Articulation handout #1 and #2 – bring to class next TuesdayExam format:20 mult choice10 true false15 matching5 fill in the blanks(from past classes)Types of Adult Language Impairments(finished talking about aphasia)Ischemic StrokesA lot of recovery right away, recovery slows downHemoragic StrokeRecovery at beginning is slower, recover fastNeither has better prognosis, about 6 months long11/2 (class before Test)Traumatic Brain InjuryMost often young adults (males 18-25)Take more risks, play more sportsCommon causes - car or motorcycle accidentsDamage is more generalized – affects more of brain due movement of brain in skull (doesn’t affect specific area of brain)Damage in wider area (from side to side or front to back, brain rickasheas)Mild cases of traumatic brain injury = concussionNot really aphasia, in fact these patients do well on aphasia testingAphasia can only be on left side of brainThis is through whole brainPrimarily cognitive-linguistic deficitsNot specific problems, general onesCognitive-Linguistic DeficitsAttentionMemory/word finding problemsOften cant remember what happened to themHave trouble coming up with words that they want (like aphasia)Learning difficulties: esp. for NEW infoDecreased inhibition, poor pragmatic skillsSay rude things to doctors, etcOrganizational skills (frontal lobe) planning and executing actions, problem solvingFrontal lobe is most commonly injuredEx. Couldn’t spread past topic (cats, reds), hard to do specific tasksRecovery from TBIGo through stages that are relatively predictable (8 stages-Rancho Los Amigos Scale)Need ongoing evaluation and treatmentChanging everydayOften going from comatose to re-entry into communityDepends on severity of brain injuryOften may have swallowing and/or speech problems as well as cognitive-linguistic onesUsually 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 APHASIAMore difficult to detectNot quite as obvious to family members or care giversInclude some cognitive-linguistic problems: memory, orientation, awareness of deficits (don’t really believe there is anything wrong with them)Could have paralysis of left side (crosses over)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 with themSometimes don’t think left side of body belongs to themVisual Neglect-usually unilateral-problems reading, using any visual materialsDon’t visual this side of body, often don’t visualize anythingIgnore a whole left side of picture when asked to redraw itWork on having them look all the way overEspecially important in reading – might start in middle of page, can’t figure out why it doesn’t make sense to themLanguage is often confused, tangential, irrelevant due to poor organizationTangential – go off on tangents even if they don’t make senseMANY PRAGRATIC PROBLEMSDon’t initiate conversation very well, likely to sit all day long and never initiate conversationAssessment/Treatment of RHDHas own set of tests- NOT aphasia testsNeed to look at visual problems, attention, neglect, memory, organizational skillsSometimes you actually have to treat them by teaching them these things – how to initiate communication, use facial expressionsVideotape them in a conversation with someone, and show it to themDon’t understand why people don’t communicate with them and why its hard to communicate with themTeaching pragmatics, facial expression, initiation of communicationProgress depends on amount of damageDementiaProgressive, irreversible, generalized damage in all cognitive abilities including languageGets worse, can’t get better, some medicines can slow progression but nothing will stop itInterferes with all cognitive abilitiesMost common type: Alzheimer’s diseaseCan 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 problemsCant remember answers to very simple questions, often cant remember names of thingsEnd stage patients may use stereo-typical responses or be mute (have been through all the stages of dementia)Don’t recognize people. Don’t remember who they are or where they areGo through some combativeness like head injury patients, but less common than in head injuriesUsually also have swallowing problemsas if they have forgotten how to swallow, don’t know what to do with the food in their mouthTreatment for DementiaEarly – may provide memory strategies or orientation information (memory books)Counseling families about how best to communicate with family memberEvaluate swallowing to determine safety for eating or more appropriate dietXray – see what best type of food is, could recommend that person should not eat, anything they eat will go down into lungsMay need to make recommendations regarding tube feeding13/12/2012 22:22:00Articulation handout #1 and #2 – bring to class next TuesdayExam format:20 mult choice10 true false15 matching5 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 testingo Aphasia can only be on left side of braino This is through whole brain- Primarily cognitive-linguistic deficitso Not specific problems, general ones←← Cognitive-Linguistic Deficits- Attention- Memory/word finding problemso Often cant remember what happened to themo Have trouble coming up with words that they want (like aphasia)- Learning difficulties: esp. for NEW info - Decreased inhibition, poor pragmatic skillso Say rude things to doctors, etc- Organizational skills (frontal lobe) planning and executing