8 Aphasia TREATMENT STRATEGIES

Wernicke’s Aphasia • Promoting Aphasics’ Communicative Effectiveness
– Therapist and client take turns conveying information to each other participating equally as senders and receivers of messages. – There is an exchange of new information. – Therapist can model communication options. – Any Communication channel is acceptable: visual, gestural, graphic, verbal – Barrier Activities useful in PACE therapy
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Syntax
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tions for Tx.
• 1. Describe the general treatment strategies suggested by Chapey. • 2. What is the difference between traditional therapy strategies and Functional Communication therapy approaches? • 3. Is the differentiation of stimulation vs. restoration relevant to Aphasia treatment? • 4. Describe the approaches for Broca’s Aphasia. • 5. Describe the approaches for Wernicke’s Aphasia • 6. Describe Schuell’s Stimulation Approach • 7. Describe PACE therapy • 9. Differentiate between two other diagnostic categories a clinician should consider in a differential diagnosis.
• A clinician should be able to differentiate between the following disabilities • Normal Elderly Expectations • Aphasia • Dementia • Alzheimer’s Dementia • Progressive Aphasia • Right Hemisphere Damage • Closed Head Injury
Promoting Aphasics’ Communicative Effectiveness, PACE Therapy
• PACE therapy is a type of Functional Communication Therapy (FCT) – purpose: emphasis on PRAGMATIC aspect of communication and information involving a RANAGE OF COMMUNICAITON INTENTIONS, such as informing, requesting, questioning, negating • primary objective of traditional therapy has been to stimulate (Schuell) or restoration of patient’s language function across 4 modalities – leads to isolated modality practice – Goals are written to address Activities of Daily Living (ADL) using COMMUNICATION, not the motor skills of performing the tasks
Scheull’s Stimulation Approach to Rehabilitation • Primarily use of controlled Auditory Stimulation
– employs strong, controlled, and intensive auditory stimulation of the impaired symbol system – Because it is an auditory stimulation approach, materials and procedures should be extensive. Therapist is NOT retraining BUT stimulating currently inaccessible language centers
– Pragmatically based=emphasis on content that is personally relevant
• Materials such as newspapers, Barrier activity using relevant materials
9. Differential Diagnosis
PACE Therapy, continued
– Principles
• 1. Exchange of new information in a conversational setting • 2. Encouraged to use ANY EXPRESSIVE MODALITY: speech, signing, gestures, writing • 3. Both therapist and client are senders and receivers engaging in a variety of COMMUNICAIOTN INTENTIONS • 4. Feedback is simply the success of communicating, the characteristic of Normal Communication
Symptom
Aphasia
Normal Aging X
Alzheimners
Progressive Aphasia X x
Right Hemnisphre X
Closed Head Injury
Anomia
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Paraphasic Errors
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Paragrammatic X Errros Fluency X
• Activities for Auditory Abilities, Verbal Abilities, Reading & Writing
Chapey’s Cognitive Linguistic Therapy
• Language is a knowledge of a code for representing ideas about the world through a conventional system of arbitrary signals for communication. • Cognition is the use of the five mental operations of recognition, memory, convergent thinking, divergent thinking and evaluative thinking. • Therapy is divided into 4 levels depending on a patient’s ability • Each level has specific activities pertaining to each of those 5 cognitive skills as they relate to LANGUAGE, including the 4 modalities. • Excellent therapy ideas for more traditional therapy and for beginning clinicians.
• 2. Response Elaboration Training (RET)
Treatment Strategies for Broca’s Aphasia • 2. Response Elaboration Training (RET)
– Designed for nonfluent aphasia patents in order to increase the length and information content of verbal responses – Strategies • Elicit spontaneous response • Model and reinforce initial response • Expand and elaborate response through scaffolding • Reinforce client’s attempts at elaboration • Always repeat and expand the client’s utterance • Modeling and Expansion based on Scaffolding of Client’s response
Treatment Strategies for Broca’s Aphasia
• 1. Melodic Intonation Therapy