CODA 1014 - Communication Disorders in Adults - Notes

Land Acknowledgement

• Georgian College acknowledges its campuses are on the traditional land of the Anishnaabeg people, including the Odawa, Ojibwe, and Pottawatomi nations (Three Fires Confederacy).
• The college is dedicated to honoring Indigenous history and culture and is committed to reconciliation and respect with all First Nations, Métis, and Inuit people.
• A renewed Coat of Arms was unveiled on Oct. 5, 2022, in the spirit of Truth and Reconciliation, acknowledging the college's location on the Treaty Land and traditional territory of the Anishnaabeg.

Introductions

• Instructor asks: Who am I? Who are you? Why am I here? Why are you here (besides the obvious)?

Course Overview and Syllabus

• Objective: To create an overview of how to get the most out of the course.
• Includes instructor's objectives, student's objectives, and course objectives.
• Syllabus:
  • Download from Blackboard and check for updates.

Recommended vs. Required Reading

• Recommended books/texts are for reference only and not required to purchase.
• Required reading: Online resources or handouts provided electronically.
• Required readings need to be completed before class unless otherwise specified.
• Suggestions/feedback on online reading/resources are appreciated.
• AI Expectations:
  • Permitted for generating therapy lists (e.g., word lists starting with /s/).
  • Not permitted for generating scenario responses/answers to how you would apply this material.

How to Reach the Instructor

• Email: megan.woodpagonis@georgiancollege.ca
• Call or Zoom: by appointment – times vary based on instructor's caseload.
• Available before class: 20 minutes prior, unless otherwise notified on Blackboard.

Questions

• Open forum for questions from students.

Neurology Overview

• Brain Apps: Helpful for quick reference/review.
  • Example: 3D Brain App allows a 360° view of different structures with descriptions.

Brain Structures

• Review of the lobes of the brain:
  • Frontal Lobe
  • Temporal Lobe
  • Parietal Lobe
  • Occipital Lobe
  • Brain Stem
  • Cerebellum

Cognitive Communication Disorders and Brain Lobes

• Frontal Lobe:
  • Cognitive Communication Disorders
  • Dysarthria
  • Dementia
  • Swallowing
  • RHD
• Temporal Lobe:
  • Cognitive Communication
  • Dementia
  • RHD
• Cerebellum:
  • Dysarthria / Ataxia
  • ABI/TBI

Cranial Nerve Summary

• CN I: Olfactory
  • Sensory (S)
  • Function: Smell
  • Structures Innervated: Nasal Mucosa
• CN II: Optic
  • Sensory (S)
  • Function: Vision
  • Structures Innervated: Retina
• CN III: Oculomotor
  • Motor (M)
  • Function: Eye movement (control of 4 eye muscles), Regulation of pupil, accommodation of lens for near vision
  • Structures Innervated: Eyelid, pupil, lateral portions on either side of the eye
• CN IV: Trochlear
  • Motor (M)
  • Function: Downward eye movement
  • Structures Innervated: Tendon on inferior surface of eye
• CN V: Trigeminal
  • Sensory/Motor (S/M)
  • Function: Sensory and Motor function for speech and mastication
  • Structures Innervated:
    • Motor - muscles of mastication, tensor tympani, tensor veli palatini, mylohyoid muscle
    • Sensory- oral and nasal mucosa, face, scalp, tongue
• CN VI: Abducens
  • Motor (M)
  • Function: Lateral eye movement
  • Structures Innervated: External lateral portion of each eye
• CN VII: Facial
  • Sensory/Motor (S/M)
  • Function: Saliva, taste; facial muscles; facial expression
  • Structures Innervated:
    • Motor all muscles for facial expression, salivary glands
    • Sensory - tongue and palate
• CN VIII: Vestibulocochlear
  • Sensory (S)
  • Function: Hearing and balance
  • Structures Innervated:
    • Vestibular - semicircular canals of the vestibular system
    • Cochlear - cochlea
• CN IX: Glossopharyngeal
  • Sensory/Motor (S/M)
  • Function: Taste; swallowing
  • Structures Innervated: Tongue and pharynx
• CN X: Vagus
  • Sensory/Motor (S/M)
  • Function: Heart, lungs, digestion; phonation, swallowing
  • Structures Innervated:
    • Motor branches - muscles of larynx, pharynx and velum
    • Sensory branches - abdominal organs
• CN XI: (Spinal) Accessory
  • Motor (M)
  • Function: Pharynx, velum, neck and shoulder
  • Structures Innervated: Velum, pharynx, neck and shoulder muscles
• CN XII: Hypoglossal
  • Motor (M)
  • Function: Tongue; speech and swallowing
  • Structures Innervated: All intrinsic and some extrinsic muscle of the tongue

