weakness to these individuals.
psychosocial issues - ANS ✔✔• Interference with language can have significant consequences
on an individuals and their interpersonal relations. • Dealing with loss of communication skills
involves a series of stages
WHO ICF Model - ANS ✔✔
assessment - ANS ✔✔"An organized evaluation of a patient's cognitive-linguistic functioning
abilities and multiple influential factors."
purpose of the assessment - ANS ✔✔Quantifying and qualifying cognition and communication
strengths and weaknesses Identifying the presence and possible influence of concomitant
conditions Establishing treatment goals Providing informational basis for predicting treatment
outcomes and recovery.
setting assessment - ANS ✔✔Acute care: immediate physical survival, basic communication
needs, provide info to caregivers
Subacute- rehab, outpatient, long term care: comprehensive evaluations, detailed information
about impairments
,ICF model - ANS ✔✔Body structure and function: describe nature and severity of patients
impairments, evaluate specific cognitive linguistic skills, impairment based assessment-
language specific
Activity and participation: evaluate patients ability to interact with family friends and social
situations, caregiver perception, consider impact on activity and participation outcomes, ALA
FACS, important to address these levels in long term care
Lesion location - ANS ✔✔Left hemisphere: determine type and severity of aphasia,
understanding and production of language word, sentence or discourse.
Patient premorbid abilities: education, work background, number of languages, most frequently
used languages, personality and social profile
Clinicians role in the team: sometimes it is not appropriate for SLPs to assess using cognitive
skills using certain cognitive tests
other assessment factors - ANS ✔✔Clinician's role in the healthcare team • Collaboration is
important • Role may vary with work setting or individual cases • Sometimes it is not
appropriate for SLPs to assess cognitive skills using certain cognitive tests. • Must *always* try
to include patients and family members/caregivers in the assessment process • Assessment
should be driven by patient needs • Appropriate referrals • Many conditions may go undetected
(e.g., mild aphasia, EF problems) when patients are hospitalized. • Therapeutic nihilism may
negatively impact referrals (often occurs with progressive diseases).
soruces of information about the patient - ANS ✔✔+ Patient referral (consultation requests) •
Often by professionals in medical or care team • Patient demographics • Medical diagnosis •
Services needed
+ Medical records • Legal document that contains all information about the patient's medical
care • Patient ID, personal history, medical history • Physical and neurological exam reports •
Doctor's orders • Progress notes • Lab reports (e.g., CT scan, MRI, EEG findings)
Important to take time and review patient information and medical records • Provides clinicians
with more information about patient • Medical and neurological history • Potential speech and
, cognitive-communication impairments • Behavioral and emotional state • Guides assessment
and treatment plans
neurologic examination - ANS ✔✔Most completed completed by the physician + Systematic
evaluation of the functions of the nervous system + Done to determine type, location, and
neurological impact of brain injury
Cranial nerve exam UBC Cranial Nerve Exam Demonstration + Motor and sensory function •
Tone (spasticity, rigidity, or flaccidity) • Bulk (wastage or hypertrophy) • Strength (paralysis) •
Coordination - cerebellar involvement • Involuntary movements, tremors, chorea - BG
involvement • Problems with touch, pain, temperature - probable thalamic damage • Reflexes
(Babinski sign, gagging, swallowing, corneal reflex)
Consciousness, mental status, higher cognitive functions • Confusion, lethargy, comatose,
syncope, amnesia, seizures • Orientation - to person, place, time (oriented X 3) • Emotional
response (stable, variable, apathy) • General behavior + Common standardized screenings -
MMSE, MoCA, SLUMS + Advice against using MMSE with PWA - increased language demands -
overestimates cognitive deficits (Golper et al., 1987; Osher et al., 200
spontaneous recovery - ANS ✔✔Acute stages + Early period after onset of brain injury/aphasia
+ Patients show some remission of their language dysfunction without any active
intervention/formal therapy *advisable not to do formal assessment until patient becomes
neurologically stable
Diaschisis • Temporary damage - local edema, suppression of blood flow, reduced metabolic
activity (can happen in both hemispheres) • Structurally undamaged portions of the brain
regain functions
Collateral Sprouting • When an axon is damaged the next neuron in the chain may sprout new
axons or dendrites • Increase in chemicals associated with axonal growth in areas around infarct
and contralateral side
GUIDE 2026/2027
Cognitive symptoms - ANS ✔✔Growing evidence of cognitive impairments in aphasia (e.g.,
Baldo et al., 2015; Murray, 2012; 2017). • Even patients with mild stroke can have cognitive
impairments (Hommel et al., 2009). • Overlap of neural structures underlying cognition and
language. • Lesions that commonly result in aphasia can produce non-linguistic cognitive
deficits. • Can expect to see difficulties in one or more domains of non-linguistic cognition. •
Common cognitive problems seen in patients with aphasia: attention, memory, and EF. • Can
exaggerate language problems and impede aphasia recovery. M
attention problems - ANS ✔✔Varying degrees of attentional impairment in persons with
aphasia. • None, some, or all domains of attention may be affected. • Compared to individuals
without brain damage, people with aphasia may be less accurate and slower on attention tasks
evaluating (one or a combination of different types may be affected): • Sustained attention,
attention switching, focused attention, divided attention • May be easily distracted or be
impacted by noise or other distractors, problems with resource allocation. • These difficulties
might be seen in different modalities. • Can further impair language functions (e.g., auditory
comprehension, reading)
Neglect can also be seen in people with aphasia • Commonly associated with RH damage •
Approximately 15-65% of individuals with LH injury show right sided neglect. • Impaired
attention/inattention to information presented to the right side of the body. • Commonly seen
examples of neglect: • Not eating food on the right side of the plate • Failing to attend to
sounds presented to the right ear • Omitting words on the right side of a sentence, paragraph,
or page • Reading errors: television for telephone - *maybe the only sign of neglect
memory problems - ANS ✔✔Different aspects of memory may be vulnerable in aphasia. •
Damage in the frontal, temporal, and parietal regions • Short term and working memory
problems - more commonly seen in this population. • Particular problems with tasks that
involve short term/temporary storage and subsequent recall of verbal or visuospatial
information. • Reduced retention span could lead to language comprehension and production
deficits • Some people with aphasia might show long term memory issues • Retrieving verbal or
,visual information from long term memory might be problematic. • Maybe more common in
patients with anterior lesions. • Not much research in this area - findings remain inconclusive. •
Clinical evidence suggest problems in this area.
