Chapter 1: Systems-based Clinical Approach

Which approach is being described

• targets specific communication/swallowing disorders

disorder-based approach

Which approach is being described

• Integrates impairments typically addressed by related disciplines

• viewed holistically

case-based approach

which approach aligns with clinical practice

case-based approach

_______, _____, ______, and _______ can all be affected by a single etiology or disease

• speech

• language

• cognition

• swallowing

True/false: co-occurence of disorders is common in focal strokes

true

List the disciplines involved in care of patient with neurogenic disorder (11)

1) OT

2) PT

3) SLP

4) Respiratory therapy

5) Social work

6) Nursing

7) Neurology

8) Neuropsychology

9) ENT

10) Gastroenterology

11) Radiology

it is important to look at neurogenic disorders as ______ or _____-_____

connectionist or system based

Cortical & subcortical speech, swallowing, cognition, and language systems are all ________

interconnected

Overlap exists between functional organization of _____ and ____ ____ ____

structures and white matter tracts

Damage to brain structures seldom cause ____ ____ to systems

discrete effects

No ____ ____ captures everything

single approach

Look at case history examples

…

Name the models

• DIVA

• Dual stream

• ACT-R

• IFSiP

why are models important

• map out and illustrate components of larger process

• help link function to brain regions

• Help make predictions that damage in certain area will result in predictable function

DIVA stands for

Directions into Velocities of Articulators

Purpose of the DIVA model

speech production is dependent on numerous interdependent brain structures

Name the interdependent brain structures (based on DIVA)

• motor (planning, initiating, refinement)

• Kinesthetic

• Auditory

• cognitive

• language

Three main principles (DIVA)

• feedforward

• feedback

• monitoring/adjustments

______- primarily internal kinesthetic placement ________ to achieve target sound productions

Feedback

______ - pre-planning sequences of articulatory placements sensitive to production contexts such as coarticulation

Feedforward

_______ and ______ - Altering articulator placements when there is structural or physiological change

Monitoring and adjustments

Dual stream model states

language is processed through two bidirectional pathways (dorsal and ventral streams)

______ stream - motor production stream

dorsal stream

_____ stream - semantics and comprehension stream

ventral stream

Dual stream model states that language production is _____ hemisphere dominant, comprehension is ______

• left

• bilateral

Dual stream model states that emotional prosody production and comprehension are ____ hemisphere dominant

right

ACT-R stands for

Adaptive Control of Thought-Rational

ACT-R states cognition is ______ and ______ set of processes. Encompasses ______, _____, ______, and ______ _____

• complex

• distributed

• language

• memory

• attention

• executive functions

What are the 5 modules of the ACT-R

• Visual model

• aural module

• Intentional module

• declarative module

• central production system

IFSiP states swallowing is a _____ function but is impacted by ______ and ____ factors

• motoric

• sensory

• cognitive

IFSiP attempts to show _________ between cognitive, motor, sensory, and autonomic functions

interdependency