CSD 303: Aphasia, Motor Speech Disorders, Cognitive Disorders, and AAC

Comprehensive vocabulary flashcards covering etiology, symptoms, assessment, and intervention for Aphasia, Motor Speech Disorders, Cognitive Disorders (RHD, TBI, Dementia), and Augmentative and Alternative Communication (AAC).

Aphasia

An acquired deficit in language comprehension, production, or both (across spoken and written modalities) resulting from brain damage, most frequently due to a stroke in the language-dominant hemisphere, that is not caused by motor, intellectual, or psychological impairment.

Anomia

Difficulty or inability to retrieve names or words; recognized as the most pervasive deficit seen in individuals with aphasia.

Phonemic Paraphasia

A speech error involving the substitution, omission, or transposition of speech sounds within a target word (e.g., producing "taples" for "staple").

Semantic Paraphasia

A paraphasic error where an intended word is replaced with a semantically related word (e.g., saying "fork" when intending to say "spoon").

Unrelated Paraphasia

A verbal error where the substituted word bears no clear semantic relationship to the target word (e.g., producing "bicycle" for "lunch").

Neologism

The production of an entirely novel, nonsensical word substitution that is not part of the language (e.g., saying "dowlfer" for "pencil").

Cortical Aphasia Tree

A diagnostic classification flowchart used to differentiate cortical aphasias into eight distinct syndromes (Global, Mixed transcortical, Broca's, Transcortical motor, Wernicke's, Transcortical sensory, Conduction, and Anomic) based on fluency, auditory comprehension, and repetition abilities.

Broca's Aphasia

A nonfluent cortical aphasia caused by damage to Broca's area in the left frontal lobe, characterized by halting, effortful, agrammatic (telegraphic) speech output, anomia, and repetition deficits, with relatively intact auditory comprehension.

Wernicke's Aphasia

A fluent cortical aphasia resulting from a lesion in Wernicke's area in the left temporal lobe, presenting with severe receptive language deficits, impaired repetition, empty speech filled with jargon, neologisms, and paraphasias, alongside a lack of awareness of deficits.

Primary Progressive Aphasia (PPA)

A condition caused by progressive neurodegeneration (frontotemporal dementia) marked by initial signature language disturbances without prominent cognitive deficits, before worsening over time as other cognitive impairments emerge.

Melodic Intonation Therapy (MIT)

A restorative aphasia intervention that leverages the preserved melodic and prosodic processing capabilities of the right cerebral hemisphere to facilitate expressive language retrieval in patients with nonfluent aphasia.

Errorless Learning Therapy

A therapeutic paradigm designed to prevent the patient from producing errors during language or cognitive tasks, avoiding the reinforcement and habituation of incorrect responses.

Dysarthria

A collective term for a group of neurologic speech disorders caused by damage to the central or peripheral nervous system, producing deficits in the strength, speed, range, steadiness, tone, or accuracy of movements necessary for respiration, phonation, resonance, articulation, and prosody.

Flaccid Dysarthria

A motor speech disorder resulting from lower motor neuron damage, characterized neuromotorly by hypotonia and muscle weakness, which results in breathy voice, hypernasality, imprecise consonants, and reduced phrase length.

Spastic Dysarthria

A motor speech disorder caused by bilateral upper motor neuron lesions, characterized neuromotorly by spasticity and weakness, clinically manifesting as a strained-strangled voice quality, monopitch, excess and equal stress, and imprecise articulation.

Ataxic Dysarthria

A motor speech disorder caused by damage to the cerebellum or its CNS connections, having a neuromotor basis of incoordination.

Hypokinetic Dysarthria

A motor speech disorder linked to pathology in the basal ganglia or its circuitry, defined by reduced movement and range of motion, monopitch, monoloudness, reduced stress, imprecise consonants, and short bursts of rapid speech (characteristic of Parkinson's disease).

Hyperkinetic Dysarthria

A motor speech disorder caused by damage to the basal ganglia or related CNS connections, characterized neuromotorly by extra, abnormal, involuntary movements affecting speech production.

Motor Appearance of Parkinson's Disease

A classic clinical profile featuring stooped posture, forward tilt of the trunk, rigidity, flexed elbows and wrists, reduced arm swinging, and a masked facial expression.

Festination of Gait

A progressive shuffling pattern of short, increasingly rapid footsteps exhibited by individuals with Parkinson's disease in an effort to maintain their balance.

Hypomimia

A reduction in facial movement and animation that creates a flat, masked facial expression typically observed in Parkinson's disease.

Bradykinesia

Slowness in the execution of movements or extreme difficulty initiating voluntary motor action.

Micrographia

A progressive reduction in handwriting size, progressing from normal initial script to diminutive, abnormally tiny letters, frequently observed in Parkinson's disease.

