Adult Language Disorder Flashcards

Seizure

sudden, uncontrolled electrical disturbance in brain

90% of treatments for aphasia are targeted towards ____ aphasia?

expressive

anosognosia

impaired awareness of deficits; can be motor, sensory, cognitive, emotional, etc.

left neglect

unawareness of left side of body; difficulty processing and attending to information from the left side

flat affect

reduced emotion in their own speech and response to emotion in other’s speech

global aphasia

severe impairment in ALL language functions; non-fluent, relative weakness in comprehension, weakness in repetition

mixed transcortical/isolation aphasia

non fluent, relative weakness in comprehension, repetition is relative strength

brocas aphasia

non fluent, comprehension is relative strength, repetition is relative weakness

transcortical motor aphasia

non fluent, comprehension is relative strength, repetition is relative strength

wernickes aphasia

fluent, comprehension is relative weakness, repetition is relative weakness

transcortical sensory aphasia

fluent, comprehension is relative weakness, repetition is relative strength

conduction aphasia

fluent, comprehension is relative strength, repetition is relative weakness

anomic aphasia

fluent, comprehension is relative strength, repetition is relative strength; word finding is main issue!!

fluent utterance length

4 or more word uninterrupted utterances

non fluent utterance length

less than 4 words

anterograde amnesia

cannot form new memories (can’t remember after the accident)

retrograde amnesia

can’t recall old memories (can’t remember before the accident)

what are the 4 aspects of language impacted by aphasia?

auditory comprehension, verbal expression, reading, and writing

what are the 3 categories we use to type aphasia?

fluency, comprehension, and repetition

what are the two primary causes of primary progressive aphasia?

FTD and Alzheimers

what is one of the best prognostic indicators for wernicke’s aphasia?

how intact auditory comprehension skills are

bilingual aphasia considerations

you need to include a language history in assessment (look at their acquisition of language and use); assess changes in both languages separately

executive functions

higher order cognitive functions that are critical for self-management and goal-oriented behaviors (problem solving, reasoning, organization, inhibition, initiation, etc.)

aprosodia

difficulty producing or comprehending paralinguistic or affective information

fluency should always be assessed in ____

connected speech

parallel bilingual aphasia recovery pattern

both languages impaired, both recover at generally the same rate

differential bilingual aphasia recovery pattern

languages recover differently relative to their pre-injury levels

selective bilingual aphasia recovery pattern

one language improves, one does not

blended bilingual aphasia recovery pattern

mixture of languages (“inappropriately“) during recovery

antagonistic bilingual aphasia recovery pattern

one language recovers to a certain level, but begins to regress when the other language begins to recover (least common)

successive bilingual aphasia recovery pattern

both languages may eventually recover but the recovery of the 2nd language doesn’t start until the 1st language is almost fully recovered

restorative/rehabilitative treatment

improving or restoring impaired function; also called impairment based or medical model

compensatory treatment

aimed at compensating for deficits not amenable to retraining; use of intact abilities to maximize effective communication

person and family-centered care

collaborative approaches grounded in mutally beneficial partnership among individuals, families, and clinicians

stimulation-facilitation

knowledge is not lost, but is inaccessible; therefore, the more frequently a response has been produced the higher the probability of later accuracy

thematic language stimulation (TLS)

patient is bombarded linguistically; 10-15 different exercises presented for each vocabulary item; sequenced, multimodality tasks

melodic intonation therapy (MIT)

uses prosody, intonation in RH to stimulate language in LH for those with severe expressive aphasia

response elaboration training (RET)

for those with broca’s aphasia, eliciting spontaneous responses to picture stimuli, then modeling and using wh cues to prompt clients to elaborate on initial responses

visual action therapy (VAT)

non-verbal, global aphasia; hierarchy of activities used with visual input as primary factor

script training

client practices a script that is personally and/or contextually relevant; practiced EXTENSIVELY; gradual decrease in cues/support is progress

semantic feature analysis

improves retrieval of conceptual information by accessing semantic networks; category, use/function, location, association, properties, action, parts/whole (descriptors); patient produces words semantically related to target word; functional circumlocution

phonological components analysis

based on SFA approach, but instead of targeting words, it targets awareness of the phonological aspects of words- rhyming, syllable segmentation, first and last sounds, etc.

verb network strengthening treatment (VNeST)

designed to promote lexical retrieval in context of a sentence, targeting verbs and their roles in semantic networks; begins with pairing of related agents/objects (artist-paints, painter-paints-house)

life participation approach to aphasia

philosophy, not treatment model; focuses on re-engagement in life

major cognitive function domains impacted by RHD

executive function, attention, awareness, communication/language use, memory

coarse coding deficit hypothesis

when we encounter a word/language, the RH diffusely activates large semantic fields; more distant meanings and features, regardless of how well they fit the context; rotten-apple; language USE

suppression deficit hypothesis

ambiguity triggers activation of multiple meanings of words and phrases, often without awareness or intention; when we hear and process language, we are filtering out words, meanings, and multiple interpretations

