Aphasia

asphasia

difficult with language/speech

dysarthria

difficult/unclear articulation of speech (slurred, breathy, hoarse, very loud/quiet speech)

apraxia

neurological disorder inability to perform movements - limb and oral

dysphagia

Swallowing difficulties - includes coughing and choking when eating/drinking

respirating

breathing difficulties affecting volume of voice and sequencing and coordinated breathing

phonation

production of utterances of speech sounds\####
Aphasia

Symptoms of aphasia

Difficulty understanding
Difficulty word finding
Can't read
Cant spell
Grammatical errors in speech
Phonological erros- paraphasia
Semnatic errors cat-dog- paraphasia

Boston classification for aphasia

Believes functions are localised to a specific region
BDAE- Boston diagnostic aphasia examination

Broca's aphasia

Non fluent aphasia
Slow, effrtful, agrammatic output
Have comprehension but low expression
Often noun out out and short simple phrases
Poor naming, writing, reading around and repition

Wernickes aphasia

Fluent aphasia
Difficulty with comprehension but have low expression
Excessive expressive output
Paraphasia - semantic and phonemic
Neologisms
Auditory comprehension is worse then written
Impaired naming and repition
Visual processing (hemianopia) can be common

Conduction aphasia

Lesion in temporary- parietal border
Primary impairment- poor repetition
Have phonological errors but fluent speech
Word finding difficulties, naming , repetition, reading aloud and writing
Are aware they make mistakes

Anomic aphasia

Often temporary parietal lesion
Fluent aphasia with word finding difficulties, circumlocutions and pauses
About to recognise and describe objects but often cannot name
Intact - comprehension, reading aloud and repetition

Global aphasia

Most severe
Lesion is late caused by occlusion of left middle cerebral artery
Severe motor and sensory impairments
Visual fields impaired and oral apraxia
Non fluent aphasia - 1 word utterances
Sometimes able to produce over learned sequences- numbers, dates (repeated a lot in life)
Serverly impaired- comprehension, naming, repetition, reading writing

Transcortical aphasia

3 types- motor, sensory and mixed
Have god comprehension
Caused by infarcts (Lsions) to border of 2 artery zones (a trashed areas)
Result from lesion isolating speech areas from cerebral cortex

Transcortical motor aphasia

Lesion: usually anterior or superior to Broca's area
Non fluent speech, agrammatic and echolocation
Poor initiation, written output, reading around,
Good repition, comprehension, abilities

Transcortical sensory aphasia TSA

Lesion- parietal- occipital region
Has expressive language
Fluent but broken speech - phonological errors and word finding difficulties
Severely impaired comprehension verbal and written , reading aloud, naming and writing
Intact repetition - words and entrances

Oral apraxia

Difficulty in coordinating muscle tissue

Agrammatic output

Missing out words
Not using full sentences
Telegraphic speech\####
Impacts from stroke

Model of coping- parr et al 2007

Experience of aphasia

Pre aphasia identity (biography, attributes, status, prospects)
Experience of aphasia
Knowledge of aphasia
Personal and family attitudes and beliefs
Account of aphasia (biography,aphasic,identity, prospects)

Assessments of functional communication

Communicative Abilities of Daily Living: Holland (1980)
• Edinburgh Functional Communication Profile: Skinner et al (1984)
• Everyday Communicative Needs Assessment (Worrall 1992)

4 types of repair - analysis of frequency

Self-initiated self-repair: Most common in normal
conversation, suggests competence
Self-initiated other-repair: Common in WFD- repair yourself and then other person does it for them
Other-initiated self-repair: Asking for clarity- convo partner
Other-initiated other-repair: Initiating and carrying out repair e.g. 'you're wrong, it's not x, it's y'!- convo partner initiates and repairs convo

Aphasia can effect turn taking

Word-finding problems
➢ Silences/pauses
➢ Comprehension
'Minimal turns' common e.g. 'mm hm' •
Short turns e.g. 'yes', 'no', 'maybe'

Assessment of conversation

Capps
Spparc
Ca samples

Talking mats

Often used for ald
Explain and talk about the picture
Organise pictures by thumbs up, not sure ad thumbs down

Shows what they want to work on and dint

Total communication

To communicate a complex message
Gesture
• Pictorial materials
• Drawing
• Writing
• Written words
• Environmental props or objects

Malcomess care aims

• Investigation (assessment)
• Anticipatory (prevention)
• Stabilisation (maintenance)
• Participation (enabling)
• Resolution (curative)
• Improvement(rehabilitation)
• Adjustment(supportive)
• Comfort(palliative)