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COMD 4200 APHASIA and TBI EXAM

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COMD 4200 APHASIA and TBI EXAM

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COMD 4200 APHASIA and TBI EXAM
age matters - ANSWER-because atrophy naturally occurs in typically aging brains, the
age at which a person experiences brain damage may have implications for the level of
decline that he or she is already experiencing. However, other factors such as mental
and phyiscal status pre-insult are important to consider when setting goals, projecting
progress, and identifying treatment outcomes.

Aphasia - ANSWER-impairment of language, usually caused by left hemisphere
damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing
understanding).

constraint-induced therapy - ANSWER-restorative/linguistic approach

1. Massed practice (intenstive therapy over a relatively short period of consecutive
days, such as 30 hours of practice over a 2-week period)

2. Shaping by successive approximation (presenting tasks in small steps of gradually
increasing linguistic difficulty within natural communication contexts)

3. Constraint (restricition of the client's use of any compensatory/nonverbal
communication strategies)
--- gestures are allowed

fluent aphasia - ANSWER-lesion often in temporoparietal lobe of dominant hemisphere.
word output is functional. empty speech or jargon. speech lacks any substance. uses of
paraphasias (substitution of incorrect words)

Wernicke's area

Gestural Program: Amer-Ind - ANSWER-based on American Indian Hand Talk
Used with severely restricted verbal repertoires

Main Steps:
1. Use extensive imitation to establish comprehension and production of very common
and easily recognized (iconic) gestures such as head nods and shoulder shrugs.

2. Gradually fade imitation in favor of more spontaneous and communicatively
meaningful use of the signs

3. Begin to pair the signs with spoken words after mastery of several signs

4. Gradually shape the imitative nature of the client's response to spontaneous
production of the sign + word combination.

, Gestural Program: Visual Action Therapy (VAT) - ANSWER-3 level program that utilizes
objects, realistic line drawings of the objects, and action pictures depicting a figure
appropriately manipulating the objects.

for severaly impaired individuals

Gestures and Naming Therapy - ANSWER-Uses gestures and verbal modalities (or
written)

Heirarchy of treatment:
1. Recognition - individuals associating gestures and/or words with corresponding
pictures
2. Production - require the production of gestures/words corresponding to a picture
presented by the therapist.
3. Higher - require production targets that are not known by the clinician and the
clinician must identify

hemianopsia - ANSWER-blindness in half of the visual field of one or both eyes

hemiparesis - ANSWER-weakness on one side of the body

hemiplegia - ANSWER-paralysis of one side of the body

Intensity matters - ANSWER-It is important to note that it is possible for intervention to
be too intense and thus negatively impact the client's prgoress, especially early on in
the process. However, this principle provides evidence that the greater the intensity
(e.g., the number of trials), the great the long-term effect of the intervention. Treatment
schedules can be altered during the recovery process, starting off slowly in the acute
phase and increasing in intensity as the patient enters the chronic phase.

interference matters - ANSWER-there are several ways in which intervention and/or the
individual's actions may induce plasticity that does not have a positive effect on the
individual's recovery. For example, an individual may develop compensatory strategies
that are not as sophisticated or efficient as the original skill. Further, attempts to rewire
one skill may interfere with the neural networks underlying a different skill.

Life Participation Approach to Aphasia (LPAA) - ANSWER-The overriding philophosy of
this approach is to maximize the client's re-engagment in life and base all therapeutic
decision making on hte life concerns identified by clients and their families.

Melodic Intonation Therapy (MIT) - ANSWER-objective: " to stimulate recovery of
propositional speech skills of individuals who, despite relatively good auditory
comprehension, are severely nonfluent in their ability to communicate even through
single words

uses pitch, temp/rhythm, and stress to recruit participation of the right hemisphere

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