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8. Aphasia TREATMENT STRATEGIES. General Treatment Strategies. Use intact modality or stronger modality to BEBLOCK impaired modality/ies. Circumvent difficulty via self-cueing strategy. Self-cueing is generalized from clinician cueing Stimulation before response expectation

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general treatment strategies
General Treatment Strategies
  • Use intact modality or stronger modality to BEBLOCK impaired modality/ies.
  • Circumvent difficulty via self-cueing strategy. Self-cueing is generalized from clinician cueing
  • Stimulation before response expectation
  • Using functional or pragmatically based therapy, such as promoting Aphasics’ Communicative Effectiveness (PACE)
  • Scaffolding language activities
  • Family/caregiver inclusion
treatment strategies for broca s aphasia
Treatment Strategies for Broca’s Aphasia
  • 1. Melodic Intonation Therapy
    • Best candidates are patients whose Auditory Comprehension is better than their verbal expression and verbal expression is severely impaired
    • Strategies:
      • Intonation pattern uses a range of 3-4 notes
      • Elements include an exaggerated melody line composed of at least 2 syllables. The rhythm and point of stress help to convey meaning
      • MIT is slower, similar to Chant Talking
      • Program Progresses to Longer syntactic units and to Clinician Question, Client Answer using progressively faster melodic patterns.
  • 2. Response Elaboration Training (RET)
treatment strategies for broca s aphasia4
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
wernicke s aphasia
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
scheull s stimulation approach to rehabilitation
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
  • Activities for Auditory Abilities, Verbal Abilities, Reading & Writing
chapey s cognitive linguistic therapy
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.
promoting aphasics communicative effectiveness pace therapy
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 DailyLiving (ADL) using COMMUNICATION, not the motor skills of performing the tasks
pace therapy continued
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
  • Pragmatically based=emphasis on content that is personally relevant
    • Materials such as newspapers, Barrier activity using relevant materials
9 differential diagnosis
9. 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
questions for tx
Questions 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.