Exam #2 - COMD242

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**Terms that cannot be found in book/slides are intentional! Professor wants us to tell the difference between right/wrong answers for multiple choice questions

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101 Terms

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Cultural competence

To recognize, honor, + respect beliefs, interaction styles, behaviors of individuals + families

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Challenges in serving adults with Culturally and Linguistically Diverse (CLD) Backgrounds

  • Low income

  • Poor diet

  • Lack of health insurance

  • Lack of access to medical services

  • Barriers to service delivery

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Barriers to Service Delivery

  • Limited English

  • Lack of health insurance

  • Lack of transportation

  • Differing beliefs about optimal health care

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Ethnocentrism

View that members of a culture do things the “right way”

  • ex. Assuming your own language is superior, or that everyone should speak your language

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Cultural tendencies

Patterns of behavior + values commonly observed among a culture; Recognizes heterogeneity + diversity within cultures

  • ex. Religion, age, beliefs

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Cultural relativism

Other people’s ways of doing things are different yet equally valid

  • ex. In some cultures, bowing is the preferred greeting form; in others, handshakes are the preferred greeting

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Code switching

Using different linguistic styles for different situations

  • ex. Speaking politely to parents, yet using slang around friends

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Language difference

Regional, social, or cultural variations of language, such as a specific regional dialect

  • ex. In Spanish, the adjective is placed after noun, whereas in English the adjective is before noun

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Dynamic Assessment

Analyzes how much + what types of support/assistance needed to bring individuals’ communicative performance to higher level; Rooted in theories from Leo Vygotsky

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Static testing

An individual is assessed at given point in time, + results of test determine what they can/cannot do on their own

  • Norm referenced + Criterion referenced fall under this

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Systematic observation

Process of observing how individuals use communication for functional purposes in real world activities; Allows professionals to examine one’s communicative performance at home, school, work, in the community

<p>Process of observing how individuals use communication for functional purposes in real world activities; Allows professionals to examine one’s communicative performance at home, school, work, in the community</p>
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Steps to interpret assessment findings

  1. Diagnosis (differential diagnosis)

  2. Determining severity of disorder (very mild-very severe)

  3. Characterizing client’s prognosis

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Differential diagnosis

Diagnosis that differentiates a person’s disorder from other similar disorders

  • ex. Spastic dysarthria differs from flaccid dysarthria

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Language disorder

Impaired comprehension and/or use of spoken, written, and/or other symbol system

  • Impacts semantics, syntax, morphology, phonology, or pragmatics

  • Can affect children/adults

  • Can compromise reading development (reading disabilities)

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*Language deviance

A child's language development that differs from normal expectations; A unit of language that doesn't follow grammar rules

  • ex. Using an question mark instead of a period when writing

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Specific language impairment (SLI)

Primary developmental language disorder; Impairment of expressive/receptive language in (pre)school-age children that cannot be attributed to other causal conditions (with no known cause); Language skills seem poor relative to intellectual capabilities

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Language delay

Children exhibiting problems with language achievements get a late start with language development + can be expected to catch up with their peers; Late talkers who end up catching up with other children

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Silent period

Little to no talking when exposed to second language

  • ex. Father speaks Spanish to child, yet child solely responds in English (or does not respond to second language at all)

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Simultaneous bilingual acquisition

Under 5 years of age; Two languages acquired simultaneously from birth

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Sequential bilingual acquisition

Over 5 years of age; First language learned from birth + second language learned later

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Language loss

Skill reduction of first language when learning second language; Second language becomes dominant

  • ex. If a child who experienced this concept tests in the first language, they may show low scores in first language than in their second language

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Error transfer

Errors in second language caused by influence of first language

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Anomia

Means “no name”; Word-finding problems/inability to retrieve a word; Persistent deficit in aphasia, word retrieval problems may remain even after recovery

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Telegraphic speech

Phrases/sentences made of content words (nouns + verbs) with function words omitted; Seen in Broca’s aphasia + transcortical motor aphasia