Apraxia of Speech (AOS)

A neurogenic speech disorder defined by an inability to formulate and execute motor plans for speech production in the absence of muscle weakness or paralysis, characterized by effortful articulation, inconsistent errors, and visible articulatory groping.

Lee Silverman Voice Technique (LSVT)

An intensive behavioral treatment program designed for individuals with Parkinson's disease that uses vocal loudness cues to stimulate increased respiratory and phonatory effort and open mouth posture to improve overall speech clarity.

Deep Brain Stimulation (DBS)

A surgical approach for Parkinson's disease involving the implantation of an electrode into deep brain structures (e.g., subthalamic nucleus) connected via an extension lead to an infraclavicular neurostimulator; it improves gait more reliably than speech.

Prosopagnosia

A communication and perceptual deficit typically following right hemisphere damage, defined by the inability to recognize familiar human faces.

Hemispatial Neglect

An attentional deficit in right hemisphere disorders resulting in failure to attend to or perceive visual, auditory, or sensory stimuli on the side opposite the lesion (typically the left visual or body space), assessed via line bisection, cancellation, and drawing tasks.

Anosognosia

A neurological condition characterized by a patient's complete lack of awareness, recognition, or acknowledgment of their own deficits or illnesses.

Open Head Injury

A traumatic brain injury occurring when an external object or projectile fractures and penetrates the skull to enter brain tissue, as observed in ballistic trauma.

Phineas Gage

A historic railroad construction foreman who survived an open head injury in $1848$ when an explosion propelled a tamping iron through his left frontal lobe, producing profound personality changes and emotional control deficits.

Coup-Contrecoup Injury

An acceleration-deceleration closed head injury mechanism where focal damage occurs at the initial site of skull impact (coup), followed by focal injury on the exact opposite side of the brain as it rebounds against the inner skull wall (contrecoup).

Diffuse Axonal Shearing

A microstructural injury mechanism in acceleration-deceleration closed head trauma characterized by the rotational stretching, tearing, and disruption of neuronal axons throughout widespread areas of the brain.

Dementia (DSM-IV Definition)

A cognitive syndrome characterized by memory loss alongside deficits in at least one additional domain: verbal expression/receptive language, object recognition/identification, execution of motor activities, or abstract thinking/executive function.

Delirium

A sudden, acute disturbance in consciousness and cognitive function that fluctuates significantly across the course of a day, typically stemming from an identifiable underlying general medical condition (such as a urinary tract infection).

Mild Cognitive Impairment (MCI)

A level of cognitive decline that is noticeably beyond the spectrum of changes expected in normal aging, yet not severe enough to significantly compromise an individual's independence in daily living activities.

Alzheimer's Disease Neuropathology

The progressive accumulation of extracellular amyloid plaques and intracellular neurofibrillary tangles (involving tau protein), resulting in cortical shrinkage, ventricular enlargement, and severe atrophy of the hippocampus.

Global Deterioration Scale (GDS)

A seven-stage observational assessment system used to categorize and track the progression of cognitive decline in dementia, ranging from Stage $1$ (no cognitive decline / normal aging) to Stage $7$ (very severe cognitive decline / late-stage dementia).

Reminiscence Therapy

A semi-cued conversation intervention that reviews past events, personal artifacts, and life experiences to enhance orientation and trigger pleasant episodic and long-term memories in individuals with dementia.

Validation Therapy

A dementia intervention developed by Naomi Feil in $1982$ based on accepting, listening with empathy, and entering the reality, beliefs, and feelings of the person with dementia to reduce emotional stress without arguing or reality confrontation.

Augmentative and Alternative Communication (AAC)

An area of clinical and educational practice that seeks to compensate for temporary or permanent impairments, activity limitations, and participation restrictions in individuals with severe speech and language disorders (ASHA, $2005$).

Unaided AAC Systems

Communication methods that rely entirely on the user's physical body without requiring any external equipment or materials, including natural gestures, body language, facial expressions, and manual signs (e.g., ASL, SEE, tactile signing).

Aided AAC Continuum

A spectrum of assistive equipment encompassing no-tech (non-electronic materials like alphabet boards and paper/pencil), low-tech (simple battery-operated tools with few moving parts like BIGmack or VoicePal Max), and high-tech electronic computerized devices (e.g., DynaVox, Lightwriter).

Direct Selection

An AAC access technique where an individual indicates a target choice directly from a display set using a body part (e.g., finger pointing), head pointer, joystick, or eye gaze tracking.

Indirect Selection (Scanning)

An AAC access method suitable for users with significant motor impairments, where items within a selection set are presented sequentially (visually or via a partner) until the user activates a switch or signal to confirm the choice.

Operational Competence

The technical knowledge and physical skill required for an individual to operate, maintain, and navigate an AAC system's mechanics or software.

Strategic Competence

The ability of an AAC user to employ compensatory strategies to prevent, navigate, or repair communication breakdowns that arise during interactions.