Fripty Study Bundle SLP Set 14 - Student Developed - Fripty Approved

How can an SLP assist a transgendered patient?

To achieve lower pitch, they can go through hormonal therapy. testosterone thickens the VFs. Estrogen doesn't change the folds. You can help them build up vocal stamina so they don't experience fatigue. You help them use more rising pitch inflections, greater articulatory precision, softer voice, more modals, forward resonance, feminine body language. Encourage psychological support.

What are the different types of strokes?

Ischemic: caused by blocked or interrupted blood supply to the brain. Thrombosis is a build up of stuff and embolus is arterial debris that gets stuck in a smaller artery.

Hemorrhagic: caused by ruptured blood vessels. they can by intracerebral (within the brain) or extracerebral (within the meninges)

Discuss brocas aphasia

Damage (usually) to brocas area (broadmanns area 44 and 45) which is located in posterior, inferior frontal gyrus of left hemisphere. supplied by MCA.

These patients have nonfluent, effortful, slow speech. Limited word output. short phrases and sentences. Misarticulated speech. Agrammatic or telegraphic. (limited to nouns and verbs).

Impaired repetition.

Impaired confrontational naming.

Better comprehension than production (if syntax is simple). Poor oral reading and comprehension of what has been read.

Writing problems.

Monotonous speech.

Discuss transcortical motor aphasia

Damage to anterior superior frontal lobe. Brocas is not affected.

Absent/reduced spontaneous speech (because the superior frontal lobe is responsible for initiation)

Nonfluent, paraphasic, agrammtic, telegraphic

REPETITION IS INTACT

echolalia and perseveration

awareness of grammaticality

limited word fluency

simple syntax

good comprehension of simple conversation

slow and difficult reading aloud

seriously impaired writing

exhibit some MOTOR disorders (hence the name) such as rigidity of extremities, absence of movement (akinesia), slowness.

Discuss mixed transcortical aphasia

Spared brocas and wernikes.

Limited spontaneous speech

Automatic unintentional and involuntary nature of communication

severe echolalia

severely impaired fluency

severely impaired auditory comprehension

refusal to repeat nonsense syllables/words

naming difficulty and neologisms

mostly unimpaired automatic speech

severely impaired reading, reading comprehension and writing

Discuss global aphasia

Most severe form of nonfluent aphasia. Extensive lesions in perisylvian area (language). Damage to MCA.

Profoundly impaired language skills

Greatly reduced fluency

Limited to few words and utterances

Impaired repetition, naming, auditory comprehension

Perseveration

Impaired reading and writing

Discuss wernickes aphasia.

Damage to wernickes area. Posterior portion of the superior temporal gyrus in left hemisphere.

Effortlessly produced speech with normal fluency (logorrhea or press for speech)

Rapid rate of speech with normal prosody and artic

Intact grammatical structures

severe word finding problems

paraphasic speech (semantic and literal)

neologisms

circumlocution

empty speech

poor auditory comprehension

impaired conversational turn taking

impaired repetition

reading and writing problems

Discuss transcortical sensory aphasia

brocas, wernickes and accurate fasiculus is unaffected.

fluent speech with normal phrase length, artic, prosody grammar and syntax

paraphasic and empty

severe naming problems

good repetition skills but poor comprehension of repetition

echolalia of grammatically incorrect forms, nonsense words (unlike TMA)

impaired auditory comprehension

normal automatic speech

good reading aloud, poor comprehension

writing problems that parallel speech

Similar to wernikes, but repetition in intact.

Discuss conduction aphasia

lesion between brocas and wernikes area.

impairment in repetition, HALLMARK

variable fluency

paraphasic

word finding problems: content

empty speech because of omitted content words

efforts to correct errors in speech

good syntax, prosody and artic

naming problems

ok auditory comprehension

better at pointing than confrontational naming

variable reading problems, better comprehension of reading

writing problems

buccofacial apraxia

similar to wernickes, only difference is pretty good auditory comprehension

Discuss anomic aphasia

word finding difficulty

everything else is good

Discuss subcortical aphasia. ---caused by lesions in basal ganglia or other structures

fluent speech

intact repetitions

normal auditory comprehension

artic problems, like broca

prosodic problems

word finding problems

good writing skills

How do you address aphasia in bilingual populations?

The first language may be more impaired than the second. Some people only recover one language.

What are some standardized aphasia tests?

Boston Diagnostic Aphasia Examination 3

Western Aphasia Battery-Revised

Aphasia Diagnostic Profile

What does the Boston Diagnostic Aphasia Examination 3 look at?

Evaluates articulation, fluency, word finding, repetitions, serial speech, grammar, paraphasias, auditory comprehension, oral reading, reading comprehension, writing, musical skills. Classifies aphasia into types.

What does the Western Aphasia Battery-Revised look at?

Evaluates speech content, fluency, auditory comprehension, repetition, naming, reading, writing, calculation, drawing, nonverbal thinking, block design. Classifies aphasia into types.

What does the Aphasia Diagnostic Profile look at?

Evaluates severity of aphasia, comprehension, word retrieval, repetition and alternative communication. Helps classify.

What is functional communication?

Communication needed in everyday settings

What are some commonly used functional communication tools for aphasia?

Communicative Abilities in Daily Living-2

Functional Assessment of Communication Skills for Adults

What does the Communicative Abilities in Daily Living-2 look at?

Communication in everyday situations. Skills such as reading, writing, estimation of time, use of verbal and nonverbal contexts in communication, role playing, social conventions, nonverbal symbolic communication, humor, absurdity, and metaphors.

What does the Functional Assessment of Communication Skills for Adults look at?

Developed for ASHA. Rates social communication, basic needs, reading, writing, number concepts, daily planning. Clinicians or other familiar individuals can complete the form.

What needs to be assessed in an aphasia assessment?

Repetition

Naming skills (responsive-what do you use to write. confrontational. word fluency-name all animals you can think of)

Sentence and discourse production

Speech fluency

Functional

communication (requests, participation, telephone conversation, facial recognition, understanding signs, ability to write name, make grocery list)

Auditory comprehension

Reading skills

Writing skills

Gestures and pantomime

Automated speech and singing

How do you treatment auditory comprehension in aphasia?

comprehension of single words: ask the pt to point to something

comprehension of spoken sentences: yes/no, following directions, sentence verification

comprehension of discourse: retell a narrative, answer comprehension questions

How do you treat naming in aphasia?

start with words that are familiar and functional. cues are important

incomplete sentences, phonetic cues, syllabic cues, silent phonetic cues, personalized verbal cues, functional descriptions, etc

How do you expand utterances in aphasia?

systematically increasing length and complexity.

How do you treat reading skills in aphasia?

based on premorbid skills and current need for reading survival reading skills

reading and comprehension of printed words

reading and comprehension of phrases and sentences

reading and comprehension of paragraphs and extended materials

How do you treat writing skills in aphasia?

FOR FUNCTIONAL

writing functional words

writing functional lists

writing short notes, reminders

filling out forms

writing letters

FOR OTHER

point to letter

point to printed words

saying sound of letter

saying a printed word shown

tracing printed letters

copying printed words/phrases

spelling words correctly

writing to dictation

What is alexia?

loss of reading skills due to recent brain damage. writing and other language skills are intact.

What is agraphia?

loss of writing skills due to recent brain damage.

What is agnosia? what are the types?

Agnosia is the impaired understanding of certain stimuli. impaired recognition.

auditory agnosia

auditory verbal agnosia

visual agnosia

tactile agnosia