CSD 1080 Final Exam Study Guide

Aphasia

Language disorder characterized by the breakdown in the ability to formulate, retrieve, or decode language

Pointing

Most users of communication boards indicate their selection by _________

Hypokinetic Dysarthria

A breathy, monopitch voice would most likely be found in an individual with ________

Dyskinesia

Uncoordinated movement

Audiology

Involved in:

• The prevention, identification, and evaluation of hearing disorders

• The selection of appropriate hearing aids for individuals with hearing impairments

• Habilitation & rehabilitation of hearing loss

Stroke

Most common cause of aphasia

Language

What type of disorder is aphasia?

Aphasia difficulties

• Speak in short or incomplete sentences.

• Speak in sentences that don't make sense.

• Substitute one word for another or one sound for another.

• Speak unrecognizable words.

• Have difficulty finding words.

• Not understand other people's conversation.

• Not understand what they read.

Aphasia problem categories

• Spoken language

• Written language

• Physical / sensory functions

• Cognitive changes

Anomia

• Difficulty in naming things, objects, or people

• Word finding difficulty

• Patient will often “talk around” the missing word 

• I.e. circumlocution

• May perseverate on incorrect word even though they know it’s not the right one

Paraphasia

• Word substitution

• Phonemic or semantic

Phonemic paraphasia

Substituted word sounds like correct word

Semantic paraphasia

Substituted word has similar meaning or is associated to correct word

Neologism

The use of words that don’t exist

Agrammatism

a pattern of syntactically defective speech

Hemiplegia

Paralysis on one side of the body

Contralateral

affected side of the body is opposite the side of the brain

Hemiparesis

Weakness or incomplete paralysis on one side of the body

Wernicke’s aphasia

• Fluent aphasia

• Primary feature: Disturbed auditory comprehension

• Speech comprehension: Poor

• Spoken characteristics: Semantic paraphasis, jargon, poor repetition, impaired naming, meaning sentences are usually grammatical but often lack content 

Broca’s aphasia

• Non-fluent

• Primary feature: Impairment in expression

• Speech comprehension: Relatively poor

• Spoken characteristics: Short & a-grammatical sentences, slow & labored speech with articulation and phonological errors, poor repetition, poor naming

Global

• Fluent

• Primary feature: Fluent & confluent features present to a severe degree

• Speech comprehension: Very poor

• Spoken characteristics:  Limited to a few spontaneous productions. Few words or stereotypes, poor repetition, poor naming

Fluent aphasia characteristics

Relatively normal:

• Prosody

• Pitch

• Loudness

Non-fluent aphasia characteristics

• Limited speech production

• Poor repetition & naming

• Effortful speech

Global aphasia

Most severe aphasia type

Aphasia recovery

• Recovery depends on the amount & location of brain damage 

• Recovery focuses on functional communication solutions

• Significant recovery can occur

• Recovery process begins within days of stroke

• Assisted recovery included a rehabilitation team of SLPs, PTs, OTs, etc.

Treating aphasia tactics

• Looking for strategies that exploit strengths and minimize deficits

• SLPs, PTs, OTs, etc.

2/3

What proportion of TBIs are caused by motor vehicle accidents?

No - nonfocal

Is brain damage with TBI usually located in one small area?

Anywhere

Where can brain damage occur?

Coup

Injury due to impact, moving object hits stationary head

Contracoup

Injury on the side opposite to the impact, moving head hits stationary object

Yes

Do TBIs often result in a coma?

Impulsive

Individuals with TBI frequently exhibit ________ behaviors

General TBI Impairments

• Voice & swallowing

• Speech & language problems

• Cognitive problems

• Reading & writing

• Behavioral & emotional

Problems associated with TBI

• Cognitive:

• Orientation

• Short & long term memory

• Difficulty maintaining attention & concentration

• Reasoning and problem solving

• Speech and language:

• Dystharia

• Language impairment (aphasia)

• Anomia & impaired comprehension 

• Problems with pragmatics

• Disinhibition: inability to stop certain inappropriate behaviors

• Behavioral/emotional:

• Mood swings

• Anxiety

• Depression

• Lack of motivation

• Inability to self monitor (denial)

• Impulsivity

• Difficulty with emotions

• Control and anger management

TBI Areas for SLPs

• Orientation

• Memory

• Listening comprehension

• Speech intelligibility

• Pragmatics

• Reasoning & problem solving

Cognitive rehab

Treatment regimen designed to increase functional abilities for everyday life by improving the capacity to process incoming information

Cognitive rehab professionals

SLPs, OTs, PTs, etc.

Restorative approach

• Repetitive activities to rebuild neural circuity

• E.g. classification tasks, word associations rehearsal, memory aids

Compensatory approach

Develop alternatives, since some functions will not be recovered

Early recovery

Beginning responses to environment in hospital - stabilization is the overriding goal

Middle recovery

Goal is to reduce confusion & improve memory / goal - directed behavior

Late recovery

Goal is client independence

Dysarthria

A motor speech disorder due to paralysis, weakness, or poor coordination of speech muscles

Apraxia

When you have ______ of speech, the messages do not get through correctly due to brain damage. You might not be able to move your lips or tongue the right way to say sounds. Sometimes, you might not be able to speak at all.

