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Cloned from: Neurogenics Midterm

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Neologisms
Nonword utteranse (e.g., mandernost) that follow the phonologic conventions of the lanaguaage. Neologisms are often heard in the speech of adults withs severe Wernicke’s aphasia or Global aphasia.
Logorrhea
an excessive flow of words or run on sentences, due to insufficient self-monitoring skills - often seen with Wernicke’s  and Conduction Aphasias.
Apraxia of Speech
Disruption of the volitional movement sequences in the absence of sensory loss, weakness, paralysis, or incoordination of the muscles involved in speech. Usually a consquence of damage in the premotor cortex.
Alexia
Impaired reading
Agraphia
Impaired writing
Agnosia
Inability to recognize stimuli in a sensory modality in spite of intact sensation in the modality.
Types:

●    Auditory Agnosia: Can’t identify by hearing alone
●   Visual Agnosia: Can’t identify by sight alone
●    Tactile Agnosia: Can’t identify by touch alone
●    Auditory-Verbal Agnosia: Inability to comprehend the spoken word, in the absence
of aphasia or defective hearing.
●    Visual-Verbal Agnosia: Loss of the power to comprehend written materials despite preservation of the ability to write (i.e., alexia without agraphia)
Agrammatism
Speech in which content words (nouns, verbs, adjectives) are present, but most function words (articles, prepositions, conjunctions) are missing. A common characteristic of the speech of adults with Broca’s aphasia.
Effectiveness
Whether treatment causes a meaningful change in patients’ daily life adequacy.
Efficacy
Whether treatment causes a significant change in patients’ performance on one or more objective measures.
Literal (phonemic) paraphasia
  • Substitutions or transpositions of correct sounds. Ex: shooshbruss for toothbrush or tevilision for television.
Verbal (semantic) paraphasia
  • Substitutions of one word for another
  • Three types (according to Goodglass, Kaplan and Barresi)
    • Semantic: substitution of semantically similar words - ex: father for mother
    • Unrelated: substitutions of words with no relationship to the target word - ex: cigarette for motorcycle
    • Perseverative: substitution of a previously used word.
Circumlocution
Literally, talking around words that an individual is unable to say. Patients with conduction or Wernicke’s aphasia often use circumlocution to communicate the sense of words that they cannot retrieve.
Physiatrist
A doctor who specializes in rehabilitation
Fluency
When used to classify adults with aphasia, fluency refers to the prosodic or melodic characteristics of speech. Adults with fluent aphasia speak with essentially normal rate, intonation, pauses, and emphatic stress patterns. Adults with nonfluent aphasia speak slowly, with diminished intonation, abnormally placed and excessively long pauses, and diminished variation in emphatic stress. Fluent aphasia is associated with postcentral damage, and nonfluent aphasia is associated with precentral damage.
Directness
How straightforward a stimulus is
Saliency
How much a stimuli stands out from the environment
Length
How long a stimulus is
Stimulus manipulation
Involves manipulating several characteristics of task stimuli to keep the patient working at an optimum level w/o overwhelming. Includes: Intensity and salience; clarity and intelligibility; redundancy and contextual support; novelty and interest value; and cues.
Response manipulation
Involves manipulating the characteristics of response expected from patients as another way to control difficulty of the tx exercise. Includes: length and complexity; familiarity and meaningfulness; delay; and response redundancy.
Generalization
Transfer of learned skills, behaviors, or responses from one setting to another.
Functional communication
Communication used in daily life
MRI
A lab test that uses a strong magnetic field and a computer to create images of internal structures based on differences in the chemical composition of body tissues.
CT
A radiological test in which a computer constructs cross-sectional images of internal body structures by analyzing information from a series of x-ray exposures made at consecutive horizontal levels of a body part.
FIM
Functional Independence Measure. Pros: General estimates of functional ability in a small number of important areas. Cons: Not sensitive to small differences in specific abilities, do not provide enough detail about specific abilities. Compromise quality of care.
Embolism
A fragment that travels through a blood vessel lodges itself and occludes and artery, causing an embolic stroke.
Thrombosis
Accumulation of a plug of material at a specific site in a blood vessel. If it grows large enough to occlude a cerebral artery, it causes a thrombotic stroke.
Aneurysm
Balloonlike bulges in an artery caused by weakness in the arterial wall. Aneurysms are susceptible to hemmorrhage.
Forms of Feedback
  • Incentive feedback: positive reinforcement that’s not from clinician; behavioral conditioning (ie M&Ms for every right answer)
  • Informational feedback: gives pt about accuracy correctness or appropriateness of their response; more pertinent to severe pts as therapy activities may be obscure as to how it will help them
  • Clinician comments: motivating positive verbal praise (e.g. “you’re doing great”)
Disorder
a derangement or abnormality of function; a morbid physical or mental state.
Validity
The degree to which a test actually measures what it purports to measure.
    • Content Validity: is an indicator of how well the items in a test represent the domain of concern.
    • Construct Validity: is an indicator of how well the content of a test relates to an established model, theory, or concept of the skill, process or structure to which the test relates.
Reliability
Performance on a test is consistent (across days and examiners)
  • Test-retest reliability: the stability of test scores over time as measured by repeated testing of a group of subjects within a short period of time.
  • Different forms : (ex. forms A & B of a subtest)
  • Split half reliability: score on evens = score on odds

