The therapy protocol is individualized, because the therapist selects specific strategies tailored to each PWA. The selection of strategies and cues was based on the performance of each PWA. The graphs for all 3 clients show an increase in number of words named correctly in combination with a decline in the number of perseverations.
Considering how persistent perseveration can be, I find it notable that the therapy provided to the 3 PWAs in the original study resulted in such a decrease in the percentage of perseverative responses in a relatively short time i.
Five sessions of TAP to address such a formidable problem may not suffice in all cases where PWAs exhibit a moderate to severe degree of perseveration.
This further substantiates the fact that focusing on the language deficit in a specific way led to the observed improvement. The general strategies and time interval strategy allowed the PWA to benefit more from the specific training and types of cues employed in the confrontation naming task. The general strategies are part of the therapy protocol.
They address important, basic issues that every language therapist should be aware of, and adhere to, when treating any type of language deficit or when evaluating PWAs. To obtain the best possible response or overall language performance from a PWA, the clinician should regularly establish a new set and even make the PWA aware of a new stimulus item within a set. Related to this point, although listed as one of specific strategies, the time interval strategy is also basic and relevant for interactions with a PWA, in particular a PWA with a moderate to severe degree of impairment.
Even if the slip of paper is ripped up in front of the client, the process of recording an incorrect response and placing the paper on the table in view for the client draws attention to the error and may reinforce or strengthen the error. In any therapy protocol I have administered, I have avoided reproducing an error. In this case, both forms are presented.
Do you hear the difference between X correct form and Y incorrect form? However, the greatest therapy challenges are presented by PWAs who produce only recurring utterances in combination with severely impaired comprehension. However, the full representation to be produced is not available. The prepairs are also an indication for pre-speech monitoring. The main issue is what is assumed to be the cause or origin of the perseverative response s.
If one accepts the hypothesis that perseverative responses are produced because of, or as a reflection of, the underlying deficits e. Perseverative responses reflect the underlying deficit s. This point is further discussed in the following sections. Other Publications on Treatment of Perseveration Moses et al.
Moses et al. By providing specific cues that are adequate for the PWA, the clinician can increase the activation level for the target word, which should result in the production of the correct name. This suggestion is in line with the view that the activation of the target word is insufficient. The therapist should avoid using the perseverated word and should not produce it when providing the PWA with feedback or assistance. Finally, the authors suggested the therapist educate family members and caregivers about perseveration.
Basso presented a study of 50 PWAs with perseveration, including a description of therapy administered to 2 PWAs who showed a high rate of perseveration. Treated Subject 1 TS1 revealed transcortical sensory aphasia with a severe impairment of the lexical-semantic system and preserved sublexical processing for the most part.
He perseverated in all production and comprehension tasks, except for repetition, reading aloud, and writing to dictation. The therapy provided to TS1 was reported in Papagno and Basso The authors aimed their therapy specifically at the impaired semantic system, because perseverations were produced only when TS1 was unable to produce the correct response.
The perseverations first disappeared in pointing tasks, followed by written naming tasks. She also revealed damage at the level of the semantic system, which presented in the form of semantic errors in naming.
She perseverated on all writing tasks. TS2 received treatment for her output buffer; the result was a great reduction of perseverative responses in writing.
MV had worked as a pharmacist in her own pharmacy until she suffered a stroke. She presented with a severe Wernicke's aphasia subsequent to a territorial infarct of the left middle cerebral artery with right hemiparesis. CT examination showed an ischemic lesion in the left middle cerebral artery and hypodensity in the left basal ganglia area. At 6 months post-stroke, she required a shunt operation Medos-Shunt system right frontal.
Following her discharge from the clinic, staff initiated language testing and therapy at our unit. The results from the standardized aphasia examination that was administered pre- therapy Test 1 and post-therapy Test 2 —the Aachen Aphasia Test AAT —are shown in Figures 1 and 2, respectively. At 12 MPO Test 2 , after she had received 60 therapy sessions i. Her main difficulty was on the naming subtest Benennen , which consisted of pictured objects to be named as simple nouns, compound nouns, colors, and sentence naming.
She scored 59 points out of On the repetition subtest for phonemes, one-syllable, loan words, compound words, and sentences Nachsprechen , her score was out of attainable points. Post-therapy test results on the AAT are shown in Figure 2. Her performance on the other subtests showed no impairment. The goal of this program is to improve the essential components of oral sentence production; the program uses picture stimuli depicting everyday life activities.
Picture stimuli are from the ELA photo series Stark, , , a. MV was asked to describe what is happening on a picture card. She worked intensively, using multiple repetitions for each card. Afterward, MV was asked to say the entire sentence once again. Steps 3 and 4 were administered successively for all the cards. About this product. Stock photo.
Brand new: Lowest price The lowest-priced brand-new, unused, unopened, undamaged item in its original packaging where packaging is applicable. The Aphasia Therapy Files represent a practical resource for people who work with individuals with aphasia, either as therapists or as researchers. Each author presents one or more of their clinical practices in order to share their therapy experiences and reasoning with others. AB - A stroke results in brain damage, often causing loss or reduction in speech and language capacity.
Overview Fingerprint. Abstract A stroke results in brain damage, often causing loss or reduction in speech and language capacity. Keywords clinical improvisation music and language music and the brain music therapy Nordoff-Robbins stroke. While each of the chapters is of considerable interest on its own, the final chapter offers readers a method of describing and capturing what happens in therapy and why, to enable comparisons between therapies and application by readers themselves.
Written by speech and language therapists working in clinical practice, the studies included in this unique resource reflect the realities of everyday practice and will appeal to therapists, students and researchers in aphasia.
Media The Aphasia Therapy File. Save Not today. Format ebook. Author Sally Byng.
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