No

Is cerebral palsy a disease?

Cerebral palsy

Can be the result of brain injury in fetal or infant development

Spastic CP

Type of CP characterized by rigidity and reflex problems

Athetoid CP

Type of CP characterized by writhing movements

Ataxic CP

Type of CP characterized by uncoordinated movements

Flaccid dysarthria voice

Breathy, mono pitch

Spastic dysarthria voice

Harsh, strained

Who benefits from AAC

Anyone who’s communication needs are not being met via speech alone. About 3.5 million Americans have communication disabilities and require AAC, with the prevalence rising

Types of disabilities that benefit from AAC

Individuals with congenital and acquired disabilities. Also helps anyone temporarily unable to speak

Unaided systems

• Do not require any equipment, involve only the person’s body

• Signs, gestures, facial expressions

Aided systems

• Require some external equipment

• Low / light tech: picture board, alphabet board

• High tech: computer based devices with voice output

Direct selection

In ________, the individual directly selects the desired symbol

Ex: Pointing with a finger or body part, using a head pointer, eye gaze

Scanning

Items are “highlighted” and the communicator signals to select desired item

Habilitation

Born with hearing loss

Rehabilitation

Acquired hearing loss

Audiologist work settings

• private practice settings

• Hospitals

• rehabilitation centers

• Schools

  • Classroom acoustics a big focus right now

  • Kids don’t have processing ability to screen out extraneous noise the way adults do

• hearing aid companies

• Industry

  • E.g., hearing conservation programs ( such as coal mines)

Audiologist

An expert in hearing & hearing disorders

Sound

Vibrations traveling through a medium (such as air or water) that are audible

Vibration (sound wave)

Sound is caused by _______

Frequency

Physical characteristic, The vibrations / cycles per second

Hertz (Hz)

How is frequency measured?

Pitch

The perceptual correlate of frequency, can be heard

Frequency, pitches

When the ______ changes, we hear different ________

Increase

Increase frequency = _______ pitch

Pure tone

A tone of a single frequency

Complex tone

A tone containing two or more different frequencies, most everyday sounds

Periodic sound

A pattern that repeats itself at regular intervals, relative to sound

Aperiodic sound

A sound with no repetitive pattern

Amplitude

The extent of the molecules displaced during vibration

Loudness

The perceptual correlate of amplitude

Amplitude, loudness

_______ is determined by the physical characteristic of intensity. The higher the intensity / ________, the greater the loudness

Decibel (dB)

Measurement of sound pressure

50 - 70 dB

The intensity (loudness) of a typical conversation

Outer, middle, inner

3 main divisions of the ear

Pinna

• In outer ear

• Helps funnel sound to the ear canal and localize sound

Ear canal

• Starts at outer ear and ends in eardrum

• Increases the intensity of sound waves by concentrating them in a smaller area

• Stores ear wax (cerumen) to help keep the ear canal clean

Tympanic membrane

• Also known as the eardrum

• Located in the middle ear space

• Is a cone shaped structure of tissue that concentrates sound at its center

• Sound waves hit the _________ __________, causing it to vibrate

Middle ear space

• Lined with mucus membrane and filled with air, connect to Eustachian tube

• Otitis media is an infection of the middle ear caused by inflammation, usually from a cold

Eustachian tube

• Passageway for air to move in and out of middle ear

• Connects the middle ear to the nasopharynx

• Equalizes pressure in the ear

Ossicles

• 3 small bones in the middle ear

• Smallest bones in the human body

• Connect the eardrum to the inner ear and amplify the vibration of the eardrum

Ossicles bone names

Malleus (hammer), Incus (anvil), stapes (stirrup)

Ossicles function

Connect the eardrum to the inner ear and amplify the vibration of the eardrum

Semicircular canals

• Inner ear, part of the vestibular system

• Help the body maintain balance

Cochlea

• Primary inner ear structure

• Shaped like a snail

Base

High frequency sounds stimulated at the ______

Tip

Low frequency sounds stimulated at the ______

Electrical

Mechanical impulses are converted to ________ impulses

Auditory nerve

• Cranial nerve

• Carries electrical impulses from the cochlea to the brain

• The primary auditory area in the temporal lobe

Audiometer

an instrument used to measure hearing

Air conduction

using headphones; sound travels through outer, middle, and inner ear

Bone conduction

• Bone oscillator on skull behind ear

• The bones of the skull vibrate and stimulate the fluids in the cochlea

• Assesses cochlear function because it bypasses the inner and outer ear

Speech Reception Threshold (SRT)

Quietest level of speech a person can hear and understand 50% of the time

Speech Discrimination

• Also called Word Recognition Score

• Stimuli: 1 syllable words

• Presented at a comfortable listening level

• Calculate the % of words correctly repeated

• Measures impact of hearing loss on person’s communication

Immittance Testing

Measures automatic responses of the auditory system

Tympaanometry

• Measures movement of the tympanic membrane (eardrum) while changing the air pressure in the external auditory canal

• Measures pressure in the middle ear