cognitive resources hypothesis

awareness of capacity (attentional resources) and working memory capacity for language; RHD deficits become evident when cognitive-linguistic tasks place high demands on attentional resources

social cognition deficits hypothesis

RH plays critical role in awareness and use of social conventions and norms; RHD can reduce ability to engage in competent social relations and understand social information

dementia

chronic, persistent cognitive disorder caused by brain injury or disease; severe enough to interfere with functioning/daily life; dementia is a group of symptoms- memory + language, problem solving, thought, judgement, executive function, perception, procedural skills

alzheimer’s disease

size of brain changes/lessens over time; thought to be caused by plaques and tangles; tangles are twisted fibers of the protein tau found within neurons; plaques= amyloid beta plaques

vascular dementia

quickly rising in incidence/prevalence- 2-3rd most leading cause of dementia; results from diseases impacting the vascular system

frontotemporal dementia FTD/FTLD

degeneration in the frontal/temporal cortical region

variants of FTLD

behavioral variant, language variant (primary progressive aphasia), movement variant (corticobasal, progressive supranuclear palsy, motor neuron disease)

first sign of PPA

language deficits

Epilepsy

2+ seizures less than 24 hours apart

ischemic CVA

blockage or occlusion

thrombosis

blood clot forms locally and narrows vessel/limits blood flow

embolism

clot formed remotely becomes mobile

hemorrhagic CVA

burst/release of blood

aphasia definition

acquired language disorder cause by injury to the brain; impacts all language modalities (auditory comprehension, verbal expression, reading, and writing); is often chronic in nature; categorized by relative strengths and weaknesses in comprehension, fluency, and repetition; anomia is hallmark feature; not an impairment in intellect or cognitive function and not a motor disorder

hallmark characteristic of aphasia?

anomia

most common cause of aphasia?

CVA- 1st; tumors and infections- 2nd; brain injuries-3rd

prosody

ability to vary intonation patterns, stress, and rhythm in connected speech

agrammatism

non-fluent speech with fewer function words (think telegraphic; primarily nouns and verbs)

paragrammatism

fluent speech with inaccurate semantic rule use (not in line with speaker’s language rules); errors in subject-verb agreement, tense markers, pronouns, etc.

paraphasia

language output error

phonemic (literal) paraphasias

sound/phoneme level errors (target: hat, says: cat); more than half of word is said correctly

semantic (verbal) paraphasias

word level error; in category- same concept (target: chair, says: couch), remote- different concept (target: chair, says: dog)

neologism

less than half of word is said correctly; ex: sklerver

neologisms are often seen in _____ aphasias

fluent

extended paraphasia

jargon, “word salad”, multiple paraphasias are present in connected speech

perseveration

continuation of response beyond a desired or appropriate point

circumlocution

talking around intended target

fluent aphasias

Wernicke’s, Transcortical sensory, Conduction, Anomic (typically seen in more posterior lesions)

non fluent aphasias

Global, Mixed transcortical, Broca’s, Transcortical motor (typically seen in more anterior lesions)

Broca’s aphasia damage location

Broca’s area, often from L MCA CVA

Apraxia often co-occurs with which aphasias?

brocas and transcortical motor

Global aphasia damage location

large perisylvian lesion; typically diffuse injury pattern across frontal, temporal, and parietal lobes; prominent site of lesion in posterior temporal gyrus (L MCA)

transcortical motor aphasia damage location

damage is superior to or immediately around Broca’s area

mixed transcortical aphasia is also known as

isolation aphasia

mixed transcortical aphasia damage location

damage to regions anterior and superior to Broca’s area

wernicke’s aphasia damage location

wernicke’s area

which aphasia has high occurance of neologisms

wernicke’s

conduction aphasia damage location

damage to cortical region connecting broca’s and wernicke’s (arcuate fasciculus)

which aphasia has repetitive self corrections which leads to conduit d’approche?

conduction aphasia

conduit d’approache

repetitive effort to approximate the appropriate word/phrase

transcortical sensory aphasia damage location

damage to regions deep and posterior to wernicke’s area; appears like wernicke’s but is rarer and less severe

anomic aphasia damage location

damage to temporal/parietal region; usually small/focal lesion

what form of aphasia is the mildest?

anomic

social approaches to intervention

there is no precise or concrete method of service delivery for social approaches

TBI

traumatic brain injury, can be closed or open/penetrating

closed TBI

contact injury from outside

open TBI

injury from outside; piercing of/tearing into the dura mater of the brain and beyond

non- accidental head injury

used to be referred to as shaken baby syndrome, happens when there is intentional injury

mTBI

mild traumatic brain injury, also known as concussion; BI that is considered to be less severe

GCS for mTBI

greater than or equal to 13 on GCS

confabulation

memory error where we “fill in the gaps“; not lying- the person is unaware

Glasgow Coma Scale

used in the field to assess level of alertness following TBI; scored from 3 (worst) to 15 (best); severe < 8-9, moderate 8 or 9-12, minor greater than or equal to 13

alert and oriented x4

alert and oriented to person, place, time, and event (a&o x3 = person, place, time)