Test 1 (acquired language disorders)

What is clinical aphasiology?

A discipline that includes research intended to identify and explain aphasia and rehabilitation intended to help patients and their families tackle their challenges.

What are acquired neurogenic communication disorders?

Communication disorders caused by problems in the brain that occur after a person has previously acquired language.

What are the two major categories of acquired neurogenic communication disorders?

Acquired neurogenic cognitive-linguistic disorders and acquired neurogenic speech disorders.

What are acquired neurogenic cognitive-linguistic disorders?

A wide array of disorders of language caused by problems in the brain of a person who had previously acquired language; they can affect formulation, comprehension, and cognitive processing.

What are examples of acquired neurogenic cognitive-linguistic disorders?

Aphasia, dyslexia, dysgraphia, cognitive-linguistic disorders associated with TBI, language of generalized intellectual impairment, language of confusion, and right hemisphere syndrome.

What are acquired neurogenic speech disorders?

Disorders involving the motor aspects of speech, including apraxia of speech and dysarthria.

What is apraxia of speech?

A problem of motor programming for speech articulation.

What is dysarthria?

A problem involving the innervation and execution of movement of the speech mechanism for articulation.

What is the difference between apraxia of speech and dysarthria?

AOS is impaired motor programming for speech without a neuromuscular deficit, while dysarthria involves impaired execution/innervation of the muscles used for speaking.

What is a major difference between aphasia and AOS?

Aphasia is a language disorder, while AOS is a motor programming disorder for speech.

What is a major difference between aphasia and dysarthria?

Aphasia affects language, while dysarthria affects the motor execution of speech.

What is an agnosia?

An impairment in the ability to recognize a stimulus even though sensory transmission is intact.

What is visual agnosia?

A condition in which an object can be seen but is not recognized.

What is auditory agnosia?

A condition in which a familiar sound is heard but is not recognized.

What is tactile agnosia?

An inability to recognize an object by touch even though the person can sense characteristics such as pain, texture, and temperature.

What physical problems can occur with dysarthria?

Speech may be slowed or slurred, and the person may also have difficulty chewing or swallowing.

Does apraxia of speech necessarily cause chewing or swallowing problems?

No. A person with AOS may not have difficulty with chewing or swallowing because AOS is a motor programming problem for speech.

What is the most common problem associated with aphasia?

Word finding.

What is a multimodality deficit?

A language impairment that affects multiple communicative modalities, including speaking, writing, listening, reading, and naming.

Are all language modalities impaired equally in aphasia?

No. The modalities are not necessarily impaired equally.

How do people with aphasia typically perform across modalities?

They usually comprehend better than they talk or write, and reading and writing are often more impaired than auditory-speech skills.

What is expressive language?

Speaking and writing.

What is receptive language?

Listening and reading.

Does aphasia itself include sensory disorders?

No. Aphasia does not itself include hearing, vision, or touch disorders, although a person with a stroke may have sensory deficits in addition to aphasia.

What does it mean that aphasia is a central disorder?

The damage causing aphasia is located in the brain rather than in the peripheral/transmissive systems.

What does central vs. peripheral mean in aphasia?

Central refers to language processing in the brain; peripheral/transmissive functions involve sensory or motor systems that transmit or execute communication.

What does it mean that aphasic impairment is disproportionate to other intellectual functions?

Linguistic tasks may show significant impairment while nonverbal abilities, such as drawing or completing puzzles, are relatively stronger.

What disorders should aphasia be distinguished from?

Confusion, amnesia, nonverbal dysfunctions such as amusia or visuospatial problems, sensory disorders, motor speech disorders, and developmental language disorders.

What is an acquired disorder?

A disorder that begins after a substantial or completed period of normal development or previously acquired ability.

What is the key distinction between aphasia and developmental language disorder?

The key distinction is whether the developmental process was compromised, not simply the person's age when the diagnosis was made.

Why is aphasia in adults considered acquired?