Universality in Therapy

• Consider how aspects apply to all situations.
• What to ask/do to help the SLP with functional goals?
• Focus on client and family-centered goals.
• How to make therapy easier to accomplish and understand.
• Expectation: apply these principles to all topics covered in the course.

Acronyms

• Ax = assessment
• Tx = therapy
• Rx = prescription
• PRN = as needed
• NPO = nothing per oral

Communicative Confidence vs. Competence

• Consider:
  • Frequency
  • Willingness
  • Happiness

AAC

• Always think about using AAC.
• Have it available.
• Dual use – therapy tool AND communication breakdown.

Building Rapport: FRIER

• Family & Friends
• Roles and Responsibilities
• Interests and Hobbies
• Employment & Volunteer
• Reading

Case Example

• 47-year-old female (she/her) with TBI from an MVA, presenting cognitive communication and dysarthria challenges.
• Married, with two children (8yo, 11 yo).

STERLING & Building Rapport

• Importance of building rapport:
  • Trust
  • SLP support / time constraints
  • Buy in
  • Enjoyment
  • Productivity
  • Satisfaction
  • Outcomes
• FRIER
  • Family & Friends
  • Roles and Responsibilities
  • Interests and Hobbies
  • Employment & Volunteer
  • Reading

Scripts & Self-Advocacy

• Circles of Comfort:
  • 0 = You / client
  • 1 = Closest people to you
  • 2 = Close people
  • 3 = Acquaintances
  • 4 = Strangers

Scripts

• Prepare ahead of time for a situation and how to handle it.
• Examples:
  • Asking for help in a store.
  • Preparing questions for a Dr.’s appointment.
  • Going to a family get-together - anticipate questions and answers.

Self Advocacy

• A set of scripts that you can customize to your audience that lets them know what you need to have a successful interaction.
• Examples:
  • Going to a family get together in the evening
  • Explaining memory needs/strategies

Tracking Progress

• Ask SLP how to track / what preferred for documentation.
• When to check in with SLP – clear expectations.
• Offer suggestions based on activities.
• Make it easy.

Community Resources

• Groups
  • FB/online chats
  • Activities
• Community-funded programs

Don’t be Surprised…

• Nudity
• Asked to help with transfers, feeding, dressing, etc.
• Bodily fluids/secretions/smells
• Crying/upset

Self-Care

• Doesn't always have to mean a day at the spa
• During the day:
  • Take breaks, even if for only 5 minutes.
  • Do something that brings you calm – dance, wiggle, walk, breathe.
  • Look for opportunities to laugh.
  • Find opportunities to talk.

Resilience Resources

• Course by Diana Tikasz – Fostering Resilience in Midst of Challenging Work.
• Recommended websites:
  • www.tendacademy.ca
  • Mindfulness: www.franticworld.com; www.Tarabrach.com
• Resilience Support Toolkit – HHS website with tools and videos: https://www.hamiltonhealthsciences.ca/wp-content/uploads/2021/02/HHS-Resilience-Toolkit-and-PRN-Resources.pdf

Guest Speaker – Lily Belanger

• Student at McMaster’s Speech-Language Pathology Program.
• In year 1, going into Unit 3 of 5.
• Structure of Mac:
  • Problem Based Learning
  • Foundational Knowledge to start
  • Progressive training, building on concepts instead of distinct classes
  • EBP applications – in course work and placements
  • ICF from the WHO
• Any Questions?

Required Reading

• Required reading for next week is linked in the Syllabus.