Studied by 96 people
Aphasia
Language disorder characterized by the breakdown in the ability to formulate, retrieve, or decode language
Pointing
Most users of communication boards indicate their selection by _________
Hypokinetic Dysarthria
A breathy, monopitch voice would most likely be found in an individual with ________
Dyskinesia
Uncoordinated movement
Audiology
Involved in:
The prevention, identification, and evaluation of hearing disorders
The selection of appropriate hearing aids for individuals with hearing impairments
Habilitation & rehabilitation of hearing loss
Stroke
Most common cause of aphasia
Language
What type of disorder is aphasia?
Aphasia difficulties
Speak in short or incomplete sentences.
Speak in sentences that don't make sense.
Substitute one word for another or one sound for another.
Speak unrecognizable words.
Have difficulty finding words.
Not understand other people's conversation.
Not understand what they read.
Aphasia problem categories
Spoken language
Written language
Physical / sensory functions
Cognitive changes
Anomia
Difficulty in naming things, objects, or people
Word finding difficulty
Patient will often “talk around” the missing word
I.e. circumlocution
May perseverate on incorrect word even though they know it’s not the right one
Paraphasia
Word substitution
Phonemic or semantic
Phonemic paraphasia
Substituted word sounds like correct word
Semantic paraphasia
Substituted word has similar meaning or is associated to correct word
Neologism
The use of words that don’t exist
Agrammatism
a pattern of syntactically defective speech
Hemiplegia
Paralysis on one side of the body
Contralateral
affected side of the body is opposite the side of the brain
Hemiparesis
Weakness or incomplete paralysis on one side of the body
Wernicke’s aphasia
Fluent aphasia
Primary feature: Disturbed auditory comprehension
Speech comprehension: Poor
Spoken characteristics: Semantic paraphasis, jargon, poor repetition, impaired naming, meaning sentences are usually grammatical but often lack content
Broca’s aphasia
Non-fluent
Primary feature: Impairment in expression
Speech comprehension: Relatively poor
Spoken characteristics: Short & a-grammatical sentences, slow & labored speech with articulation and phonological errors, poor repetition, poor naming
Global
Fluent
Primary feature: Fluent & confluent features present to a severe degree
Speech comprehension: Very poor
Spoken characteristics: Limited to a few spontaneous productions. Few words or stereotypes, poor repetition, poor naming
Fluent aphasia characteristics
Relatively normal:
Prosody
Pitch
Loudness
Non-fluent aphasia characteristics
Limited speech production
Poor repetition & naming
Effortful speech
Global aphasia
Most severe aphasia type
Aphasia recovery
Recovery depends on the amount & location of brain damage
Recovery focuses on functional communication solutions
Significant recovery can occur
Recovery process begins within days of stroke
Assisted recovery included a rehabilitation team of SLPs, PTs, OTs, etc.
Treating aphasia tactics
Looking for strategies that exploit strengths and minimize deficits
SLPs, PTs, OTs, etc.
2/3
What proportion of TBIs are caused by motor vehicle accidents?
No - nonfocal
Is brain damage with TBI usually located in one small area?
Anywhere
Where can brain damage occur?
Coup
Injury due to impact, moving object hits stationary head
Contracoup
Injury on the side opposite to the impact, moving head hits stationary object
Yes
Do TBIs often result in a coma?
Impulsive
Individuals with TBI frequently exhibit ________ behaviors
General TBI Impairments
Voice & swallowing
Speech & language problems
Cognitive problems
Reading & writing
Behavioral & emotional
Problems associated with TBI
Cognitive:
Orientation
Short & long term memory
Difficulty maintaining attention & concentration
Reasoning and problem solving
Speech and language:
Dystharia
Language impairment (aphasia)
Anomia & impaired comprehension
Problems with pragmatics
Disinhibition: inability to stop certain inappropriate behaviors
Behavioral/emotional:
Mood swings
Anxiety
Depression
Lack of motivation
Inability to self monitor (denial)
Impulsivity
Difficulty with emotions
Control and anger management
TBI Areas for SLPs
Orientation
Memory
Listening comprehension
Speech intelligibility
Pragmatics
Reasoning & problem solving
Cognitive rehab
Treatment regimen designed to increase functional abilities for everyday life by improving the capacity to process incoming information
Cognitive rehab professionals
SLPs, OTs, PTs, etc.
Restorative approach
Repetitive activities to rebuild neural circuity
E.g. classification tasks, word associations rehearsal, memory aids
Compensatory approach
Develop alternatives, since some functions will not be recovered
Early recovery
Beginning responses to environment in hospital - stabilization is the overriding goal
Middle recovery
Goal is to reduce confusion & improve memory / goal - directed behavior
Late recovery
Goal is client independence
Dysarthria
A motor speech disorder due to paralysis, weakness, or poor coordination of speech muscles
Apraxia
When you have ______ of speech, the messages do not get through correctly due to brain damage. You might not be able to move your lips or tongue the right way to say sounds. Sometimes, you might not be able to speak at all.