Because it occurs after a substantial or completed period of normal language development.

Is developmental language disorder the same as aphasia?

No. Developmental language disorders such as SLI are not aphasia.

What is propositional language?

The creative formulation of words with specific and appropriate regard to the situation, such as the language used during normal conversation.

What are sub-propositional forms of language?

Routine or overlearned language behaviors such as counting, singing a familiar song, and producing routine greetings.

Why might a person with severe aphasia retain sub-propositional language?

Overlearned or automatic language may be relatively preserved even when propositional language is significantly impaired.

What is encoding?

The internal process of putting an idea or message into sounds or writing.

What is decoding?

The process of listening to or reading a message and determining its meaning.

What is cognition?

The collection of mental processes and activities used in perceiving, remembering, thinking, and understanding.

What is the mind-body problem in aphasiology?

The question of whether communication should be explained primarily through concrete neural processes in the brain or through mental/psychological processes.

What is a neural-process explanation?

An explanation that focuses on the concrete wiring and functioning of the brain involved in encoding and decoding messages.

What is a mental-process explanation?

An explanation that focuses on psychological or cognitive processes involved in encoding and decoding messages.

Why is a neurological explanation important in aphasiology?

The features and severity of neurogenic communication disorders depend partly on the location and magnitude of neurological damage.

Why is every case of brain damage different?

No two brains or pathologies are exactly the same, so the effects of neurological damage can differ across individuals.

What are two fundamental features of cognition?

Knowledge and process.

What is knowledge in cognitive theory?

Our relatively stable store of information, including knowledge of the world and knowledge of language.

What is process in cognitive theory?

The fleeting activity of the mind, such as problem solving and the mental response to a stimulus.

What is a mental representation?

The inner form of information represented in the mind.

What is memory?

The retention of information in the mind beyond the life of the external stimulus.

What is long-term memory?

A system in which knowledge is stored for longer periods of time.

What is episodic memory?

Memory for individually experienced events; also called autobiographical memory.

What is semantic memory?

Memory for common knowledge about the world.

What is procedural memory?

Memory for skills and how to perform them.

What is lexical memory?

Memory for words and information about words.

What can aphasia tell us about memory organization?

Aphasia provides evidence that words and world knowledge can be represented or stored differently.

What are the primary frameworks for conceptualizing aphasia?

Unidimensional, multidimensional, medical, cognitive neuropsychological, biopsychosocial, and social frameworks.

What is the unidimensional framework?

A framework that conceptualizes language as a single interconnected system.

What is the multidimensional framework?

A framework that recognizes different patterns or dimensions of aphasia and relationships between communication impairments and neurological damage.

What is the medical framework?

A framework emphasizing neurological cause, diagnosis, impairment, and medical aspects of aphasia.

What is the cognitive neuropsychological framework?

A framework that uses models of mental representation and information processing to understand where language processing may break down.

What is the biopsychosocial framework?

A framework that considers biological, psychological, social, activity, participation, and contextual factors together.

What is the social framework?

A framework emphasizing communication in real-life situations, relationships, participation, identity, and quality of life.

Why should clinicians understand multiple aphasia frameworks?

The excellent clinical aphasiologist appreciates multiple viewpoints and uses flexibility of interpretation depending on the clinical context.

How are aphasia frameworks relevant to other neurogenic language disorders?

They can also be applied to language disorders associated with TBI and neurodegenerative conditions.

What is an impairment-based approach?

An approach that focuses primarily on deficits at the level of body structure and function.

What is the difference between neuropathology, functional terms, and dysfunction?

Neuropathology refers to the cause, functional terms refer to functions such as language or memory, and dysfunction refers to the effect on the person, such as aphasia or amnesia.

What are examples of neuropathology?

Stroke, TBI, and Alzheimer's disease.

What are examples of functional terms?

Language, music, memory, and general intellect.

What are examples of dysfunction?

Aphasia, amusia, amnesia, and dementia.

