Studied by 0 people
10/30 - 11/5
avoidance
a performance of the behavior prevents the occurrence of an anticipated aversive condition
type I
presentation of an aversive consequence after
previewing
planning strategy for oral and written texts
threshold
the level of input at which the sensory system registers and/or responds
what does material selection mean in a therapeutic setting?
choosing the tools or resources used to carry out a therapeutic task
how does material selection impact a therapeutic task
it often determines the type of stimulus presented to the client
two main categories of commercial materials in therapy?
therapeutic materials and recreational materials
what is the difference between commercial and created materials?
commercial materials are pre-made and often purchased
created materials are made by the therapist for a specific client or task
why is material selection important in therapy?
helps tailor therapy to the client's needs which leads the therapy task to be effective
what client factors should be considered when selecting materials for therapy?
age, developmental level, and language level of the client
why is fostering engagement important when choosing therapy materials?
Engagement helps maintain the client's interest, making therapy more effective
what does it mean for therapy materials to promote generalization?
Materials should help the client apply learned skills in different contexts outside of the therapy session
how should materials address the target in therapy
they should address the target directly, either as-is or with modifications made by the clinician
why is branching an important consideration in material selection?
allows for flexibility in therapy, enabling adjustments based on client responses and needs
what is the benefit of using materials that promote high frequency of targets?
it provides the client with multiple opportunities to practice and reinforce the target skill
how can additional stimuli be incorporated into therapy materials?
additional stimuli can be added to support or extend the learning experience
when might a clinician choose to create their own materials for therapy?
when existing materials do not address the therapeutic targets or the client's needs
what does use as directed mean in material use?
involves highlight the communication target that is naturally stimulated or easily prompted when interacting with the material
what are examples of incorporating additional demands?
earn your turn
incorporate a target
support a functional target
material use: creation
create materials specific to the client's needs and preferences
what is aphasia?
a language disorder due to brain damage that results in impaired comprehension and/or formulation of language
what are possible etiologies of aphasia
hemorrhage or blockage of blood flow to the brain
strokes/cerebrovascular accidents (CVA)
Tumors
head trauma
certain disease processes
agrammatism
syntax deficit while semantics remain intact
tree…man bed… he sleep
anomia
difficulty with word-retrieval
“it's to sleep in, under trees”
neologism
non-words, typically nouns and verbs
“that's a blick“
perservation
continuing to respond after achieving response
“Hammock..Key. Chair. Glove.”
paraphasia
errors in speech output resulting in productions that are close to the target but incorrect
phonemic paraphasia
extraneous or transposed sounds/syllables or substitutions of a phoneme
“Hammerock” “Hackam” “Pammock”
Semantic Paraphasia
Unintended whole-word substitution, usually within the same semantic category
“It's a bed”
Nonfluent aphasia
poor verbal/written output with relatively spared comprehension
symptoms of nonfluent aphasia
reduced vocabulary
agrammatism
impairments of articulation, rate, and prosody
labored and effortful production
fluent aphasia
impaired language comprehension with maintenance of normal melodic speech contour
symptoms of fluent aphasia
word-retrieval deficits
paraphasias
neologisms
perservation
melodic, natural quality to speech production
Nonfluent aphasias
broca's
transcortical motor
global
Broca’s aphasia
agrammatism, effortful articulation of short utterances, impaired prosody and intonation, apraxia of speech.
good comprehension
Transcortical Motor Aphasia
Little to no initiation of spontaneous speech, but excellent imitation
good comprehension
global aphasia
severe deficits in all areas of language comprehension and production
fluent aphasia
wernicke's
conduction
anomic
wernicke's aphasia
fluent but meaningless speech, articulation, intonation, and prosody are good.
comprehension is impaired
conduction aphasia
relatively fluent speech, frequent phonemic paraphasias, marked difficulty with imitation
good comprehension
anomic aphasia
significant word-finding difficulties with otherwise fluent and grammatical speech
good comprehension
Functions of Data Collection
Allows the clinician to monitor progress from one session to the next
Permit documentation of the efficacy of a given treatment strategy
Augmentative and Alternative Communication (AAC)
Any system that is used to enhance or replace verbal speech for communication
complex communication needs (CCN)
Those with severe speech, language, and communication differences which prevents functional speech
non-speaking
identity-first language that is most-preferred by this community (also here: minimally-speaking, part-time user)
does AAC delay verbal speech development?
No
what are some common etiologies of non-speakers
autism
down syndrome
cerebral palsy
childhood apraxia of speech (severe)
seizure disorders
genetic disorders
what individuals benefit from AAC?
non speaking individuals who need an alternative modality to receive and express communication
individuals with a significant expressive-receptive language gap
individuals with significantly compromised intelligibility
individuals experiencing significant frustration with communication
what are some priorities when using AAC?
