Adult+-+Receptive+Aphasia

**Adult Receptive Aphasia**

==**What is the communication disorder?** ==



==**Adult Receptive Aphasia** ==

o Aphasia is a language disorder that causes problems with an individual’s reading, speaking, understanding and writing skills. Aphasia can be either mild or severe. The severity of communication difficulties depends upon the amount and location of damage to the brain. o Aphasia is caused by brain damage, usually from a stroke or head injury which affects one or several parts of the brain that involve language. o There are three types of Aphasia, however every person with Aphasia have different skills and different problems depending on the type of brain injury they acquired and how severe it is. o The three types of Aphasia are: 1. Expressive Aphasia 2. Receptive Aphasia 3. Global Aphasia o Damage or injury to the temporal lobe of the brain or Wernicke's Area. o Effects Include:
 * ==What is Aphasia? ==
 * ==What causes Aphasia? ==
 * ==What are the types of Aphasia? ==
 * == What is Receptive Aphasia? ==
 * 1) Severe impairment in auditory comprehension
 * 2) Articulation may be normal but speech is uninterrupted, often consisting of long sentences where words are frequently made-up or unnecessary
 * 3) Difficulties in understanding what other people are saying and spoken language
 * 4) Ability to read is greatly impaired
 * 5) Disassociations with sounds or sights of words and their meanings
 * 6) Can't follow extensive, complex directions
 * 7) Often needs information and spoken language repeated and slowed down
 * 8) Individuals require visual or touch cues to help them understand
 * 9) Needs extra time to understand spoken messages
 * 10) Misinterpretations of subtleties of language and takes meaning literally

**﻿<span style="background-color: #c8f292; color: #2b7ea6; font-family: 'Trebuchet MS',Helvetica,sans-serif; font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">How is the communication disorder diagnosed? **

<span style="font-family: Arial,Helvetica,sans-serif;">According to Lezak (1983) an effective communication test must touch on each of the following six communication aspects: <span style="font-family: Arial,Helvetica,sans-serif;">1.) Spontaneous speech <span style="font-family: Arial,Helvetica,sans-serif;">2.) Reptition of words, phrases, and sentences <span style="font-family: Arial,Helvetica,sans-serif;">3.) Speech Comprehension <span style="font-family: Arial,Helvetica,sans-serif;">4.) Reading <span style="font-family: Arial,Helvetica,sans-serif;">5.) Writing﻿ <span style="font-family: Arial,Helvetica,sans-serif;">6.) Naming


 * <span style="font-family: Arial,Helvetica,sans-serif;">It is important that when assessing clients with receptive aphasia's comprehension skill that they use non-verbal tasks because it is not assume that these clients can not comprehend language simply because they can not give a coherant response to verbal questions.
 * <span style="font-family: Arial,Helvetica,sans-serif;">The first step when there is a question of a language disorder is to do a screening. This will then point to, and even possiblly present some of the characteristics of the type of aphasia that are present but it does not give a definite diagnosis.
 * <span style="font-family: Arial,Helvetica,sans-serif;">It is then time to choose from the variety of different available aphasia tests:

The Boston Diagnostic Aphasia Examination-Ed. 3 was created by Harold Goodglass, Edith Kaplan, and Barbara Barresi. This assessment takes anywhere from 35-45 minutes, and was created in order to help distinguish between all the different types of aphasic disorders. This is a beneficial test because it gives quick results, and also is able to determine a clients commicative abilities. The test is made up of six different items that test the visuospatial and qualitative abiltity of the client and measure the severity of their communicative abiltity.

Boston Dianostic Aphasia Examination- Ed. 3 (BDAE-3) Authors: Harold Goodglass, Edith Kaplan, and Barbara Barresi Cost: For Full Kit: 457.95 BDAE-2 Naming Test Kit: 104.00 Publication Date: 2000 []



The Comprehensive Aphasia Test was created by Kate Swimburn, Gillian Porter, and David Howard. This is a test that can be used on individuals that have acquired aphasia and the assessment can be done in one to two assessment sessions. This assessment is made up of a cognitive section, language section, and also an optional disability questionairre that help to identify a person's strengths and areas of challege to help guide therapy. This test, along with the beneficial scoring guide can be purchased from the Neuropsychology Arena webpage.