  • ex. “Tom go store”

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Word-finding problems (Anomia)

Inability to come up with words/names of items in spontaneous conversation/naming tasks; Seen in Broca’s aphasia, transcortical motor aphasia, global aphasia, Wernicke’s aphasia, conduction aphasia, transcortical sensory aphasia, anomic aphasia

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Jargon

Production of language that is meaningless + may run ongoing; Seen in Wernicke’s aphasia

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Neologisms

Making up a new word; Seen in Wernicke’s aphasia

  • ex. “The bramble-thingie is over here”

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Agrammatism

Leaving out grammatical markers in sentences/phrases, like verb inflections, articles, + prepositions; Seen in Broca’s aphasia, transcortical motor aphasia

  • ex. “He go store”

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Semantic/Verbal paraphasia

Substituted word, likely in same category as targeted word

  • ex. Identifying a photo of a sofa as “furniture” or “chair”

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Phonemic/Literal paraphasia

Substitution or transposition of a sound

  • ex. Identifying a sofa as a “tofa” or “fosa”

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Standard Scores

Index that identifies how a person’s test performance compares to their normative peers

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Screening tools

Designed for quick administration; Given to large number of children

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Echolalia

When one frequently repeats auditory stimuli

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Evidence-based practice

Process where clinician integrates these areas for a client’s best action plan:

  1. Scientific evidence

  2. Clinical expertise

  3. Client perspective

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Clinical expertise

Knowing how to do a method; Evidence that it works

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Client perspective

When a client believes a method does not work for them, prompting to try new method

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Norm-Referenced Test

Compares performance with same-age peers; Is standardized, has normative sample

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Norm-Referenced Test Differences

  • Ranks students based on test achievement, scores given as rank based on other students’ scores

  • Assesses large number of students

  • Takes longer period of time

  • Normed for certain group (ex. Testing individuals across USA) → can cause issues that may not be normed for other populations

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Criterion-Referenced Test

Determines achievement levels in particular area/criteria; Requires establishment of a clear performance standard, specific design tasks, + provide guidelines for interpretation

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Criterion-Referenced Test Differences

  • Measures skills + knowledge a student has mastered

  • Student scores are given as 100%

  • Assesses small number of students

  • Lasts a class period usually

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Family-centered approaches/intervention

Based on family systems theory; Emphasizes the “family as a whole is greater than sum of its parts”

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Family centered approaches/intervention: Treatment goals

  • Emphasize an individual’s participation within + access to family activities/contexts

  • Incorporate family members’ perspectives on viable treatment approaches

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Child-centered approaches

Child sets pace + chooses the materials; Professional seeks ways to facilitate language form, content, or use in child-selected activities

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Behaviorist approaches

Based on learning theory; Emphasizes how environment shapes behavior + influence of consequences on behavioral change

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Behaviorist approaches: Clinicians’ responsibilities

  • Identifying observable + measurable goals

  • Specify level of mastery at each goal

  • Controlling each intervention session

  • Collecting data in each session

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Clinical-directed approaches

Adult (therapist, teacher, parent) selects activities, materials, + sets instruction pace

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Naturalistic environment

Intervention for children is effective when it engages them in environments where they must use their skills

  • ex. Environments include homes, child-friendly classrooms, etc.

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Natural Environment characteristics

  • Increases carryover

  • Increases discourse skills

  • Respects least restrictive environments when consultant/collaborative model is used

  • Involves family

  • Produces functional outcomes

  • Enhances access to curriculum

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Intervention

Action plan to improve individuals’ communicative abilities

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Purpose of Intervention

  1. Prevention

  2. Remediation

  3. Compensatory

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Comprehensive Language Evaluation

Determines if a language disorder is present:

  • Profiles linguistic strengths/weaknesses

  • Identifies supports to improve language skills

  • Involves case history + comprehensive analysis of child’s language

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False positive

Child who doesn’t have a language disorder is diagnosed as having one

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False negative

Child who has a language disorder isn’t accurately identified as having one

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False positive/negative causes

