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Thematic Language Stimulation Therapy. Chapter 16. Defining TLS. Type of organized aphasia therapy that improves language processing and functional communication skills by using thematically related vocabulary in multimodality stimulation.

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defining tls
Defining TLS...
  • Type of organized aphasia therapy that improves language processing and functional communication skills by using thematically related vocabulary in multimodality stimulation.
  • Based on words, contexts, tasks, and target improvements
  • Clinician based: determines patient’s skill level
tls organization
TLS Organization
  • Organization, 2 ways:
  • 1. Thematic vocabulary
    • personally relevant
    • fairly universal
    • units consist of 8-10 words
      • primarily nouns/verbs
  • 2. Creation of predictable linguistic stimuli for each task
tls delivery
TLS Delivery
  • Stimulus Adequacy:
    • intended result
    • functionality
    • redundancy
  • Maximal Patient Response:
    • all modalities
  • Extension of Material and Language:
    • variety of tasks
    • thematic units broken down over time
  • Systematic and Intense Presentation:
    • from introductory to identification of theme, to manipulation of language in sequence
tls and functional communication
TLS and Functional Communication
  • Transition to a functional context
  • Natural environments
  • analysis and problem solving
  • provides combinations of cues and strategies to facilitate improved language function
  • links from clinical to functional language stimulation by manipulation of the theme.
tls assessment
TLS Assessment
  • Thorough assessment should derive:
    • which cerebral processes are impaired
    • the level at which performance breaks down
  • Formal tests may provide some info, but observation is best!
establishing baseline
Establishing Baseline
  • A baseline of functional communication should be obtained by consdiering:
    • 1. How well does the patient initiate and sustain conversation?
    • 2. How well does the patient express himself or herself verbally/nonverbally?
    • 3. How well does the patient follow conversation and directions? How complex can auditory demands be before performance breaks down?
formal testing
Formal Testing
  • Focal Points of Formal Testing:
    • Repetition
    • Sentence Construction
    • Automatic Language
    • Picture Description
    • Following Instructions
    • Yes/No Reliability
    • Reading Comprehension
    • Oral Reading
    • Graphic Expression
cognitive and behavioral considerations
Cognitive and Behavioral Considerations
  • Certain behaviors should be observed, described and noted:
    • Patient Involvement
    • Specific Symptom Awareness
    • Task Orientation and Retention
    • Perseveration
    • Visual Perception
treatment delivery
Treatment Delivery
  • These ?’s should be asked before therapy can begin:
    • 1. Is this person a good candidate for TLS?
    • 2. How should tasks be chosen and sequenced?
    • 3. What cues are most beneficial to achieve maximal success in treatment?
    • 4. How do I select theme and vocabulary?
insight of tls outcome a study
Insight of TLS Outcome: A study
  • Design Choice
    • single-subject studies
    • Looked @ whether or not TLS was more effective than a “traditional” approach.
    • TLS and NON TLS models alternated for 3 weeks
  • Subject Selection
    • individuals able to complete course
    • no regard to age, type of aphasia, etiology, duration of symptoms
  • Procedures
    • Audiotaped/videotaped
    • .5 hour sessions 5 days week for 3 weeks
  • Results
    • little can be confirmed b/c small # pts. In study
conclusion
Conclusion
  • TLS therapy, because of its strong dependence upon structure, may be a more organized observational environment for shared therapy insights!