Articulation handout 1 and 2 bring to class next Tuesday 13 12 2012 22 22 00 Exam format 20 mult choice 10 true false 15 matching 5 fill in the blanks from past classes Types of Adult Language Impairments finished talking about aphasia Ischemic Strokes A lot of recovery right away recovery slows down Hemoragic Stroke Recovery at beginning is slower recover fast Neither has better prognosis about 6 months long 11 2 class before Test Traumatic Brain Injury Most often young adults males 18 25 o Take more risks play more sports Common causes car or motorcycle accidents Damage is more generalized affects more of brain due movement of brain in skull doesn t affect specific area of brain o Damage in wider area from side to side or front to back brain rickasheas Mild cases of traumatic brain injury concussion Not really aphasia in fact these patients do well on aphasia testing o Aphasia can only be on left side of brain o This is through whole brain Primarily cognitive linguistic deficits o Not specific problems general ones Cognitive Linguistic Deficits Attention Memory word finding problems o Often cant remember what happened to them o Have trouble coming up with words that they want like aphasia Learning difficulties esp for NEW info Decreased inhibition poor pragmatic skills o Say rude things to doctors etc Organizational skills frontal lobe planning and executing actions problem solving o Frontal lobe is most commonly injured o Ex Couldn t spread past topic cats reds hard to do specific tasks Go through stages that are relatively predictable 8 stages Rancho Los Recovery from TBI Amigos Scale Need ongoing evaluation and treatment o Changing everyday Often going from comatose to re entry into community o Depends on severity of brain injury Often may have swallowing and or speech problems as well as cognitive linguistic ones o Usually think of brain injury as a language problem but often have frontal lobe damage where motor skills are may have swallowing speech movement problems Right Hemisphere Disorders RHD NOT APHASIA More difficult to detect them with them materials o Not quite as obvious to family members or care givers Include some cognitive linguistic problems memory orientation awareness of deficits don t really believe there is anything wrong with o Could have paralysis of left side crosses over o Left side might not be working and still say they have to leave hospital to go to work deny deficits like there s nothing wrong o Sometimes don t think left side of body belongs to them Visual Neglect usually unilateral problems reading using any visual o Don t visual this side of body often don t visualize anything o Ignore a whole left side of picture when asked to redraw it o Work on having them look all the way over o Especially important in reading might start in middle of page can t figure out why it doesn t make sense to them Language is often confused tangential irrelevant due to poor organization o Tangential go off on tangents even if they don t make sense MANY PRAGRATIC PROBLEMS o Don t initiate conversation very well likely to sit all day long and never initiate conversation Assessment Treatment of RHD Has own set of tests NOT aphasia tests Need to look at visual problems attention neglect memory organizational skills o Sometimes you actually have to treat them by teaching them these things how to initiate communication use facial expressions o Videotape them in a conversation with someone and show it to them o Don t understand why people don t communicate with them and why its hard to communicate with them Teaching pragmatics facial expression initiation of communication Progress depends on amount of damage Dementia Progressive irreversible generalized damage in all cognitive abilities including language o Gets worse can t get better some medicines can slow progression but nothing will stop it o Interferes with all cognitive abilities Most common type Alzheimer s disease o Can get it from multiple strokes parkinson s disease for a long period of time parkinson s type dementia senile dementia from being old Earliest symptoms are memory loss and word finding problems o Cant remember answers to very simple questions often cant remember names of things End stage patients may use stereo typical responses or be mute have been through all the stages of dementia o Don t recognize people Don t remember who they are or where they are o Go through some combativeness like head injury patients but less common than in head injuries Usually also have swallowing problems o as if they have forgotten how to swallow don t know what to do with the food in their mouth Treatment for Dementia Early may provide memory strategies or orientation information Counseling families about how best to communicate with family member Evaluate swallowing to determine safety for eating or more appropriate memory books diet o Xray see what best type of food is could recommend that person should not eat anything they eat will go down into lungs May need to make recommendations regarding tube feeding 13 12 2012 22 22 00 13 12 2012 22 22 00