Poorly constructed tests, or linguistically/culturally biased tests; Child’s illness, shyness, underlying conditions, etc. may cause poor test results

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Reading + Writing goals

Addressed within language intervention; Emphasize skills foundational to reading achievement (decoding/comprehension); Includes:

  • Phonological awareness

  • Alphabet knowledge

  • Print-concepts knowledge

  • Alphabetic principles

  • Reading fluency

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Alphabet knowledge

Knowledge of letters, upper/lower case correspondence, letter-sound correspondence

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Print-referencing

When reading books/texts, adults refer to letters by pointing to them + commenting on them so child learns letters

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Motor learning

How practice/experience leads to “permanent changes in capability for movement”; Important for understanding normal + disordered speech motor control

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Phonological awareness

Awareness of rhyme patterns; Syllabic composition of words; Onset + rime boundary in single-syllable words; Initial, medial, + final sounds in words

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Print-concept knowledge

Knowledge about rules that govern print; Includes:

  • Knowing how books are organized (ex. cover page, title page, text)

  • Functions of print in various genres (ex. lists, invitations)

  • Major print units (ex. letters, punctuation, words)

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Language disorders classification

  • Etiology

  • Manifestation

  • Severity

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Etiology

Cause of language disorders

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Primary disorder

Impairment attributable to no other cause; Occurs in absence of any other disability

  • ex. Autism can cause language disorders, but language disorders do not cause autism

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Secondary disorder

Impairment caused by another primary source; Occurs in presence of another disability

  • ex. Hearing loss causes language disorder

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Manifestation

Language disorders classified according to affected language aspects

  • Does disorder affect: comprehension, expression? Form, content, use? Spoken language or reading/writing?

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Severity

Language disorders range from mild to profound; Extent it hinders child’s abilIties to use language for social and/or educational functioning

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ASD

Autism Spectrum Disorder; Developmental conditions characterized by:

  • Repetitive behaviors

  • Difficulties w/ social relationships + communication

  • Restricted interests

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ASD risk factors

  • MMR vaccine said to have linkage, but studies proved it does not

  • Prenatal/perinatal complications

    • maternal rubella + anoxia

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Purposes of Assessment

  1. Identify skills one has/doesn’t have in a communication area

  2. Guide design of intervention for enhancing one’s skills in a communication area

  3. Monitor one’s communicative growth/performance over time

  4. Qualify one for special services

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TBI

Traumatic brain injury; Caused by car accidents, falls, recreational sports; Most common type: Closed-Head Injury (CHI)

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TBI Characteristics

  • Open-head: Penetrated skull + meninges

  • Closed-head: Brain jostled within skull, yielding diffuse brain injury

  • Polytrauma: Mix of open + close-head injuries, etc

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Aphasia

Language disorder acquired after one has developed language competence; Absence of language

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Dysarthria

Motor speech disorder

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Right-hemisphere dysfunction (RHD)

Damage to right cerebral hemisphere:

  • Language + cognition impacted, symptoms differ from aphasia

  • Cognitive-linguistic disorder

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RHD Characteristics

  • Lack of awareness of cognitive-linguistic deficits + denial of problem areas

  • Lack of awareness of left side of body + external stimuli to left side

  • Difficulty recognizing faces

  • Compromised pragmatics

  • Wordy expression

  • Difficulty understanding/using higher-level cognitive-linguistic skills

  • Dysarthria, Dysphagia

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Dementia

Chronic + progressive decline in memory, cognition, language, + personality; Results from central nervous system dysfunction

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Mild Dementia

  • Forgetfulness of basic info/common routines

  • Losing/misplacing items

  • Missing appointments/plans

  • Decreased vocab

  • Reduced/verbose conversation, anomia

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Moderate Dementia

  • Increasingly disoriented in time + place

  • Poor attention + memory

  • Marked language difficulties

  • Deficits of language (anomia, difficulty repeating)

