SP14 SLPA200

• Collect patient history
• Assess patient ability in communication
• Assess patient health problems
• Assess patient quality of life
• Assess family and social support systems
• Obtain occupational information
• Assess social dynamics
• Assess cultural background

• Ask patient what troubles them most
• Assess most prominent features first then less prominent later
• Go over case history
• Assessment is an ongoing activity - Diagnostic Therapy
• Select tests vs client specific assessment (may change based on family/patient goal)
• Obtain previous reports

repeated measures of the same skill result in consistent scores

• Starting point - Very important information.
• Base is established before starting treatment to improve reliability.

Measures only the targeted skills.

Designed specifically for an individual patient.

• Fluency of speech
• Syntactic & morphologic features
• Conversational speech samples
• Auditory comprehension skills
• Repetition skills
• Naming skills
• Speech production
• Writing

Progressive neurological disease which affects cognitive skills, social and personal behavior, continues to deteriorate.

Speech disorder, neurologically based, motor processing - NO muscle weakness.

Speech disorder, motor planning disorder, weakness, slowness of speech muscles - connection between brain and mouth not working.

Mild, moderate, severe, profound.

Primary difference=

• Broca's + Wernicke's
• Affects expressive and receptive language
• Affects all communication skills, including non-verbal

• Nonfluent
• Agrammatic speech
• Slow speech

• Frontal
• Parietal
• Occipital
• Temporal

language disorder based on recent brain trauma or injury

• TIAs (mini-strokes)
• CVAs (cerebrovascular accidents: ischemic, hemorrhagic)
• Brain Trauma
• Tumors
• Infections in brain (bacterial & viral)
• Toxemia
• Epilipsy
• Progressive neurological diseases

• Superior
• Inferior
• Anterior
• Posterior

• Primary function is respiration
• Secondary function is speech

Very important nerve for functions of larynx, respiratory system, cardiac system and GI system.

• Olfactory
• Optic
• Oculomotor
• Trochlear
• Trigeminal
• Abducens
• Facial
• Acoustic/Vestibular
• Glossopharyngeal
• Vagus
• Accessory
• Hypoglossal

• Globally impaired communication skills
• Severely reduced fluency
• Extremely limited verbal expressions
• Impaired repetition
• Impaired naming
• Impaired auditory comprehension
• Impaired reading and writing skills

• Functional living: driving, shopping, etc
• Life skills:  traffic signals, playing cards, etc
• Bilingual tests
• Independent tests for specific skills: test for auditory comprehension, Token Test, etc.

• Assess case history
• Current problems vs premorbid communication and intellectual skills
• Patient history: age, education, occupation, hobbies
• Family History:  living arrangements
• Medical History:  meds, health history, psych history
• Behavioral history

• Record speech sample
• Repetition skills-single words and sentences
• Naming skills-responsive naming (what color is a banana?) and confrontation naming
• Speech fluency
• Automated speech and singing (alphabet, prayers)
• Syntactic & morphologic aspects:  speech sample

• Verbal commands
• Assess hearing-refer to audiologist
• Assess vision
• Always look for ways to refer patients

• Patients usually respond better to:
• personal vs neutral questions
• frequent commands vs infrequent
• stories of daily events vs general
• simple sentences vs more complex sentences
• Comprehension of commands
• comprehension of single words
• comprehension of sentences and connected speech

• Oral reading skills
• Reading comprehension
• Matching pictures to words
• Read book

• letter formulation (hand use)
• writing skills

• Oral facial/Oral motor exam
• Apraxia- conversational speech
• Dysarthria- conversational speech

• common gestures
• pantomine
• signs

Determination of which of the two or more diseases with similar symptoms it truly is.  It examines all the possible causes for the symptoms to arrive at a diagnosis.

• Auditory-
• Auditory Verbal-
• Visual-
• Tactile-

Spontaneous recovery - in 1st year-when patient improves to an extent without professional help.

Patients who receive treatment attain better communication skills than patients who do not.

Variables which affect treatment-timin of treatment initiation, family involvement (positive), severity.

• intact skills & deficiencies
• family communication patterns and support
• expectations regarding treatment = social and occupational demands
• client specific and meaningful target behaviors=greatest improvement
• intensive treatment regimen as possible
• maximum amount of stimulus control in the beginning (objects, role playing)
• fading, modeling
• *target language skills = 80% accuracy
• *provide immediate corrective feedback to improve self-monitoring
• independent self-monitoring skills
• training significant others

• Both patient and the family need to learn to live with Aphasia
• Family members-educated
• compensatory communication strategies taught
• realistic prognosis
• treatment - client specific
• team based treatment (RT, OT, SLP, MT,ACT, NSG)
• be prepared to make judgment regarding ethics to continue treatment

Slow rise time:  does not comprehend the 1st few words but comprehends the rest

Noise build-up (*Auditory Fade):  comprehend the 1st few words, but not the last few words of the message as it gets louder

Info processing lag:  comprehends the 1st and last few words, but does not comprehend the middle