Comprehensive Aphasia Test (CAT) Authors: Kate Swimburn, Gillian Porter, and David Howard Cost: $243.00 --Also purchase Scoring Software for the CAT Authors: Robin Keith and Elise Croot Cost: 157.00 []

The EFA-4, or Examining for Aphasia the 4th ed. was based off of Jon Eisenson's previous editions of the test. This is a 30-60 minute test that has been designed for individuals who have acquired aphasia and are over eighteen years of age. This test is set up to look at a client's strengths and challenges in both receptive and expressive language, and it has also been designed to evaluate the cognitive functions, linguistic modalities, and personality changes that occur from acquired aphasia. The way this particular test has been set up to test expressive language skills was to have the client perform simple tasks, automatic language, and arithmetic computations. There are similar skills and tasks set up to test receptive language skills.

Examining for Aphasia 4th ed. (EFA-4) Authors: Leonard L. LaPointe and Jon Einsenson Cost: $321.95 []

<span style="font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">**<span style="background-color: #c8f292; color: #2b7ea6; font-family: 'Trebuchet MS',Helvetica,sans-serif; font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">What theoretical approaches guide treatment of this disorder ** > <span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 16px; line-height: 23px;">**Life Participation Approach to Aphasia**
 * <span style="color: #333333; font-family: Arial,Helvetica,sans-serif; line-height: normal; margin-bottom: 0in;">Receptive Aphasia has several different theoretical approaches or broad philosophies and models of service-delivery to its treatment rather than a definite clinical approach. Depending on the severity or aphasia and the goals and needs of the person with aphasia, the type of treatment will vary as well which range from specialized computer programs, published materials, and also less formal approaches. For those with Receptive Aphasia, both formal and informal approaches are used to help since Receptive Aphasia has a spectrum of severity. An approach in particular that is commonly used by SLPs is the "Life Participation Approach to the treatment of Aphasia." Of course, there are many other approaches as well due to the variety of cases of Aphasia.

> <span style="color: #333333; font-family: Arial,Helvetica,sans-serif; line-height: 13.5pt; margin: 0in 0in 12pt;">This approach, LPAA, involves everyone who has been effected by Receptive Aphasia and includes parents, siblings, brothers, and friends making decisions constantly to help the person with Receptive Aphasia grow and improve. The success rate of recovery has also improved because familiar friends and family take part in getting the client to participate in the activities he or she was previous to the brain damage or head injury that took place. The generally help draw up and execute the intervention tasks that are most important to the client specifically. This way, they also help decrease the consequences of Aphasia that could end up costing the client more complications.
 * <span style="color: #333333; font-family: Arial,Helvetica,sans-serif; line-height: 13.5pt; margin: 0in 0in 12pt;">The "Life Participation Approach to Aphasia" (LPAA) is a modeled service-delivery approach that helps those with receptive aphasia in overcoming their prospective short term and long term goals. LPAA emphasizes the importance of expanding treatment beyond the clinic. If an individual is effected by Receptive Aphasia, he or she should begin by seeing an SLP frequently, but slowly work on incorporating treatment into everyday life activities and routines. Researchers have found that Aphasia is better treated in these situations so that the ultimate goal of therapy can be achieved: to have the client with aphasia communicating effectively and no longer needing support.


 * <span style="font-family: Arial,Helvetica,sans-serif;">Some of these intervention tasks might include naming objects around the house, playing games that can help the client drill through vocabulary, working with the client on following directions, or quizzing the client on movies or books. The SLP would work on finding the best medium that will help the client achieve their goals faster such as writing versus gestures and pictures. Group therapy is sometimes used to gage the effectiveness of the client's communication improvements and encourage more growth and less communication breakdowns. For Receptive Aphasia, LPAA is one of the most effective approaches to treatment because it allows the client to constantly be practicing their language skills.

