Aphasia

Aphasia definition

An acquired language disorder resulting from damage to brain areas responsible for language comprehension and production.

general/Core Symptoms of Aphasia

anomia, agrammatism, difficulty with spoken or written language, nonsensical fluent speech

anomia

characterized by significant difficulty in word finding

What are the four areas of language, and are the receptive or expressive?

Receptive: listening, reading
Expressive: speaking, writing

Characteristics of aphasic speech (5)

1. agrammatism

2. paraphasia

3. anomia

4. perseveration

5. non-fluent output

agrammatism

omission of grammatical markers, leading to simplified speech (saying “want cookie” instead of “I want a cookie”)

Paraphasia

errors in word choices, where a similar sounding or related word is substituted

types of paraphasia

• uninformative statement

• informative circumlocutions

• phonemic paraphasia

• semantic paraphasia

• neologistic

• perseveration

what type of paraphasia? (target word: hammock) “its one of those things you see”

uninformative

what type of paraphasia? (target word: hammock) “you lay on it outside”

informative circumlocutions

what type of paraphasia? (target word: hammock) “its a kammick”

phonemic

what type of paraphasia? (target word: hammock) “its a cot”

semantic

Common Causes of Aphasia

Strokes, traumatic brain tumors, and neurodegenerative diseases.

stroke definition

occurs when blood flow to a part of the brain is interrupted, and a blood vessel is either blocked by a clot or bursts. When this happens, the brain is unable to get the blood and oxygen it needs, and so the brain cells die.

stroke symptoms

sudden numbness, confusion, trouble speaking, vision problems, severe headache

BE FAST

Balance, Eyes, Face, Arms, Speech, Time to call

risk factors for stroke

hypertension, smoking, diabetes, high cholesterol, obesity, heart complications

why is a head CT completed first?

Often performed first to quickly identify any bleeding or swelling in the brain, helping to differentiate between ischemic and hemorrhagic strokes

3 types of static studies (brain behavior correlation)

• Post mortem clinicopathological examination

• Computerized Axial Tomography (CAT scan)

• Magnetic Resonance Imaging (MRI)

Ischemic Stroke

Caused by a clot blocking blood flow, accounting for 87% of strokes.

Hemorrhagic Stroke

Occurs when a blood vessel in the brain ruptures, accounting for 13% of strokes.

Neuroplasticity

The brain's ability to reorganize itself by forming new neural connections, crucial for recovery after brain injuries.

what are some future prospects for brain imaging?

Using a combination of neuroimaging and other brain mapping techniques. For aphasia, it will become possible to use these brain mapping techniques to see which areas of the brain are active during recovery

basic facts about strokes

• African American more impacted group

• Stoke is the leading cause of long term disability and the leading preventable cause of disability 

• Number 5 leading cause of death

Treatment options (for both ischemic and hemorrhagic)

Ischemic: 4 hr window to get TNK

Hemorrhagic: catheter sometimes threaded up artery of leg

sensory changes due to stroke

• vision or sight - blurred, double, blind spots, one side neglect

• smell - loss of ability to smell, over sensitivity

• taste - bad taste, or inability to taste

• touch - difficulty feeling things

• hearing - auditory comprehension or true hearing loss

Integrative model of brain language relations

proposes that language processing involved multiple areas and overlapping brain systems. these systems work together. the “zone of language” acts as a central hub for integrating language elements

Anomia and the different types of naming

• generative - category naming

• responsive

• confrontation - picture naming

outcome measures for speech

subjective reports of social/psychological well being
-

• SAQOL - 39

• CCRSA

• QCL

• COAST

• BOSS

WHO-ICF

A theoretical framework focusing on functioning and disability, considering personal and environmental factors.

A-FROM

Emphasizes participation and quality of life for individuals with aphasia.

C.A.P.E.

Stands for Connecting people, Augmentative and Alternative Communication (AAC), Partner Training, and Education and Resources.

FOURC

prioritizes client participation and functional outcomes in treatment

classical/localist view

co-anatomical correlations, one area of the brain has a specific function

contemporary/connectionist

widespread involvement of the brain in most language activities

frontal lobe function

executive functioning

temporal lobe function

hearing and analysis of auditory signals

parietal lobe function

perception and awareness of sensations

occipital lobe function

receives and analyzes visual information

CT Scan

First-line imaging technique to quickly identify bleeding or swelling in the brain.

MRI

Provides detailed images of brain structures and can identify ischemic areas.

what is the process approach?

Based on the idea that reliance on test scores often obscure critical information about individual differences in cognitive styles and strategies, preserved abilities, and the way in which a task was passed or failed

Applying the process approach to the quantitative exam helps us obtain critical information about adaptive and maladaptive behaviors, as well as problems solving strategies

What does a clinician with an observational mindset look like?

clinician closely monitors and analyzes a person's behaviors, strategies, and responses during therapeutic activities. Instead of focusing solely on the outcome (i.e., correct or incorrect responses), the observational mindset emphasizes understanding how the person approaches tasks, what processes they use, and how they handle challenges

(assessment of alexia and agraphia) Reading and writing definition:

symbolic skulls built on knowledge of spoken language. Reading relies on visual system alone. Writing requires both motor-kinesthetic and visual system.

alexia

reading disorder caused by brain damage

agraphia

writing disorder caused by brain damage

alexia and agraphia can exist ______ of aphasia. They usually involve the inferior _______ lobe lesions.

independent, parietal

apraxia definition

disturbed ability to produce learned, purposeful movements despite intact mobility, usually as a result of left hemisphere damage

general types of apraxia (4)

1. limb apraxia (transitive - tool, intransitive- no tool)

2. ideational

3. ideomotor

4. apraxia of speech

Important points about identity and aphasia

• Quality of life and identity are linked

• People need people to renegotiate identity and for identity to be authenticated 

• Conversation affirms identity

Social Model - primary goals

Focuses on functional communication methods, life participation, and acknowledging competence in individuals with aphasia.

primary goals are ______ and _____, the medium is _______

transaction, interaction, conversation

social model applies _____ to aphasia than ______ model

better, traditional

education ______ remediation

before

if you were stranded on an island, what test would you take?

verbal fluency assessment (generative naming, divergent naming, divergent classification) tells you how someone’s language is