1. Traumatic Brain Injury
1.1. Definition
1.1.1. Refers to neurological damage to the brain resulting from the impact of external forces.
1.2. Characteristics
1.2.1. Open-head Injuries
1.2.1.1. Occur when the skull and the menings have been penetrated.
1.2.1.1.1. Phineas Gage
1.2.2. Closed-head Injuries
1.2.2.1. Although outer protection of the brain remains intact, the brain is josted within the skull, yielding diffuse.
1.3. Identification
1.3.1. Testing for communication ability and potential for communication relies on subjective behavioral observations like Glascow Coma Scale and the Rancho Los Amigos Levels of Cogntive Function
1.4. Treatment
1.4.1. There are 10 different levels of treatment through Rancho Los Amigos Levels of Cognitive Function. Levels 1-3 are focused trying to get an individuals response. Levels 4-6 are focused on trying take tasks of basic communication skills and levels 7-10 is facilitating independence.
2. Dementia
2.1. Definition
2.1.1. A chronic and progressive decline in memory, cognition, language and personality resulting from central nervous system dysfunction.
2.2. Characteristics
2.2.1. Mild Dementia
2.2.1.1. Exhibit forgefulness, even of basic information or common routines.
2.2.2. Moderate Dementia
2.2.2.1. Becomes increasingly disorientated in time and place, and exhibits poor attention, memory and marked language difficulties. Motor skills still work for walking and talking.
2.2.3. Severe Dementia
2.2.3.1. Extreme disorientation and minimal, if any cognitive ablity are defining characteristics of severe dementia. Comprehension skills are severely impaired and they're normally in a wheelchair and are not able to control bladder or bowel functions.
2.3. Identification
2.3.1. Imaging studies such as MRI or CT may reveal neurological changes suggestive of dementia such as loss of gray and white matter.
2.4. Treatment
2.4.1. There are medications that help slow down the process or improve the systems, there are no cures.
3. Aphasia
3.1. Definition
3.1.1. A language disorder that is acquired sometime after an individual has developed language competence.
3.2. Classification
3.2.1. Taxonomy: draws upon those characteristics of aphasia that most differentiate disorders from one another.
3.2.2. Categorized by the cause and location of the brain damage.
3.3. Behavioral Symptoms
3.3.1. Fluency
3.3.1.1. Exhibit a significant lack of fluency due to impairments in formulating and producing verbal output. Short, choppy phrases. Slow, labored production of speech. Grammatical errors. Telegraphic quality.
3.3.2. Motor Output
3.3.2.1. Individuals may show slow and labored articulation of sound, with some groping of the articulators as they seek accurate placement.
3.3.3. Language Comprehension
3.3.3.1. Also known as auditory comprehension, is the ability to understand spoken language.
3.3.4. Repetition
3.3.4.1. The ability to accurately reproduce verbal stimuli on demand.
3.3.5. Naming
3.3.5.1. Anomia, meaning a term used to describe word-finding problems or the inability to retrieve a word.
3.3.6. Reading and Writing
3.3.6.1. Very unlikely that a person with mild to severe aphasia is unimpaired in reading and writing skills.
3.4. Characteristics
3.4.1. Broca's Aphasia
3.4.1.1. Fluency and Motor Output
3.4.1.1.1. Typically produces slowed, halting, and labored speech, yielding what some describe as a telegraphic or robotlike quality
3.4.1.2. Language Comprehension
3.4.1.2.1. Exhibits mild to moderate auditory comprehension problems, particularly when messages increase in length and complexity or when contextual cues are removed.
3.4.1.3. Repetition
3.4.1.3.1. Highly variable in their repetition abilities, ranging from mildly to severely impaired.
3.4.1.4. Naming
3.4.1.4.1. Like to have mild to severe anomia, characterized typically by phonemic paraphasias.
3.4.1.5. Reading and Writing
3.4.1.5.1. Reading aloud is slow and laborious with misarticulations or distortions, and writing is effortful, characterized by oversized printing called macrographia.
3.4.2. Transcortical Motor Aphasia
3.4.2.1. Results from damage to the frontal lobe, typically the superior and anterior portions. Symptoms are similar to Broca's Aphasia except that their repetition skills are much better than their spontaneous speech.
3.4.3. Global Aphasia
3.4.3.1. Occurs as a result of large region of brain damage or multiple sites of brain injury in the language-dominant hemisphere. They're likely to be nonfluent and have poor language comprehension, have limited gestures, having issues to understand simple messages.
3.4.4. Wernicke's Aphasia
3.4.4.1. Fluency and Motor Output
3.4.4.1.1. Produces spontaneous speech that flows well with normal prosody. May talk excessively. May make up words or make up weird phrases with real words.
3.4.4.2. Language Comprehension
3.4.4.2.1. Key disturbance dealing with great difficulty interpreting verbal and written messages.
3.4.4.3. Repetition
3.4.4.3.1. Comprehension system is usually significantly impaired, which impacts the ability to repeat.
3.4.4.4. Naming
3.4.4.4.1. Moderate to severe naming difficulties.
3.4.4.5. Reading and Writing
3.4.4.5.1. Reading may be intact, although comprehension of the text is likely to be degraded to the level of comprehension of spoken communication.
3.4.5. Transcortical Sensory Aphasia
3.4.5.1. Results from injuries to the language-dominant hemisphere at the border of the temporal and occipital lobes of the superior region of the parietal lobe. Like Wernicke's Aphasia but have better repetition skills.
3.4.6. Conduction Aphasia
3.4.6.1. Fluency and Motor Output
3.4.6.1.1. The conduction profile is fluent, with only mild to moderate deficits in expressive output.
3.4.6.2. Language Comprehension
3.4.6.2.1. Tends to be fair to good with relatively little impairment.
3.4.6.3. Repetition
3.4.6.3.1. Their able to read the messages but are not able to transfer the message to the verbal output area.
3.4.6.4. Naming
3.4.6.4.1. Causes mild to moderate difficulties in naming and word retrieval.
3.4.6.5. Reading and Writing
3.4.6.5.1. They are similar to those of auditory comprehension.
3.5. Assesment/Treatment
3.5.1. An interdisciplinary rehabilitation team work around each other with different types of screenings to see how progressed the patient is and see how they all can work together to help the patient. Their goal is to get the patient to be able to function communication wise in their everyday life
4. Right-Hemisphere Dysfunction
4.1. Definition
4.1.1. Results from neurological damage to the right cerebral hemisphere. The symptoms are quite different than Left-Hemisphere damage to the brain.
4.2. Characteristics
4.2.1. 1. Lack of awareness
4.2.2. 2. Completely neglect the left side of the body.
4.2.3. 3. Difficulty recognizing faces.
4.2.4. 4. Having issues with the ability to read other peoples cues and recognizing others communication interests.
4.2.5. 5. A tendency to being wordy.
4.2.6. 6. Difficulty understanding problem solving or abstract thoughts.
4.2.7. 7. Dysarthia or Dysphagia.
4.3. Identification
4.3.1. Requires a comprehensive speech-language assessment as part of an interdisciplinary assessment. The team works individually and then helps each other as a whole of how to tackle the situation depending upon the patient.
4.4. Treatment
4.4.1. Initial therapy for RHD targets the management of attention and visual disruptions, since these impact productive treatment activities.