  • Misunderstanding humor + empty conversations

  • Restlessness + roaming

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Severe Dementia

  • Extreme disorientation

  • Minimal cognitive ability

  • Language skills compromised (limited meaningful communication)

  • Frequent repetitions + jargon

  • Comprehension skills impaired

  • May be unable to control bladder/bowel functions + may need wheelchair

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3 Dementia Traits

  1. Memory impairment

  2. Cognitive skills impairment

  3. Presence of aphasia, apraxia, agnosia

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Broca’s Aphasia

Damage to frontal lobe, causing:

  • Slowed, halting, labored, + telegraphic/robot-like speech

  • Mild to moderate auditory comprehension problems when messages increase in length + complexity/when contextual cues removed

  • Nonfluent + expressive

  • Motor aphasia

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Transcortical Motor Aphasia

Damage to superior + anterior frontal lobe portions, causing:

  • Good repetition skills, better than spontaneous speech

  • Strong oral reading performance

  • Good language/auditory comprehension

  • Nonfluent

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Global Aphasia

Damage to large brain region or multiple sites of brain injury in language-dominant hemispheres, causing:

  • Deficits across all language modalities

  • Non-fluent

  • Poor language comprehension

  • Naming/word finding problems

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Wernicke’s Aphasia

Brain injury to superior + posterior temporal lobe regions (can reach parietal lobe of language-dominant hemisphere), causing:

  • Spontaneous speech + flow with normal prosody

  • Fluent + receptive

  • Poor language/auditory comprehension

  • Sensory aphasia

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Transcortical Sensory Aphasia

Injuries to language-dominant hemisphere (border of temporal/occipital lobes, or parietal lobe’s superior region), causing:

  • Echolalia

  • Fluent

  • Jargon + naming difficulties

  • Poor language/auditory comprehension

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Conduction Aphasia

Injury to brain’s temporal-parietal region, Arcuate fasciculus, causing:

  • Difficulties w/ repetition + reading aloud

  • Fluent

  • Naming difficulties

  • Normal prosody + articulation

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Anomia aphasia

Damage to multiple potential lesion sites, causing:

  • Fluency

  • Word-finding problems

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Rancho Levels of Cognitive Functioning Scale

  • Level I-III [1-3]: Severe (early recovery phase)

  • Level IV-VI [4-6]: Middle (middle recovery phase)

  • Level VII-X [7-10]: Mild (late recovery phase)

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Treatment settings

  • Aphasia therapy not limited to clinic or office

  • Therapies encompass other environments to facilitate carryover + generalization of progress different settings

  • Group approach may help

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Fluent

Aspect of communication/speech describing forward flow, phrasing, intonation, + rate

  • Easy, smooth, + well paced

  • Correlates with posterior brain damage (ex. temporal-parietal regions)

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Non-fluent

  • Short/choppy phrases

  • Slow/labored speech production

  • Grammatical errors

  • Telegraphic quality

  • Correlates with anterior brain injury (ex. frontal lobe)

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Polytrauma

Mixture of open + closed-head injury, multiple medical concerns, + posttraumatic stress

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Compromised pragmatics

Inability to take turns, read others’ cues, recognize others’ communication interests, + use physical space + affect during communication

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Dysphagia

Swallowing disorder; Difficulty chewing/managing food + triggering/maintaining a swallow

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Types of Strokes

  • Ischemic strokes

  • Hemorrhagic strokes

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Ischemic strokes

When blood supply to brain is inhibited because of artery occlusion

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Hemorrhagic strokes

When blood vessel/artery ruptures + excessive amounts of blood enter brain

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Intellectual disability

Arrested/incomplete development of mind; Impairment of skills during developmental period

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Intellectual disability risk factors

  • Prenatal/perinatal damage

  • Viral infections

  • Environmental influences, abuse

  • Biomedical + psychosocial factors

  • Trauma, infection, poisoning

  • Heredity

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Brain injury

Damage/insult to one’s brain; Can occur in utero, perinatally, or acquired