Chapter 7 Study Guide Chapter 7 Adult Language Impairments o Large parts is assessment and treatment of strokes o Some Impairments developed through the Lifespan Aphasia Right Hemisphere Damage Traumatic Brain Injury Dementia For most impairments are considered organic because we know the cause o Brain tissue or other transmitter problems o Normal Language Developments Unless there is neuropathology adults continue to refine communication skills Written language becomes more complex than oral language in adults Use Content Form Adults are skilled conversationalists Narratives until the 70s 30 000 60 000 words of expressive production Some words aren t used anymore and others are added o Based on hobbies occupations religion etc Its normal with age to lose accuracy and speed of word retrieval naming Use of cohesive devices o Conjunctions and or but Continue to acquire some aspects Complex sentences decrease with age Aphasia o Without language o Affects over 1 million people in the US Everyday more than 200 people come aphasic o May affect listening speaking reading writing Can also affect ability to do math gestures ability to tell time and interpret environments sounds o Can range in severity conversation Mild Generally deficits are barely noticeable in normal More reserve form can affect comprehension and production making normal communication much harder o 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 Dyphagia Agnosia Agrammatism Agraphia Blindness in the right visual field Chewing and swallowing difficulties Difficulty with comphrending sensory information visual and auditory stimuli Leaving out grammar words articles Use of meaningless or irrelevant speech but intonation Difficulty in writing Difficulty with reading Naming problems Alexia Anomia Jargon pattern is right Neologism Creates words Paraphasia Makes up words 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 Often effects the posterior left hemisphere verbal output temporal lobe Subdivision o 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 problems 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 o Anomic Aphasia problems o 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 or temporal 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 division o 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 Speech is still impaired Gets fairly good imitation skills Only mild comphrending problems Greatest problem is initiation of speech and writing Damage is to the motor cortex of o Global or Mixed Aphasia the brain Most serve form of Aphasia Characterized in deficits in all language areas Some deficits Comphrending production etc Anomia imitation stereotypic Tissue death in the greater left speech hemisphere Goes deep into the brain Cause of Aphasia o 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 Ischemic o Arteries that transport blood to brain Interruption of blood flow to the brain o Greatest improvement in first weeks slow after 3 months o Cerebral arteriosclerosis Thickening of artery walls in the brain Blood flows is restricted oxygen o Embolism o Thrombosis Caused by blood clot in another part in the body and travels to arteries Plaque builds up in arteries cerebral and clot is formed Transient ischemic attack o Mini strokes o Blood flow temporary blocked from flow Warning signs that a stroke is coming Hemorrhagic o Artery walls burst under pressure o No blood transportation o Have aneurisms and arteriovenous malformation Aneurysm o Sack in cerebral arteries Arteriovenous malformation not know o Genetic o Poorly formed arteries o Rare condition people can have it from birth and Causes of Aphasia o Injury to the left hemisphere areas o Common symptoms seen in other conditions Head injury neural infections degenerative neural disorders and tumors o Primary Progressive aphasia Doesn t fall into any other category Degenerative disorder of language Can take up to 2 years to develop Moves from minor speed problems to total disability of not Still have cognitive and daily living abilities Lifespan Issues speaking o Most who suffer aphasia are middle age and beyond Before age 50 is unusual o Risk of stroke increases with Smoking alcohol use poor diet lack of exercise high blood pressure high cholesterol diabetes obesity and previous strokes o First signs slurred speech Loss of consciousness headache weak immobile limbs and Can take a small amount of time after the first signs o One third of those affected from stroke die or soon after o The ones who survive their stroke may need services after acute care Acute care time at hospital after stroke o Spontaneous recovery Natural process after initial assessment Right Hemisphere Damage o The right hemisphere deals with perception emotion figurative language and conversations o