CSCD 6307 Aphasia Class 2 Fall 2024 PDF

4 categories of acquired neurogenic language/cognitive disorders Aphasia: impairment in expressing, understanding, reading, or writing oral and written language Right Hemisphere Damage: memory impairment, attention and impulsivity problems, and visual dysfunction Traumatic Brain Injury: cognitive-...

4 categories of acquired neurogenic language/cognitive disorders Aphasia: impairment in expressing, understanding, reading, or writing oral and written language Right Hemisphere Damage: memory impairment, attention and impulsivity problems, and visual dysfunction Traumatic Brain Injury: cognitive-communication impairment associated with brain damage Dementia: loss of linguistic and cognitive ability due to a progressive brain disease Additional Considerations Not developmental - acquired following neurological injury Language-based dysfunction, not motor-based dysfunction, although the two may coexist Person with aphasia usually has intact psychosocial skills (not always) Not to confuse language deficits for psychological disturbance  “Aphasia is an impairment, due to acquired and recent Definition damage of the central (What is nervous system, of the ability to comprehend and Aphasia?) formulate language” Rosenbek et al (1989)  Literal meaning, “without language” A disturbance in the adult language system after the language has been established Definition or learned (What is Results from neurological injury to the language- Aphasia?) dominant hemisphere of the brain Includes disturbances of receptive and/or expressive abilities for both spoken and/or written language What causes aphasia? Etiology CVA (Cerebral Vascular Accidents) Ischemic (occlusive mechanisms) Hemorrhagic Cerebral aneurysm Arteriovenous malformation https://www.stroke.org/en/about-stroke/types-of-stroke Neoplasms in the brain (tumors) TBI Medications  Classification of Aphasia Agreement to classify aphasia syndromes (taxonomy) Disagreement on how to classify How do Cause Site of lesion we Language characteristics Dichotomous (based on classify deficits) aphasia? motor / sensory receptive / expressive anterior / posterior fluent / non-fluent Boston System (characteristics of language impairment) Boston System: Characteristics of language impairment FLUENCY AUDITORY NAMING REPETITION COMPREHENSION READING WRITING  Broca’s Wernicke’s Conduction Boston System Global types: Transcortical characteristics Transcortical Motor of language Aphasia impairment Transcortical Sensory Aphasia Anomic Subcortical  Expression using a smooth, uninterrupted flow and rate of speech Fluent aphasia: Spontaneous speech flow with adequate phrase le Typically posterior brain damage (temporal/pariet regions) https://www.youtube.com/watch?v=3oef68YabD0 https://www.youtube.com/watch?v=3oef68Y Fluency https://www.youtube.com/watch?v=3oef68YabD0 abD0 Non-fluent aphasia Diminished phrase length, hesitations, slowed or labored/effortful speech production, grammatica impaired pitch and stress variation Typically anterior brain damage (frontal lobe) https://www.youtube.com/watch?v=JWC-cVQmEmY https://www.youtube.com/watch?v=JWC- https://www.youtube.com/watch?v=JWC-cVQmEmY cVQmEmY Auditory Comprehension Ability to understand spoken language being able to segment the sounds heard into meaningful phonemes Complex process that understanding the meaning of words within the sentence involves retaining the message in memory long enough to understand it and formulate a response Amount of information Frequency of word usage Influenced by: Personal relevance of information Part of speech  Ability to accurately reproduce verbal stimuli one hears Process Receive and process incoming stimulus Convey the information to regions of brain that formulate and plan motor sequence for speech Articulate to reproduce the initial stimulus Repetition Requires good connecting pathways between Wernicke’s area & Broca’s area Wernicke’s area: critical for processing & understanding auditory information Broca’s area: important for programming & movements for speech production  Ability to retrieve and produce a target word Complex process recognize the object retrieve the semantic label for the object develop the phonological form for the label program the speech movements needed to say the word Naming Anomia: disturbance in the ability to name Most pervasive and most persistent deficit Paraphasias Phonemic: substitution or transposition of the targeted phoneme Semantic: error is related or in the same category but is incorrect  Written language disturbances usually parallel spoken language impairments Non-fluent speakers will also be non-fluent in writing and Reading & reading Writing Individuals with auditory comprehension problems also have problems comprehending written information Review of Neuroanatomy (Chapter 1)  Broca’s Wernicke’s Conduction Boston System Global types: Transcortical characteristics Transcortical Motor of language Aphasia impairment Transcortical Sensory Aphasia Anomic Subcortical What are the characteristics of each type of aphasia?  Location of damage: frontal lobe, typically Broca’s area Non-Fluent Agrammatism (telegraphic speech structure with content words, lack of function words) Naming deficits (mild to severe) Paraphasias Circumlocutions Broca’s Articulation errors Difficulty with repetition (mild to severe) Aphasia Slow, labored speech, short phrases Relatively intact auditory comprehension Reading slow and labored Writing effortful / with errors https://www.youtube.com/watch?v=JWC-cVQmEmY https://www.youtube.com/watch?v=Cy6S7aMmUYo (@ 9:00-9:29) https://www.youtube.com/watch?v=1aplTvEQ6ew  Location of damage: frontal lobe, typically superior and anterior portions Non-Fluent (similar to Broca’s except repetition & oral reading) Agrammatism (telegraphic speech structure with content words, lack of function words) Transcortical Naming deficits (mild to severe) Articulation errors Motor Relatively intact repetition Aphasia Slow, labored speech, short phrases Relatively intact oral reading and auditory comprehension Writing effortful / with errors Impaired conversational speech Problems initiating speaking and writing  Location of damage: large region of brain or multiple sites of injury Non-Fluent Severe problems communicating Severe spontaneous speech deficits Global Severe auditory comprehension deficits Typically non-verbal with limited Aphasia gestures Severe reading and writing deficits https://www.youtube.com/watch?v=l7F9 9bYr5XE https://www.youtube.com/watch?v=6CJ Wo5TDHLE  Location of damage: temporal lobe, possible parietal also, specifically Wernicke’s area Fluent Spontaneous speech with normal prosody Possible logorrhea (overly fluent speech Limited meaningful content Wernicke’s Auditory comprehension deficits Naming deficits Aphasia Paraphasias, neologisms, jargon Poor repetition Fluent writing, but limited meaning (similar to verbal) Reading comprehension deficits https://www.youtube.com/watch?v=3oef6 8YabD0  Location of damage: border of the temporal and occipital lobes or the parietal lobe (superior region) Rare aphasia Fluent (similar to Wernicke’s except repetition) Spontaneous speech with normal prosody Possible logorrhea Limited meaningful content Transcortical Auditory comprehension deficits Severe Naming deficits Sensory Paraphasias, neologisms, jargon Typically intact repetition (frequent verbal Aphasia repetitions of random auditory stimuli = echolalia) Fluent writing, but limited meaning (similar to verbal) Reading comprehension deficits https://www.youtube.com/watch?v=dKTdMV6cOZ w  Location of damage: temporal- parietal region, usually the connector pathway - arcuate fasciculus Fluent Mild deficits in spontaneous Conduction speech Mild auditory comprehension Aphasia deficits Naming deficits (paraphasias) Deficits in repetition Poor ability to read aloud https://www.youtube.com/watch?v =G94TvTvjeeU  Location of damage: no specific area; most common is angular gyrus Most pervasive & most common type Fluent (meaningful) Mild deficits in spontaneous speech (fluency affected by Anomic deficits in word retrieval) May have auditory Aphasia comprehension deficits Naming deficits (spoken & written) Relatively intact repetition https://www.youtube.com/watch?v =xx03JocIa6w