What is aphasia?
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1) acquired as a result of brain damage
2) impacts all 4 modalities of language
3) severity of deficit can and often does differ between modalities
4) deficit is primary to language, cannot be contributed or explained by any concomitant deficits
5) Impacts all linguistic structures and is defined by one or all of the following in mild to severe manifestations: reduced availability to linguistic structures, reduced efficiency in deploying linguistic structures, and/or reduced retention span in holding onto linguistic structures
Assessment areasHistory, behavioral observations, cognition/sensory-motor integrity, OME, pragmatics, numerical relations, A/C, S/E, R/C, W/EWhat to do first in assessmentConversational interview (consider discourse skills)Phonological paraphasiaSound substitution, at least 1/2 the word correct Ex: tephelone for telephoneSemantic paraphasiaSubstitution of one word for another word that is similar in meaning Ex: orange instead of appleVerbal paraphasiaSaying a real word that is far off from the target (no semantic relationship to the target) Ex: pillow for lemonadeNeologistic paraphasiaMade up words (common with Wernicke's aphasia) Ex: calling a toothbrush a slunkerConfrontation namingWhat's this?What part of the brain are you testing when assessing repetition?Arcuate fasciculusCognitive tests and aphasiaCognitive tests are based heavily in language. Pts with aphasia are not cognitively impaired - use a non-linguistic cognitive test - assess cognition informally via observationGood memory, pragmatics, attention, possible limb apraxia, perseveration, intact cognitionS/E nonfluent, severe anomia - attention is a strengthWhat kind of tasks do nonfluent pts benefit from that helps them break out of perseverative speech?Automatic tasks - also helps with severe apraxia of speech