What are the four core elements of a good definition of aphasia?

Aphasia is acquired, neurological, multimodal/affects reception and production, and involves language rather than being primarily a sensory, motor, psychiatric, or intellectual disorder.

What does it mean that aphasia is acquired?

It occurs after language has already been substantially or normally developed.

What does it mean that aphasia is neurological?

The underlying damage is associated with the brain.

What does it mean that aphasia is multimodal?

It can affect language across speaking, listening, reading, writing, and naming.

What does it mean that aphasia is a language disorder rather than a sensory, motor, psychiatric, or intellectual disorder?

The primary impairment is in the cognitive system responsible for comprehending and formulating language.

How does Hallowell define aphasia?

Aphasia is a selective impairment of the cognitive system specialized for comprehending and formulating language, leaving other cognitive capacities relatively intact.

How does Hallowell's definition differ from Darley's definition?

Hallowell's definition is more concise, omits etiology, and describes aphasia in cognitive terms as an impairment of the language processing system.

How should aphasia be explained to different audiences?

The clinician should be able to define aphasia clearly at different levels of sophistication for patients, family members, friends, caregivers, health professionals, and laypeople.

Why is flexibility important when conceptualizing aphasia?

Different frameworks provide different useful perspectives, so clinicians should select and combine viewpoints based on the individual and clinical context.

What is incidence?

The likely number of newly diagnosed cases per specified unit of time.

What is prevalence?

The proportion of a specified population that had or has the disorder at a particular time.

Why are incidence and prevalence data for acquired neurogenic language disorders questionable?

Health surveys may be substandard, information may be inaccurate, perceptions of disability vary, communication disabilities may be underestimated, and surveys rarely include communication-specific questions.

Where do aphasiologists work?

Hospitals, rehabilitation centers, skilled nursing facilities, long-term care facilities, continuing care retirement communities, home health agencies, private practice clinics, nonprofit communication disorders clinics, and aphasia centers.

Why is the career outlook for clinical aphasiologists strong?

There is a growing need for rehabilitation services because of the aging population, increased global life expectancy, and greater survival from stroke and brain injury.

What makes the field of neurogenic communication disorders “fantastic”?

Working with people and their life stories, creating positive change, advocacy and leadership, humor and fascination, professional networks, multicultural/multilingual/interdisciplinary work, lifelong learning, science and art, and rich career opportunities.

What is the WHO ICF?

A conceptual framework and system for consistently classifying health and health-related domains worldwide.

What does ICF stand for?

International Classification of Functioning, Disability, and Health.

Is the ICF a model?

No. Hallowell's slides describe the ICF as a conceptual framework rather than a model.

What does the ICF classify?

Health conditions and health-related functioning, not people.

What is the major purpose of the ICF?

To classify functional areas of health and disability in a consistent way while considering the person's life context.

What are the two major parts of the ICF?

Functioning and disability, and contextual factors.

What are body structures?

Anatomical parts of the body.

What are body functions?

Physiological and psychological functions of body systems.

What are activity and participation?

Activity refers to carrying out tasks or actions; participation refers to involvement in life situations.

What is capacity in the ICF?

What a person is able to do under standardized or supportive conditions.

What is performance in the ICF?

What a person actually does in their real-life environment.

What are contextual factors in the ICF?

Personal factors and environmental factors that influence functioning.

What are environmental factors?

External factors such as social support, communication partners, physical environments, and services that can facilitate or hinder functioning.

What are personal factors?

Characteristics of the individual that influence functioning, such as experiences, attitudes, motivation, and background.

How is the ICF relevant to ethics and human rights?

It recognizes health and well-being as broader than simply the absence of disease and supports the idea that all people have fundamental rights to health, participation, and access.

Why is communication important to human rights?

Communication is necessary for relationships, interpersonal interactions, domestic and community life, social participation, decision-making, and access to information.

What did the older WHO 1980 ICIDH include?

Impairment, disability, and handicap.