Unit Exam 2 Study Guide PDF

Week 4 Anomia: impairment in naming ,important for functional communication Assessed in confrontation naming tasks ○ Picture naming ○ Object naming Lexical retrieval/naming system (input, output, stages of processing) 1. Input triggers the...

Week 4 Anomia: impairment in naming ,important for functional communication Assessed in confrontation naming tasks ○ Picture naming ○ Object naming Lexical retrieval/naming system (input, output, stages of processing) 1. Input triggers the output 2. In confrontation tasks, the focus is what kind of input will help trigger appropriate output 3. Input is when we show them what they have to name (written word or an object) 4. Hope that we recognize that information from our memory a. Two Stages i. Semantic stage: input, the picture or word ii. Phonologic stage: lexical output, where name of whatever we’ve seen is retrieved, output could be spoken or written language 1. Confrontation: visual object recognition system (input) 2. Linguistic: written word (giving them a written word) Neurological underpinnings of lexical retrieval/anomia Caused by a diffuse in Left hemisphere neural network, associated with Broca’s Area ○ Following perisylvian and extrasylvian lesions Left-inferior temporal for semantic (lexical input) Naming/Lexical retrieval assessment o Formal and informal methods Formal methods: ○ Boston Naming Tests ○ Object and Action Naming Battery ○ Expressive Vocabulary Test ○ Language Activity Resource Kit - Informal Methods - Standardized tests can also be informally used for this if they are not being used with strict administration and scoring criteria - Language Samples - Conversation - Response, convergent, and divergent naming o Modalities Cross- modality naming assessment is important ○ Input modalities Speech object /picture ○ Output modalities Speech Writing gesture /pointing o General considerations Word finding impairments should be identified in spontaneous speech/conversation as well as in structured tasks Structured naming tasks allow for thorough assessment of naming functions with various input and output modalities  ○ In order to help with: distinguish impairment at the semantic phase of processing or the phonological phase of processing (or both) o What characteristics of stimuli can impact performance Nouns vs verbs Semantic categories Imagebality Length Familiarity Word frequency Age of acquisition o Error analysis : assess language tasks, : often correct/ incorrect - Can provide valuable information regarding nature of impairment How disruptions to different systems of processing impact performance Semantic Disruptions: Comprehension and naming tasks errors ○ difficulty with both spoken and written word comprehension. ○ Difficulty in interpreting the meaning of gesture and objects and pictures ○ Comprehension tasks errors Oral word reading and writing dictation may not be affected Phonological lexical output disruptions: Oral word production impaired ○ Comprehension will be preserved ○ Errors in oral naming ○ Errors Oral word reading Difficulty activating output lexicon, BOTH levels can affected by an injury * Naming/Lexical retrieval Treatment o Cueing hierarchies: provide less support initially and then progressively more support as needed Semantic cues Phonemic cues Target in different modality Providing target and asking for repetition Newly developed computerized programs ➔ Semantic Treatment: based on the underlying need for a string semantic system for both comprehension and word retrieval ◆ Use of comprehension treatment to facilitate word retrieval Sorting pictures into categories Auditory word and written word-picture matching (c distractors) Yes no verification about semantic characteristics of target pictures ◆ Semantic feature analysis Train patients to use a matrix of cue words that are designed to trigger an element or characteristic of the target word -Phonological treatments: give them a word and say repeat this, based on phonologic representations Word repetition effectiveness is less than comprehension and cueing strategies ○ No consensus on weather either treatment is better for word finding impairments o Re Organizational approaches to treatment Spelling knowledge may be preserved in people with anomia Spelling knowledge may facilitate word retrieval through phonemic self-cueing The idea that gestures will facilitate correct word retrieval ○ Basically type two letters into computer to generate initial phoneme of target word, pt pronounced sound to provide themselves with a phonemic cue ○ Results: improved naming skills even without comp/self-cues  ○ Gesture an target word together will elicit production o General factors to consider 1. Spaced retrieval training; patients produced small sets of personally relevant target words with systematically inc periods between retrieval 2. Intensity of treatment 3. Generalization 4. Goal: improved functional communication (in conversation contexts) Week 5: Auditory comprehension: ability to understand spoken language Single-word comprehension o Assessment: Present a word , verbally stated, provide instructions to point to the object/ structure/picture ➔ potential tasks ◆ Matching written word to picture/object ◆ Ask “is this a…” or “book” (wait for yes/no response- verbal, written, or gestural) ◆ Most of the time, nouns are targeted, but also asses verb comprehension with these methods Sentence-level comprehension o Factors impacting sentence complexity 1. Semantic reversibility: words in a sentence, knowledge about the words, these sentences are more difficult to understand, non