Chapter 7 Study Guide- Chapter 7—Adult Language Impairmentso Large parts is assessment and treatment of strokeso Some Impairments developed through the Lifespan Aphasia Right Hemisphere Damage Traumatic Brain Injury Dementia- For most impairments are considered organic because we know the causeo Brain tissue or other transmitter problemso Normal Language Developments Unless there is neuropathology, adults continue to refine communication skills Written language becomes more complex than oral language inadults Use- Adults are skilled conversationalists- Narratives until the 70s Content- 30,000-60,000 words of expressive production- Some words aren’t used anymore and others are addedo Based on hobbies, occupations, religion, etc.- Its normal with age to lose accuracy and speed of word retrieval/naming Form- Use of cohesive deviceso Conjunctions (and, or, but)- Continue to acquire some aspects- Complex sentences decrease with age- Aphasiao “Without language”o Affects over 1 million people in the US Everyday more than 200 people come aphasico May affect listening, speaking, reading, writing Can also affect ability to do math, gestures, ability to tell time, and interpret environments soundso Can range in severity Mild: Generally deficits are barely noticeable in normal conversation More reserve form can affect comprehension and production making normal communication much hardero Common problems (no matter the type/ severity) Reduced vocabulary Omission/ addition of words- Grammar gets left out Stereotypic speech- Struggling to figure out what to say Delayed or reduced output of speech- Timing issue and communication is disrupted Words substitutions- Can’t find words- Difficult comprehension any impulses coming through o Different types of deficits Hemiparesis- Weakness on one side of the body Hemiplegia- Paralysis on one side of the body Hemisensory impairment- In ability to process sensory on one side of the body Hemianopsia- Blindness in the right visual field Dyphagia- Chewing and swallowing difficulties Agnosia- Difficulty with comphrending sensory information (visual and auditory stimuli) Agrammatism- Leaving out grammar words/ articles Agraphia- Difficulty in writing Alexia- Difficulty with reading Anomia- Naming problems Jargon- Use of meaningless or irrelevant speech but intonation pattern is right Neologism- Creates words- “Makes up” words Paraphasia- Word substitutions Verbal stereotypes- Repeating a phrase over and over Fluent Aphasias- The stroke has impacted the posterior of the left hemisphere (which is specialized for language) or temporal lobe- Word substitutions, neologisms, and often verbose verbal output- Often effects the posterior left hemisphere—temporal lobe- Subdivisiono Wenicke’s Aphasia Rapid fire of sentences (frequent and fast pace with little pauses and acknowledge of their listeners) not aware of no pauses/not considering the listener Fluent and hypofluent Visual problems Problems with reading and writing Use of lots of Jargon Mild to sever naming problemso Anomic Aphasia Naming problems (in speech and writing)will have fluent speech able to innate and answer but have word retrieval problems Mild to moderate auditory comphrending problemso Conduction Aphasia Fluent speech with Anomia but mild impairments of auditory comphrending if any Have poor repetitive or imitative speech Insert extra words or sounds into speech Area impacted by stroke where contracted (no major impact on frontal ortemporal lobe) Nonfluent Aphasia- Slow, labored speech, word retrieval and syntactic problems- Site of lesion often in or near the frontal lobe- Intonation, rate problem, and frequent pauses in speech- Sub divisiono Broca’s Aphasia Tissue death happens in Broca’s area. Short sentences, Agrammatism, Anomia, problems with imitation of speech, numerous articulation areas, and slow unlabored speech and writing Broca is the control of motor area May have comphrending problems (better than output)o Transcortical Motor Aphasia Gets fairly good imitation skills Speech is still impaired Only mild comphrending problems Greatest problem is initiation of speech and writing- Damage is to the motor cortex of the braino Global or Mixed Aphasia Most serve form of Aphasia Characterized in deficits in all language areas- Comphrending, production, etc. Some deficits- Anomia, imitation, stereotypic speech Tissue death in the greater left hemisphere- Goes deep into the brain - Cause of Aphasiao Stroke Affects half a million Americans annually Approximately 100,000 become aphasic each year- More than 70% are over 65 years old Types of stroke- Ischemico Arteries that transport blood to brain Interruption of blood flow to the brain o Greatest improvement in first weeks, slow after 3 monthso Cerebral arteriosclerosis Thickening of artery walls in the brain- Blood flows is restricted/oxygeno Embolism Caused by blood clot in another part in the body and travels to arterieso Thrombosis Plaque builds up in arteries (cerebral) and clot is formed- Transient ischemic attacko Mini strokeso Blood flow temporary blocked from flow Warning signs that a stroke is coming- Hemorrhagico Artery walls burst under pressureo No blood transportationo Have aneurisms and arteriovenous malformation- Aneurysmo Sack in cerebral arteries- Arteriovenous malformationo Rare condition; people can have it from birth andnot knowo Genetico Poorly formed arteries - Causes of Aphasiao Injury to the left hemisphere areas o Common symptoms seen in other conditions Head injury, neural infections, degenerative neural disorders, and tumorso Primary Progressive aphasia Doesn’t fall into any other category Degenerative disorder of language Can take up to 2 years to develop Still have cognitive and daily living abilities Moves from minor speed problems to total disability of not speaking- Lifespan Issueso Most who suffer aphasia are middle age and beyond Before age 50 is unusualo Risk of stroke increases with Smoking, alcohol use, poor diet, lack of exercise, high blood pressure, high cholesterol, diabetes, obesity, and previous strokeso First signs Loss of consciousness, headache, weak/immobile limbs, and slurred speech Can take a small amount of time after the first signso One-third of those