EF problems - ANS ✔✔Most common symptom after acute stroke • A variety of EF skills may be
compromised in persons with aphasia • Planning • Problem solving and reasoning •
Organization • Inhibition • Cognitive flexibility • Self monitoring - anosognosia • Discordant
findings regarding whether differences are seen based on aphasia type and severity. • May not
occur in all individuals with aphasia. • Associated with poorer language recovery, difficulty
learning compensatory strategies. • Can be a strength or weakness to these individuals.
psychosocial issues - ANS ✔✔• Interference with language can have significant consequences
on an individuals and their interpersonal relations. • Dealing with loss of communication skills
involves a series of stages
WHO ICF Model - ANS ✔✔
assessment - ANS ✔✔"An organized evaluation of a patient's cognitive-linguistic functioning
abilities and multiple influential factors."
purpose of the assessment - ANS ✔✔Quantifying and qualifying cognition and communication
strengths and weaknesses Identifying the presence and possible influence of concomitant
conditions Establishing treatment goals Providing informational basis for predicting treatment
outcomes and recovery.
setting assessment - ANS ✔✔Acute care: immediate physical survival, basic communication
needs, provide info to caregivers
Subacute- rehab, outpatient, long term care: comprehensive evaluations, detailed information
about impairments
,ICF model - ANS ✔✔Body structure and function: describe nature and severity of patients
impairments, evaluate specific cognitive linguistic skills, impairment based assessment-
language specific
Activity and participation: evaluate patients ability to interact with family friends and social
situations, caregiver perception, consider impact on activity and participation outcomes, ALA
FACS, important to address these levels in long term care
Lesion location - ANS ✔✔Left hemisphere: determine type and severity of aphasia,
understanding and production of language word, sentence or discourse.
Patient premorbid abilities: education, work background, number of languages, most frequently
used languages, personality and social profile
Clinicians role in the team: sometimes it is not appropriate for SLPs to assess using cognitive
skills using certain cognitive tests
other assessment factors - ANS ✔✔Clinician's role in the healthcare team • Collaboration is
important • Role may vary with work setting or individual cases • Sometimes it is not
appropriate for SLPs to assess cognitive skills using certain cognitive tests. • Must *always* try
to include patients and family members/caregivers in the assessment process • Assessment
should be driven by patient needs • Appropriate referrals • Many conditions may go undetected
(e.g., mild aphasia, EF problems) when patients are hospitalized. • Therapeutic nihilism may
negatively impact referrals (often occurs with progressive diseases).
soruces of information about the patient - ANS ✔✔+ Patient referral (consultation requests) •
Often by professionals in medical or care team • Patient demographics • Medical diagnosis •
Services needed
+ Medical records • Legal document that contains all information about the patient's medical
care • Patient ID, personal history, medical history • Physical and neurological exam reports •
Doctor's orders • Progress notes • Lab reports (e.g., CT scan, MRI, EEG findings)
Important to take time and review patient information and medical records • Provides clinicians
with more information about patient • Medical and neurological history • Potential speech and
, cognitive-communication impairments • Behavioral and emotional state • Guides assessment
and treatment plans
neurologic examination - ANS ✔✔Most completed completed by the physician + Systematic
evaluation of the functions of the nervous system + Done to determine type, location, and
neurological impact of brain injury
Cranial nerve exam UBC Cranial Nerve Exam Demonstration + Motor and sensory function •
Tone (spasticity, rigidity, or flaccidity) • Bulk (wastage or hypertrophy) • Strength (paralysis) •
Coordination - cerebellar involvement • Involuntary movements, tremors, chorea - BG
involvement • Problems with touch, pain, temperature - probable thalamic damage • Reflexes
(Babinski sign, gagging, swallowing, corneal reflex)
Consciousness, mental status, higher cognitive functions • Confusion, lethargy, comatose,
syncope, amnesia, seizures • Orientation - to person, place, time (oriented X 3) • Emotional
response (stable, variable, apathy) • General behavior + Common standardized screenings -
MMSE, MoCA, SLUMS + Advice against using MMSE with PWA - increased language demands -
overestimates cognitive deficits (Golper et al., 1987; Osher et al., 200
spontaneous recovery - ANS ✔✔Acute stages + Early period after onset of brain injury/aphasia
+ Patients show some remission of their language dysfunction without any active
intervention/formal therapy *advisable not to do formal assessment until patient becomes
neurologically stable
Diaschisis • Temporary damage - local edema, suppression of blood flow, reduced metabolic
activity (can happen in both hemispheres) • Structurally undamaged portions of the brain
regain functions
Collateral Sprouting • When an axon is damaged the next neuron in the chain may sprout new
axons or dendrites • Increase in chemicals associated with axonal growth in areas around infarct
and contralateral side