Core Vocabulary
Consistency
Aided Language Input
what should all vocabulary sets do
provide words to be utilized across all settings
allow for redundant learning opportunities
permit modeling across all settings
support various pragmatic functions
what types of materials should be used to support cultural sensitivity?
use representative toys, books, media, AAC and visual supports that reflect the client's cultural background
How can you avoid reinforcing stereotypes when selecting materials?
by resisting stereotypical representations and choosing inclusive materials that reflect the client's culture
why should you exercise cultural sensitivity?
to avoid assumptions about holiday observations and be mindful of current events
what should you do first when considering the use of a new material?
consider the material and think about how it can be applied to treatment goals
what is the second step when determining how to use a material?
determine a specific therapeutic use or target
what is the objective of being the last student to contribute?
the last student to share an idea for using the material wins
which language modalities can aphasia impact?
spoken and written language modalities
what are two motor impairments that may co-occur with aphasia?
hemiplegia or hemiparesis, and hemianopsia
Can aphasia affect both understanding and producing language?
Yes, aphasia can impair both comprehension and formulation of language
when does spontaneous recovery from aphasia typically occur?
it occurs, if at all, to the greatest extent during the first two to three months post-injury/insult
what factors influence spontaneous recovery from aphasia?
lesion characteristics (size, location, etiology)
type and severity of initial aphasia
age at onset
overall premorbid health
How does age affect the prognosis for spontaneous recovery from aphasia?
the prognosis is more favorable for younger clients
neuroplasticity
the brain's ability to restructure its neural networks in response to internal and external stimuli
how might neural regions adjacent to a lesion respond after brain damage?
they may adopt functions of the affected area
what role can the right hemisphere play in neuroplasticity after left-hemisphere damage?
right-hemisphere sites that parallel the affected left-hemisphere may take over functions of the affected area
delayed option in intervention timing
initiating treatment once the effects of the spontaneous recovery have likely run their course
what is early intervention in aphasia treatment?
initiating treatment close to onset or injury to accelerate the natural processes of spontaneous recovery
does delaying treatment improve treatment effects in aphasia intervention?
No, delaying treatment has not been shown to improve treatment effects.
why do most clinicians recommend early intervention for aphasia?
to accelerate the natural process of spontaneous recovery and optimize outcomes
what is the main goal of the restorative/linguistic orientation in aphasia treatment?
to strengthen an aphasic individual's disrupted linguistic skills through direct instruction
what kind of participation is needed in restorative/linguistic orientation for aphasia?
intensive and repeated participation in therapy activities
what areas are targeted in restorative/linguistic aphasia treatment?
both comprehension and production skills
what is the primary focus of therapy in the substitutive/compensatory approach?
to establish functional communication
what assumption does the substitutive/compensatory approach to aphasia treatment make?
it assumes that language function has been lost
In the substitutive/compensatory approach, what is encouraged for successful communication?
the use of any available modalities the individual can use to communicate effectively
what kind of tasks are emphasized in the substitutive/compensatory approach?
tasks and responsibilities related to everyday living
what is a positive indicator for successful therapy outcomes?
individuals under 65 years old typically make greater gains in therapy
how many intervention hours are associated with better therapy outcomes?
a total of 20-50 intervention hours
what therapy duration is linked with better outcomes?
continuing therapy beyond 4-week episode of care
what factors are associated with longer-term gains in therapy?
longer-term gains are noted for individuals with milder aphasia symptoms and no deficits in executive functioning
what is recommended for aphasia treatment?
a combination of restorative/linguistic and substitutive/compensatory approaches is encouraged, tailored to what best suits the client
what are the four response levels in aphasia therapy?
nonverbal responses (pointing)
single-word tasks (responsive naming, confrontation naming)
phrase-length responses (sentence completion with phrases)
sentence-level formulation (picture description, object function)
what are the seven levels of prompts used in aphasia?
function cue
rhyming cue
written cue
spelling cue
first-sound cue
multisyllable cue
direct model
phonemic cue
a cue related to the sounds in the word, such as the first sound or rhyming
semantic cue
a cue related to the meaning of the word, such as providing a function or description of the word
orthographic cue
a cue related to the spelling of the word, such as showing the written word or providing a spelling cue
example of a function cue
describing what the object does
“You use it to eat soup” for the word “spoon”
what does a rhyming cue involve?
providing a word that rhymes with the target word to aid recall
when might a direct model be used in aphasia therapy?
when the clinician provides the exact word for the client to repeat, as a last step in cueing
what is traumatic brain injury (TBI)?
an external insult to the brain caused by events like vehicular accidents, gunshot wounds, falls, sports injuries, and explosions
what is a closed head injury?
a type of TBI where damage occurs to a widespread area of the brain without any penetration
what is a penetrating head injury (PHI)
A type of TBI where damage is concentrated in specific neurological region(s) due to penetration
how many cases of TBI occur annually in the United States?
approximately 2.87 million cases, with most being mild and due to falls
mild TBI (mTBI)
Brief changes in consciousness and memory, often with less severe symptoms compared to more severe TBI cases
common symptoms of TBI
headaches, blurry vision, dizziness, sleeping problems, irritability, anxiety and depression
How do symptoms differ in severe TBI cases?
in severe TBI, memory loss and periods of unconsciousness are pronounced than in mild TBI
what are the two levels of linguistic complexity in aphasia therapy?
literal language
figurative language
what is response latency
decreasing the expected time between the clinician's stimulus and the client's response, used as a measure of difficulty once the target is established
No Tech AAC
Involves unaided communication without equipment or materials
Manual Signs
auditory scanning
low tech AAC
Non-digital AAC systems
examples:
paper-based symbols
tactile symbols
objects
core boards
communication books
robust paper-based systems
Note 
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