Prognostic factors
  • Neurological findings – if course of disease is well known or predictable, the location of damage, the effects of nervous system abnormalities
  • Pt characteristics – age, gender, education, occupation, premorbid intelligence, handedness, personality and emotional state (motivation)
  • Associated factors – co-morbidity; other medical conditions (e.g.hemiplegia, seizures)
Broca's Aphasia
Summary:
  • Broca’s aphasia is caused by damage in the posterior inferior region of the frontal lobe in the language-dominant hemisphere.
  • Patients with Broca’s aphasia speak slowly and with great effort and they often omit function words (agrammatism or telegraphic speech).
  • Patients with Broca’s aphasia usually comprehend language better than they speak it or write it.
Wernicke's Aphasia
Summary:
  • Wernicke’s aphasia is caused by damage in the central or posterior regions of the temporal lobe in the language-dominant hemisphere.
  • Patients with Wernicke’s aphasia typically have problems comprehending spoken and written language.
  • They speak effortlessly and with essentially normal rate.
  • However, their speech may contain paraphasias and word retrieval failures.
  • think: logorrhea
Global Aphasia
Summary:
  • Global aphasia is caused by massive damage in the perisylvian region of the language-dominant hemisphere.
  • Patients with global aphasia have profound impairment of al speech, language, and comprehension, although some may get a rudimentary sense of simple conversations.
Conduction Aphasia
Summary:
  • Conduction aphasia is caused by damage in the parietal lobe of the language-dominant hemisphere, affecting transmission of information from Wernicke’s area to Broca’s area by way of the arcuate fasciculus.
  • Patients with conduction aphasia typically have fairly good langauge comprehension but grossly impaired repetition.
  • They speak fluently but with literal paraphasias.
Transcortical Sensory Aphasia
Summary:
  • Transcortical Sensory Aphasia is caused by damage in the parietal watershed region of the language-dominant hemisphere.
  • Patients with transcortical sensory aphasia speak effortlessly, but many are echolalic.
  • They have few problems repeating what is said to them but have profoundly impaired language comprehension.

Transcortical Motor Aphasia
Summary:
  • Transcortical Motor Aphasia is caused by damage in the watershed region of the anterior frontal lobe in the language-dominant hemisphere.
  • Patients with transcortical motor aphasia have markedly reduced speech output, good repetition, and good listening comprehension.
Anomic Aphasia
Summary:
  • It is not clear whether anomic aphasia represents a distinct aphasia syndrome or is simply a milder version of other aphasia syndromes.
  • The primary characteristics of anomic aphasia are impaired word retrieval in speech and writing and perseveration of other speech and language functions.
Auditory Comprehension
  • Single Word Comprehension Drills
  • Sentence Comprehension Drills
  • Discourse Comprehension Drills
Single Word Comprehension Drills
  • Single Word Comprehension Drills are most appropriate for patients with severe comprehension impairments who do not comprehned phrases or sentences. This could include the patient pointing to pictures given one word prompts.
Sentence Comprehension Drills
  • Sentence Comprehension Drills are an important treatment tool for clinicians who consider auditory comprehension a basic language process.  These drills may require patients to answer spoken questions (yes/no or open-ended), follow spoken directions (to point to something or do something), or verify the truth of spoken sentences. (“The man (in the picture) is eating the hot dog, is that right?”
Discourse Comprehension Drills
  • Discourse Comprehension Drills may require patients to answer questions about samples of discourse (yes/no, sentence completion, or open-ended questions), or to retell what they remember from discourse. Clinicians may regulate the difficulty of discourse comprehension tasks by manipulating the familiarity, length, redundancy, cohesion, coherence, salience, directness, and rate of discourse materials.
Reading Comprehension
  • Word Recognition Drills
  • Comprehension of Printed Sentences
Word Recognition Drills
  • Word Recognition Drills (or comprehension of single printed words) may be appropriate for patients who cannot read at the sentence level and who exhibit signs of either surface dyslexia or deep dyslexia.
Comprehension of Printed Sentences
  • Comprehension of printed sentences (complete sentences, choose a target from a list of foils, rearrange scrambled sentences, match-to-sample tasks)
  • Might teach survival reading skills by selecting a core sight-reading vocabulary, and doing flashcard drills or using natural materials e.g. pill bottles
Speech Production
  • Sentence completion tasks
  • Confrontation-naming drills
  • Sentence production drills
  • Connected-speech drills
Sentence Completion Tasks
  • Sentence Completion Tasks may increase volitional speech for patients whose spontaneous speech is limited to stereotypic utterances. Can go from highly constrained (“A cat says ___”) to unconstrained (“My sister has a  _____”)
Hierarchy – easiest to hardest
  • Highly constrained: “A cat says___” (only one answer)
  • Less constrained: “In a bowl you put___” (several possible answers)
  • Least constrained: “People like to___” (nearly unlimited answers)
Confrontation-Naming Drills
  • Confrontation-Naming Drills are popular with clinicians, but may not produce lasting effects or improve patients’ daily life communication.Ex. “What day is it?”
Sentence Production Drills
  • Sentence Production Drills often proceed from tasks in which patients’ responses are highly constrained (imitation, repetition-elaboration, story completion) to open-ended tasks in which patients have considerable latitude in the nature of their responses (question-answer, story elaboration).
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