CSD 1080 Final Exam Study Guide

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Aphasia

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133 Terms

1

Aphasia

Language disorder characterized by the breakdown in the ability to formulate, retrieve, or decode language

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Pointing

Most users of communication boards indicate their selection by _________

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Hypokinetic Dysarthria

A breathy, monopitch voice would most likely be found in an individual with ________

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Dyskinesia

Uncoordinated movement

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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

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Stroke

Most common cause of aphasia

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7

Language

What type of disorder is aphasia?

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8

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.

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Aphasia problem categories

  • Spoken language

  • Written language

  • Physical / sensory functions

  • Cognitive changes

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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

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Paraphasia

  • Word substitution

  • Phonemic or semantic

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Phonemic paraphasia

Substituted word sounds like correct word

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Semantic paraphasia

Substituted word has similar meaning or is associated to correct word

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Neologism

The use of words that don’t exist

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15

Agrammatism

a pattern of syntactically defective speech

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16

Hemiplegia

Paralysis on one side of the body

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17

Contralateral

affected side of the body is opposite the side of the brain

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Hemiparesis

Weakness or incomplete paralysis on one side of the body

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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 

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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

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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

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Fluent aphasia characteristics

Relatively normal:

  • Prosody

  • Pitch

  • Loudness

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Non-fluent aphasia characteristics

  • Limited speech production

  • Poor repetition & naming

  • Effortful speech

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Global aphasia

Most severe aphasia type

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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.

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Treating aphasia tactics

  • Looking for strategies that exploit strengths and minimize deficits

  • SLPs, PTs, OTs, etc.

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27

2/3

What proportion of TBIs are caused by motor vehicle accidents?

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No - nonfocal

Is brain damage with TBI usually located in one small area?

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Anywhere

Where can brain damage occur?

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30

Coup

Injury due to impact, moving object hits stationary head

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Contracoup

Injury on the side opposite to the impact, moving head hits stationary object

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32

Yes

Do TBIs often result in a coma?

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Impulsive

Individuals with TBI frequently exhibit ________ behaviors

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34

General TBI Impairments

  • Voice & swallowing

  • Speech & language problems

  • Cognitive problems

  • Reading & writing

  • Behavioral & emotional

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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

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TBI Areas for SLPs

  • Orientation

  • Memory

  • Listening comprehension

  • Speech intelligibility

  • Pragmatics

  • Reasoning & problem solving

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Cognitive rehab

Treatment regimen designed to increase functional abilities for everyday life by improving the capacity to process incoming information

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Cognitive rehab professionals

SLPs, OTs, PTs, etc.

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Restorative approach

  • Repetitive activities to rebuild neural circuity

  • E.g. classification tasks, word associations rehearsal, memory aids

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Compensatory approach

Develop alternatives, since some functions will not be recovered

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Early recovery

Beginning responses to environment in hospital - stabilization is the overriding goal

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Middle recovery

Goal is to reduce confusion & improve memory / goal - directed behavior

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Late recovery

Goal is client independence

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44

Dysarthria

A motor speech disorder due to paralysis, weakness, or poor coordination of speech muscles

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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.

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No

Is cerebral palsy a disease?

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Cerebral palsy

Can be the result of brain injury in fetal or infant development

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Spastic CP

Type of CP characterized by rigidity and reflex problems

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Athetoid CP

Type of CP characterized by writhing movements

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Ataxic CP

Type of CP characterized by uncoordinated movements

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51

Flaccid dysarthria voice

Breathy, mono pitch

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Spastic dysarthria voice

Harsh, strained

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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

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Types of disabilities that benefit from AAC

Individuals with congenital and acquired disabilities. Also helps anyone temporarily unable to speak

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Unaided systems

  • Do not require any equipment, involve only the person’s body

  • Signs, gestures, facial expressions

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Aided systems

  • Require some external equipment

  • Low / light tech: picture board, alphabet board

  • High tech: computer based devices with voice output

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Direct selection

In ________, the individual directly selects the desired symbol

Ex: Pointing with a finger or body part, using a head pointer, eye gaze

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Scanning

Items are “highlighted” and the communicator signals to select desired item

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59

Habilitation

Born with hearing loss

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Rehabilitation

Acquired hearing loss

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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)

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Audiologist

An expert in hearing & hearing disorders

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Sound

Vibrations traveling through a medium (such as air or water) that are audible

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Vibration (sound wave)

Sound is caused by _______

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65

Frequency

Physical characteristic, The vibrations / cycles per second

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66

Hertz (Hz)

How is frequency measured?

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Pitch

The perceptual correlate of frequency, can be heard

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Frequency, pitches

When the ______ changes, we hear different ________

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69

Increase

Increase frequency = _______ pitch

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70

Pure tone

A tone of a single frequency

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71

Complex tone

A tone containing two or more different frequencies, most everyday sounds

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Periodic sound

A pattern that repeats itself at regular intervals, relative to sound

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Aperiodic sound

A sound with no repetitive pattern

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Amplitude

The extent of the molecules displaced during vibration

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Loudness

The perceptual correlate of amplitude

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Amplitude, loudness

_______ is determined by the physical characteristic of intensity. The higher the intensity / ________, the greater the loudness

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Decibel (dB)

Measurement of sound pressure

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78

50 - 70 dB

The intensity (loudness) of a typical conversation

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79

Outer, middle, inner

3 main divisions of the ear

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80

Pinna

  • In outer ear

  • Helps funnel sound to the ear canal and localize sound

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81

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

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82

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

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83

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

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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

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85

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

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Ossicles bone names

Malleus (hammer), Incus (anvil), stapes (stirrup)

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Ossicles function

Connect the eardrum to the inner ear and amplify the vibration of the eardrum

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Semicircular canals

  • Inner ear, part of the vestibular system

  • Help the body maintain balance

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Cochlea

  • Primary inner ear structure

  • Shaped like a snail

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Base

High frequency sounds stimulated at the ______

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Tip

Low frequency sounds stimulated at the ______

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Electrical

Mechanical impulses are converted to ________ impulses

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93

Auditory nerve

  • Cranial nerve

  • Carries electrical impulses from the cochlea to the brain

  • The primary auditory area in the temporal lobe

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Audiometer

an instrument used to measure hearing

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95

Air conduction

using headphones; sound travels through outer, middle, and inner ear

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96

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

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Speech Reception Threshold (SRT)

Quietest level of speech a person can hear and understand 50% of the time

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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

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99

Immittance Testing

Measures automatic responses of the auditory system

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Tympaanometry

  • Measures movement of the tympanic membrane (eardrum) while changing the air pressure in the external auditory canal

  • Measures pressure in the middle ear

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