No
Is cerebral palsy a disease?
Cerebral palsy
Can be the result of brain injury in fetal or infant development
Spastic CP
Type of CP characterized by rigidity and reflex problems
Athetoid CP
Type of CP characterized by writhing movements
Ataxic CP
Type of CP characterized by uncoordinated movements
Flaccid dysarthria voice
Breathy, mono pitch
Spastic dysarthria voice
Harsh, strained
Who benefits from AAC
Anyone who’s communication needs are not being met via speech alone. About 3.5 million Americans have communication disabilities and require AAC, with the prevalence rising
Types of disabilities that benefit from AAC
Individuals with congenital and acquired disabilities. Also helps anyone temporarily unable to speak
Unaided systems
Do not require any equipment, involve only the person’s body
Signs, gestures, facial expressions
Aided systems
Require some external equipment
Low / light tech: picture board, alphabet board
High tech: computer based devices with voice output
Direct selection
In ________, the individual directly selects the desired symbol
Ex: Pointing with a finger or body part, using a head pointer, eye gaze
Scanning
Items are “highlighted” and the communicator signals to select desired item
Habilitation
Born with hearing loss
Rehabilitation
Acquired hearing loss
Audiologist work settings
private practice settings
Hospitals
rehabilitation centers
Schools
Classroom acoustics a big focus right now
Kids don’t have processing ability to screen out extraneous noise the way adults do
hearing aid companies
Industry
E.g., hearing conservation programs ( such as coal mines)
Audiologist
An expert in hearing & hearing disorders
Sound
Vibrations traveling through a medium (such as air or water) that are audible
Vibration (sound wave)
Sound is caused by _______
Frequency
Physical characteristic, The vibrations / cycles per second
Hertz (Hz)
How is frequency measured?
Pitch
The perceptual correlate of frequency, can be heard
Frequency, pitches
When the ______ changes, we hear different ________
Increase
Increase frequency = _______ pitch
Pure tone
A tone of a single frequency
Complex tone
A tone containing two or more different frequencies, most everyday sounds
Periodic sound
A pattern that repeats itself at regular intervals, relative to sound
Aperiodic sound
A sound with no repetitive pattern
Amplitude
The extent of the molecules displaced during vibration
Loudness
The perceptual correlate of amplitude
Amplitude, loudness
_______ is determined by the physical characteristic of intensity. The higher the intensity / ________, the greater the loudness
Decibel (dB)
Measurement of sound pressure
50 - 70 dB
The intensity (loudness) of a typical conversation
Outer, middle, inner
3 main divisions of the ear
Pinna
In outer ear
Helps funnel sound to the ear canal and localize sound
Ear canal
Starts at outer ear and ends in eardrum
Increases the intensity of sound waves by concentrating them in a smaller area
Stores ear wax (cerumen) to help keep the ear canal clean
Tympanic membrane
Also known as the eardrum
Located in the middle ear space
Is a cone shaped structure of tissue that concentrates sound at its center
Sound waves hit the _________ __________, causing it to vibrate
Middle ear space
Lined with mucus membrane and filled with air, connect to Eustachian tube
Otitis media is an infection of the middle ear caused by inflammation, usually from a cold
Eustachian tube
Passageway for air to move in and out of middle ear
Connects the middle ear to the nasopharynx
Equalizes pressure in the ear
Ossicles
3 small bones in the middle ear
Smallest bones in the human body
Connect the eardrum to the inner ear and amplify the vibration of the eardrum
Ossicles bone names
Malleus (hammer), Incus (anvil), stapes (stirrup)
Ossicles function
Connect the eardrum to the inner ear and amplify the vibration of the eardrum
Semicircular canals
Inner ear, part of the vestibular system
Help the body maintain balance
Cochlea
Primary inner ear structure
Shaped like a snail
Base
High frequency sounds stimulated at the ______
Tip
Low frequency sounds stimulated at the ______
Electrical
Mechanical impulses are converted to ________ impulses
Auditory nerve
Cranial nerve
Carries electrical impulses from the cochlea to the brain
The primary auditory area in the temporal lobe
Audiometer
an instrument used to measure hearing
Air conduction
using headphones; sound travels through outer, middle, and inner ear
Bone conduction
Bone oscillator on skull behind ear
The bones of the skull vibrate and stimulate the fluids in the cochlea
Assesses cochlear function because it bypasses the inner and outer ear
Speech Reception Threshold (SRT)
Quietest level of speech a person can hear and understand 50% of the time
Speech Discrimination
Also called Word Recognition Score
Stimuli: 1 syllable words
Presented at a comfortable listening level
Calculate the % of words correctly repeated
Measures impact of hearing loss on person’s communication
Immittance Testing
Measures automatic responses of the auditory system
Tympaanometry
Measures movement of the tympanic membrane (eardrum) while changing the air pressure in the external auditory canal
Measures pressure in the middle ear
Note 
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