Chapter 4

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  1. Why is it important to understand the social implications of aphasia
    Aphasia affects the social, personal, educational and occupational life or goals of individuals.  It is valuable to assessment and treatment.
  2. Arguments for classifying Aphasia
    • Different brain areas control different language functions.
    • Different types of aphasia have different cerebral sites of lesion.
  3. Arguments against classifying aphasia into types
    The brain functions as an integrated unit in controlling language.  Different parts of the brain suggest that no area functions in isolation.

    Lesions may be localized, but not necessarily functions.  Specific language functions often may be controlled by different areas of the brain in individuals.
  4. What are the major types of aphasia?
    • Fluent vs non fluent
    • Fluent:  comphrensive/receptive
    • Non fluent: expressive
  5. What are the non fluent aphasias
    • Broca's
    • Transcortical Motor
    • Mixed Cortical
    • Global
  6. What are the fluent aphasias
  7. General symptoms of aphasia
    Paraphasias- errors in speech consisting of unintended word or sound substitutions. (present in almost all kinds of aphasias)

    Verbal (Global) Paraphasia- entire word is substituted.  Substituted words may one of two kinds.

    Semantic- similar in meaning (ex. son for daughter)

    Random- substituted and intended words are not semantically related (ex. window for banana)

    Neologistic Paraphasia- meaningless, invented words. 

    Phonemic (literal) Paraphasia- substitution of one sound for another (ex. loman for woman) or addition of a sound (wolman for woman)
  8. Disorders of Fluency- fluency is an aspect of language production.
    Fluency or lack of is an important consideration in assessing all patients with aphasia.  Patients who are non fluent (or Brocas aphasia) tend to speak with a degree of muscular effort not seen in normally fluent speakers. Utterances may contain fewer words and speech is hesitant.
  9. Causes of Aphasia (Language disorder based on recent brain trauma)
    Stroke - Hemorrhagic and Ischemic Brain Trauma
  10. Auditory Comprehension - Receptive language/receptive aphasia (Wernickes).
    Difficulty understanding spoken language.  Ranging from mild to profound.
    • Poor Auditory comprehension
    •   Global aphasia (non fluent)
    •   Wernicke's (fluent)
    •   Transcortical sensory (fluent)

    • Good Auditory comprehension
    •   Broca's (non fluent)
    •   Transcortical motor (non fluent)
    •   Conduction aphasia (fluent)
    •   Anomic aphasia (fluent)
  11. Repetition in Aphasia
    Patient's imitation of single words, phrases, and sentences a clinician models.  Generally, repetition errors are more frequent or more severe in cases of impaired auditory comprehension.  (Wernicke's aphasia)
  12. Impairment of repetition skills in the major types of aphasia.  Patients with fluent and nonfluent aphasia may have either relatively poor or better repetition skills.
    Poor Repetition

    • Broca's aphasia (non fluent)
    • Wernicke's aphasia (fluent)
    • Conduction aphasia (fluent)

    Good Repetition

    • Broca's aphasia (non fluent)
    • Transcortical motor (nonfluent)
    • Transcortical sensory (fluent)
  13. Anomia-word finding
    Difficulty in naming or finding correct words during verbal expression.

    Confrontation naming, or naming in response to a verbal demand. (What is this?)

    Word fluency tasks, or naming as many items of a certain category as possible. (Name as many California cities as you can.)
  14. Agraphia
    Writing problems associated with cerebral lesions in adults.
  15. Alexia and Dyslexia
    Reading problems associated with aphasia.  Some experts use these terms interchangeably.  Medical specialists, usually define Dyslexia as reading problems associated with children.
  16. Gestures
    Aphasic patients may have difficulty imitating specific gestures.
  17. How do aphasic patients communicate?
    1.  They speak either little with some struggle or abundantly with ease but without much meaning or grammar.

    2.  Most cannot find the words at all or the right words, resulting slow, halting speech.

    3.  Invented (neologistic) words, may also substitute sounds in words or substitute wrong or less specific words for correct terms.

    4.  May omit sounds within words or whole words.

    5.  May use some form of coping strategies: use a word similar in sound or meaning.
  18. Neurogenic Speech Disorders
    Apraxia of speech - may co-exist with aphasia.

    Patient has difficulty in producing speech with normal articulation and prosody, but there is no muscle weakness or paralysis.

    Dysarthria - weakness, slowness, or incoordination in the speech muscles
    and affects all basic processes of speech; respiration, phonation, articulation, and prosody.  May also co-exist with aphasia.
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Chapter 4
2014-05-25 19:41:29
Sp14 200

Prevalence of Aphasia
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