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 * <span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">Constraint-Induced Therapy Approach **
 * <span style="font-family: Arial,Helvetica,sans-serif;">Another approach to Receptive Aphasia is Constraint-Induced Therapy, which is a treatment based on counteracting the avoidance of using the damaged areas of the brain that contribute to Receptive Aphasia. By relearning how to use Wernicke's Area through constraint, forced use, and massed practice, Aphasia clients are able to communicate effectively over time.
 * [|[[http://www.asha.org/public/speech/disorders/Aphasia.htm#tx]
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<span style="font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">**<span style="background-color: #c8f292; color: #2b7ea6; font-family: 'Trebuchet MS',Helvetica,sans-serif; font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">What are the general goals of treatment? **
 * The goals of treatment for Receptive Aphasia are to strengthen the abilities of the remaining receptive and expressive language skills the client still has. The client may not be able to regain the same amount of language he/ she had before their stroke. The clinician gives the client strategies to improve their understanding of others speech while also improving their own language to make them more comprehensible. Treatment also focuses on giving the client other ways of expressing himself/herself so they do not have to relay as heavily on their language skills and to teach the client compensatory strategies to deal with his/her Aphasia.


 * <span style="background-color: #ffffff; color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**Sample Long Term Goals:** [[image:Speech_therapy2.jpg width="188" height="260" align="right"]]
 * The client will achieve functional receptive language skills for activities of daily living.
 * The client will achieve functional expressive language skills for activities of daily living.


 * <span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**Sample Behavioral Objectives:**
 * The client will follow sets of two-step directions given by the clinician using everyday objects with 8/10 correct responses.
 * The client will name objects used around the house with 75% accuracy following a picture cue.
 * The client will repeat four-word phrases following the clinician's model with 7/10 correct responses.

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<span style="font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">**<span style="background-color: #c8f292; color: #2b7ea6; font-family: 'Trebuchet MS',Helvetica,sans-serif; font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">What kinds of techniques/activities might be observed in a typical treatment session? ** <span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**Goals:**
 * 1) <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Regaining normal language functions that were lost right after the injury
 * 2) <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Making use of the retained language abilities still in tact
 * 3) <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;"> L earning to use other forms and methods of language as a means of communication

<span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**Methods and Activities:** <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">1. **Speech Language Therapy:** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Should begin immediately and tailored to the patient’s individual needs - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Exercises consist of repetition, following directions, reading and writing <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">2. **Cognitive Linguistic Therapy:** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Emphasizes emotional components of language such as interpreting the characteristics of different emotional tones of voices or describing the meaning of descriptive emotional words such as happy. <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">3. **Programmed Simulation:** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Multiple uses of sensory modalities, including pictures and music. These are introduced in a gradual progression from easy to more difficult. <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">4. **Stimulation- Facilitation Therapy:** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Main focus is on semantic and syntactic parts of language using auditory stimulation. Improvement in language skills are best accomplished with repetition. <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">5. **Group Therapy:** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Provides a social context for patients to practice and use the communication skills they have learned during their individual therapy sessions as well as receiving important feedback from therapists and other patients. Family members are often encouraged to participate in this activity. <span style="font-family: Calibri,sans-serif; font-size: 15px; line-height: 22px;">6. **PACE (Promoting Aphasic’s Communication Effectiveness):** - <span style="font-family: 'Calibri','sans-serif'; font-size: 11pt;">Form of pragmatic therapy, promoting improvements in communication through using conversation as a tool for learning. These therapy sessions involve an enacted conversation between both the therapist and the patient. To initiate spontaneous communication, drawings, pictures, and other visual stimulating objects are often used to generate ideas to be communicated during the conversation. The patient and the therapist usually take turns conveying their ideas back and forth to each other.

<span style="color: #2b7ea6; font-family: Tahoma,Geneva,sans-serif; font-size: 120%;">**At Home Exercises**
 * 1) Assign patient to complete simple step-by-step directions. Ex. Touch your finger to your nose, then touch your head while rubbing your stomach.
 * 2) Have patient name body parts or objects present in the room.
 * 3) "I spy"- Have parent describe an object and have patient guess name of desired object.
 * 4) Name 3 things and have patient say why these things are similar.
 * 5) Show patient a picture of an object and have them write what they see.
 * 6) Give patient a word and have them create a sentence incorporating that word.
 * 7) Have patient complete a simple word scramble or cross-word puzzle.
 * 8) Have patient match a word to a corresponding picture.

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<span style="font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">**<span style="background-color: #c8f292; color: #2b7ea6; font-family: 'Trebuchet MS',Helvetica,sans-serif; font-size: 1.3em; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">What did I observe during my field observations of treatment for Receptive Aphasia? **

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