M7: Right Hemisphere Dysfunction

Play an AI-generated podcast conversation about this lesson

The __ side of the brain processes information in a linear manner. It processes from part to whole. It takes pieces, lines them up, and arranges them in a logical order.

Left

The ___ side of the brain processes from whole to parts, holistically. It starts with the answer. It sees the big picture first, not the details.

Right

If you are ___-brained, you may have difficulty following a lecture unless you are given the big picture first.

Right

In addition to thinking in a linear manner, the __ brain processes in sequence

Left Signup and view all the answers

This side of the brain uses random, fantasy oriented processing.

Right Signup and view all the answers

This is a type of memory disruption that leads to inaccurate, distorted or fabricated memories where information is made up.

Confabulation Signup and view all the answers

What is the term for the denial of deficits?

Anosognosia Signup and view all the answers

What is prosopagnosia?

The inability to recognize formerly familiar faces Signup and view all the answers

This is the term used when individuals get stuck or repeat the same information. Iti is an inability to switch ideas or responses.

Perseveration Signup and view all the answers

What is the #1 reported change in RHD patients?

Perceptual impairment Signup and view all the answers

Describe communication impairments that RHD patients display.

Diminished prosody Anomalous content/organization of speech Impaired comprehension of narratives and conversation Pragmatic impairments Signup and view all the answers

Anosognosia is a perceptual impairment characterized by the denial of deficits. It can manifest in varying ways in individuals. Please describe some of these variations/characteristics.

Variable range of denial Indifference to disabilities Underestimate severity and minimize deficits Disavow existence of major disabilities Disinterested in rehabilitation Signup and view all the answers

What causes prosopagnosia, or the inability to recognize faces?

Posterior right hemisphere damage or bilateral lesion Signup and view all the answers

Patients with RHD may suffer from this impairment, characterized by the inability to draw, copy and/or create geometric designs, and reproduce two or three dimensional figures. They often leave out left-sided details and/or add extraneous details.

Constructional apraxia Signup and view all the answers

What is left hemispatial neglect?

Patients with neglect fail to respond to information presented contralateral to their brain lesion. Failure to recognize tactile, auditory, and visual stimuli in left-sided space. Signup and view all the answers

Provide 3 examples of errors patients with left neglect may make.

Fail to respond to people and sounds on the left Leave out the left side of drawings Read only material on the right side of the page Write on the right side of the page; abnormally large left margin. Write slanted; missing letters or words Signup and view all the answers

Damage to these parts of the brain causes left hemispatial neglect.

Inferior frontal lobe Inferior parietal lobe Temporo-parietal junction Thalamus and basal ganglia Signup and view all the answers

Name 1 technique to help patients with left neglect when reading.

Train to scan both sides of the page Use colored borders, ruler, or finger placement to be aware of the left side Restructure the environment Right sided placement vs left sided Signup and view all the answers

If you have important information to share with a patient with RHD/left neglect, what side should you stand on when speaking to him or her?

Right side Signup and view all the answers

What is the main difference between hemianopia and neglect?

Hemianopsia results in dramatic attempts to compensate, whereas neglect does not Signup and view all the answers

Describe 3 characteristics of impaired communication.

Lack of normal variability in vocal pitch and loudness Speech sounds monotonous and devoid of emotion Slower than normal rate — robotic quality Diminished speech prosody Signup and view all the answers

Communication typically contains more content and fewer words.

False Signup and view all the answers

Syntax, grammar, phonological processing, and word retrieval typically are not affected in patients with right hemisphere dysfunction.

True Signup and view all the answers

Describe 3 pragmatic impairments individuals with RHD might exhibit.

Social and interactional aspects of language impaired Turn taking, topic maintenance, social conventions, and eye contact impaired Begin / end conversations abruptly Poor eye contact with partner Talk excessively without regard to listener Difficulty with topic maintenance Insensitive to turn taking rules Signup and view all the answers

The right hemisphere plays an important role in the recognition and expression of emotion. Individuals with RHD typically have impaired/inappropriate expressions of personal emotions and difficulty appreciating other people’s emotions. How else can emotion be impaired?

Fail to appreciate prosodic cues to emotion Fail to interpret facial expressions of emotions Faul to identify emotions in pictured scenes Fail to identify emotions in sentences and longer narratives / stories Signup and view all the answers

Briefly describe theory of mind.

The ability to understand that other people have thoughts, ideas, perspectives, emotions, and feelings that are different from your own. Being able to “put yourself in someone else’s shoes.” Signup and view all the answers

What are the 3 approaches to treatment? Please describe.

Relative level of impairment: Focus on areas of relative strength and weakness in a patient’s performance. Fundamental abilities: Target processes that are presumed to underlie a range of deficiencies (e.g. attention) Functional abilities: Focus on daily life competencies and concerns Signup and view all the answers

Patients with RHD may exhibit indifference and denial, are likely to be passive in therapy, and may neglect homework. How can SLPs manage these behaviors in treatment?

Treatment should be highly structured with clear treatment goals Defer therapy until denial improves/resolves Provide clear feedback about errors and inappropriate responses and work on improving self-monitoring. Signup and view all the answers

Name 3 tasks to improve attention and distractibility.

Computer based attention drills Paper and pencil tasks Letter cancellation Solving mazes Vary complexity and duration of tasks to challenge the patient (e.g. competing or distracting stimuli; change response requirements) Signup and view all the answers

Please describe how you can treat impulsivity.

Incorporate “stop” and “go” signals Must wait for a signal to respond (light cue, verbal cue, gestural cue) Gradually transfer to patient self-cueing Signup and view all the answers

In general, there is little research on treatment for cognitive-communication disorders that are associated with RHD, except for ___?

Unilateral neglect Signup and view all the answers