reversible sentences are easier because we use word meaning to interpret even if we don’t understand the syntax 2. Sentence Structure: more complex structures are more difficult to understand 3. Number of prepositions: more propositions/ verbs, the more complex it is o Common impairment patterns in aphasia ➔ Sentence level comprehension deficits are common among individuals with aphasia ◆ Wernickes and global aphasia o Assessment, Standardized forms: ○ PALPA ○ Revised Token Test ○ BDAE Informal Assessment: ○ Following commands Potential tasks ○ Simple and complex yes or not questions ○ Answering open ended questions following presentation of some information (reading or storytelling) o Auditory Comprehension Treatment approaches: based on stimulation approach, language system is not lost or destroyed, build on whatever is still there and make it work more efficiently For people who have comprehension production deficits ○ Pointing Drills ○ Following directions/commands ○ Yes or no questions Treatment based on Schuells’s Approach ○ Sentence/phrase completion: “cloze procedure” Complete simple common phrase and complete sentence with predictable answer ○ Open ended questions and retelling  Sentence-level production Informal Assessment ○ Spontaneous speech Sequence description Picture description Analysis procedures Formal/standardized Aphasia batteries ○ PAL: include subtests for production of complex linguistic structures Point to the picture that shows elephant was chase by the lion (comprehension) “I want you to start talking about the cat. Use the word chase” (production) o Treatment (verb-centered, syntactically oriented, etc.) ➔ Verb centered treatment: premise is that verbs contain information about argument structure ◆ Include cueing verbs treatment: based on verb being the “core” of sentence ◆ Patients produce sentences via structured practice producing verbs, arguments, with repetition ➔ Verb network strengthening treatment: improve retrieval of content words within simple active sentences ◆ Improve retrieval of content words within simple active sentences ➔ Syntactically oriented treatment: Sentence production program for aphasia ◆ Language production for syntax syntax ◆ Production of certain sentences types will improve if they hear and produce multiple sentences of same form with different lexical items ➔ Tx of underlying forms for functional morphologic categories: less complex structures ◆ Functional morphology Week 6: Neural bases of reading and writing Phonological Processing: Large Perisylvian Semantic processing: Large Extrasylvian Orthographic Processing: Extrasylvian Central processing impairments o Global/Deep alexia ▪ Patterns in performance Performance in reading/spelling is influenced by stimuli characteristics; roughly better than non word performance Reading and spelling errors ▪ Treatments Reestablish sublexical sound-letter/letter-sound correspondences Strengthen phonological skills Sentence and paragraph level reading/spelling tx o Surface alexia and agraphia  ▪ Patterns in performance Regularity effect: phonological approach works well for irregularly spelled words and non words, but breakdown with irregular words ▪ Treatments Relies on relative preservation of phonological ability Focus on retaining irregular orthographic representations May use CART Peripheral impairments o Pure alexia: letter to letter reading Individual has relative preservation of verbal/spoken language o Allographic alexia: impairment in converting graphemes to letter shapes Difficulty in writing shape but can say it, they can spell out loud Example: spell out loud the word dog but will be unable to write it on paper if asked to o Apraxic alexia: poorly formed letters with distortions, additions and deletions Letters might be partially right, less consistent errors, adding extra letters and shapes to words Week 7: Pragmatics o What is pragmatics? Pragmatics = structure and semantics are not the only feature of language that transmit meaning - Pragmatic competence - the ability to understand the speaker’s intended meaning o Grice’s maxims (4) 1. Quality 2. Quantity 3. Relevance 4. Manner o Assessment Informal Assessment: ○ Narrative analysis ○ Interviews ○ Behavioral observation Formal/structured assessment ○ Rating scales ○ Checklists ○ Standardized assessments o Treatment PACE ○ Main goal: improve functional communication Discourse o discourse: any form of communication o Genres of discourse Narrative Procedural Expository Conversation o Discourse analysis, including various approaches Psycholinguistic approaches  ○ Aphasic characteristics are often described specifically and tested non contextually Sociolinguistic approaches: ○ Greater focus on the use of language as opposed to form ○ Assessments ideally utilize videotaped interactions ➔ Treatment (remediation, modification of communicative environment) Formulaic language ◆ Remediation for conversational skills and narrative production Uses technology such as aphasia scripts and sentence shaper ◆ Modifications of the communicative environment during tx is beneficial Ex. provide conversation environment with varying levels of support from clinician ◆ Formulaic Language: overlearned words, phrases or longer linguistic unit that are Native to speak Occur naturally Are important for normal interaction o Neural bases of Formulaic Language Right hemisphere Subcortical structures o Impact in aphasia ➔ Formulaic language is often a component of aphasia assessment ◆ Automatic speech/ recitation ◆ Informal acknowledgment of greetings/salutations ◆ Sentence completions with idioms