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Chapter 8 Neurogenic Communication Disorders INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Introduction A neur...

Chapter 8 Neurogenic Communication Disorders INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Introduction A neurogenic communication disorder is usually a brain-based disorder. Individuals with a neurogenic communication disorder are often clients of SLPs who work in a health care setting. Neurogenic communication disorders typically are acquired disorders. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Terminology & Definitions Nervous System: central and peripheral Frontal Lobes: important in the planning of physical movement – Broca’s Area: speech production Temporal Lobes: important for perception – Wernicke’s Area: speech comprehension – Heschl’s gyrus: primary auditory center Parietal Lobes: process incoming sensory information Occipital Lobes: process of incoming visual information INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  CNS & PNS INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Four Lobes of the Left Hemisphere INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Cranial Nerves INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Terminology & Definitions Cerebrovascular Accident (CVA): injury to blood vessels in the brain (called a stroke). Thrombosis Embolism Hemorrhage Parkinson Disease: progressive loss of nerve cell function in brain that controls muscle movement. Alzheimer Disease: brain disorder that affects memory, attention and language. Multiple Sclerosis: damage to the protective covering of nerve cells. Amyotrophic Lateral Sclerosis: affects nerve cells which transmit messages from the brain to voluntary muscles. Traumatic Brain Injury: a sudden blow to head that varies in impairment depending on extent and location of injury. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Stroke INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Historic Aspects of Neurogenic Communication Disorders Franz Joseph Gall (1758-1828) Paul Broca (1824-1880) Karl Wernicke (1848-1905) Paul Broca Korbinian Brodmann (1868-1918) Augusta Dejerine-Klumpke (1859-1927) Karl Lashley (1890-1958) Hildred Schuell (1906-1970) Wilder Penfield (1891-1976) Karl Lashley INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Brodmann Numbering INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of Neurogenic Communication Disorders Impairments of Speech Dysarthria Apraxia Impairments of Language Aphasia Cognitive-Communication Disorder INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Distribution of Communication Disorders INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Impairments of Speech Dysarthria: impairment of motor control for speech caused by weakness, paralysis, slowness, or incoordination of the muscles responsible for production of speech sounds. Includes: Hyperkinetic Hypokinetic Spastic Flaccid Ataxic Mixed Apraxia: an inability to voluntarily perform skilled motor movements that are a result of muscle weakness. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of Dysarthria INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Impairments of Language Aphasia: a collection of clinically diverse disorders that affect the production and comprehension of language, and the ability to read, write, or calculate. Includes: Fluent aphasia (Wernicke) Fluent aphasia (Anomia) Nonfluent aphasia (Broca) Nonfluent aphasia (Mixed or Global) INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Language & Hearing Centers INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of Aphasia INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Impairments of Language Cognitive-Communication Disorders: used to describe a broad range of communication problems that can result from damage to the frontal lobe regions of the brain. Injury to the frontal lobes can include: Laceration Concussion Contrecoup INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Types of TBI laceration concussion contrecoup INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  TBI Role of the SLP in TBI INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Current Theories Regarding Neurogenic Communication Disorders Spontaneous Recovery (Cappa, 2000) Right Hemisphere Theory of Recovery Phonetic-Motoric Disorder of Apraxia (Ballard et al., 2000) INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Assessment of Neurogenic Communication Disorders Dysarthria Speech intelligibility Electromyography Apraxia Apraxia Rule-out muscle weakness or language comprehension problems Speech sequencing tasks Examine non-speech oral motor skills ideomotor apraxia Ideational apraxia INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Assessment of Neurogenic Communication Disorders Aphasia Initial (bedside) assessment Primary assessment Consideration of pre-morbid state Left neglect Cognitive-Communication Disorders Examination of all aspects of communication, particularly listening, speaking, gesturing, reading, and writing. INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Neurogenic Communication Disorders Dysarthria: focus is on improvement of speech clarity and speech naturalness. Includes: Lee Silverman Voice Treatment (LSVT) INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Neurogenic Communication Disorders Apraxia: treatment approach is dependent upon the severity of the impairment. Includes: Sound sequencing INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Neurogenic Communication Disorders Aphasia: goal of therapy is to: (1) maximize recovery of impaired function (2) assist in the development of communication strategies (3) help the patient adjust to the residual deficits of the brain injury INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Communication Tips for Aphasia INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Treatment of Neurogenic Communication Disorders Cognitive-Communication Disorders: goal of therapy is to assist patients in increasing their reliance on more intact cognitive abilities to compensate for those abilities that have become impaired. Includes: Validation therapy Graphic cuing Montessori-based intervention INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  FOCUSED Approach INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Cultural Considerations and Neurogenic Communication Disorders A range of multicultural factors interact with neurogenic communication disorders. Includes: Race Ethnicity Geographic region Socioeconomic status Bilingual speakers INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Current Research Motor Learning Principles Brain Stimulation Resting-State MRI INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.  Deep Brain Stimulation INTRO 3E Copyright © 2020 by Plural Publishing, Inc. Michael P. Robb All rights reserved.