Treatment Strategies for Aphasia
Aphasia Symptom Chart
| aphasia_chart.docx |
Interventions for
Aphasic Patients
Therapy Techniques for Patients with Aphasia
Functional Communication
Functional communication strategies are used to enhance the patients' everyday activities or activities of daily living (ADL's). Some of these may be practicing/using words or phrases that they would use in everyday life. Some may be helpful in ways of organization. It all comes down to what the stroke patient needs in their treatment plan, and what their Speech Language Pathologist suggests. Below are some simple strategies.
-Monthly Calendar
Using a monthly or weekly calender will assist a stroke patient in not only reading and writing, but most significantly, remembering important appointments, dates, etc. Below is a template that can be used to alter monthly.
Using a monthly or weekly calender will assist a stroke patient in not only reading and writing, but most significantly, remembering important appointments, dates, etc. Below is a template that can be used to alter monthly.
| appointmentcalendar.doc |
WH - Question Cues Free Download
The below five page document can be used in a variety of settings and therapies with all different types of disorders as well. It provides a visual cue, just one of the many cues needed in therapy and should also be practiced at home.
| wh_questions_cues.pdf |
Melodic Intonation Therapy
MIT Therapy
Melodic Intonation Therapy is a type of aphasia treatment program that uses musical intonation, continuous voicing, and rhythmic tapping to teach verbal expressions to clients with severe non-fluent aphasia with good auditory comprehension. Most recently, this type of therapy was seen being used to treat Arizona Senator Gabrielle Giffords after the horrific shooting which left her without speech. Melodic Intonation Therapy utilizes the right part of the brain centers (the non-damaged area) to sort of bring life back to the damaged part.
Candidacy for Melodic Intonation Therapy (MIT)
General Procedures for
Melodic Intonation Therapy (MIT)
General procedures
**Tapping should be used throughout each level with the left hand. Beginning with hand over hand if necessary.
Level I:
Level II:
· Introduction of item: Intone the phrase twice and tap; no response required
· Unison with fading: intone, tap, in fade halfway through the phrase
· Delayed repetition: intone and tap, and after 6 sec. of delay, let the client tap with assistance; ask the client to intone with help
· Response to a probe question: 6 sec. following the clients response, intone the probe question; do not hand tap; let the client intone the phrase
Level III:
- Select high probability words, phrases, and sentences
- Use pictures or environmental cues for each target utterance
- Intone each word, phrase, or sentence slowly and with constant voicing
- Maintain pitch and stress variations of normal speech
- Tap client’s left hand once for each intoned syllable
- Signal with your left hand when to listen and when to intone
- Generally, move to the earlier step when the client fails a step
**Tapping should be used throughout each level with the left hand. Beginning with hand over hand if necessary.
Level I:
- Humming: show a picture, hum the target item, and tap; no response required
- Unison singing: intone, tap, and fade halfway through the phrase
- Immediate repetition: Ask client to listen to you as you intone the phrase and tap; let the client imitate
- Response to probe question: Following a correct imitation, intone a probe question (eg; What did you say?)
Level II:
· Introduction of item: Intone the phrase twice and tap; no response required
· Unison with fading: intone, tap, in fade halfway through the phrase
· Delayed repetition: intone and tap, and after 6 sec. of delay, let the client tap with assistance; ask the client to intone with help
· Response to a probe question: 6 sec. following the clients response, intone the probe question; do not hand tap; let the client intone the phrase
Level III:
- Delayed repetition: Tap and intone and let the client intone the phrase after 6 sec and give tapping assistance
- Introducing Speech Song: present the target phrase twice slowly, without singing, but with exaggerated rhythm and stress; no tapping and no response required
- Delayed spoken repetition: present the phrase in normal prosody, without hand tapping and let the client imitate after 6 seconds in normal prosody.
- Response to a probe question: ask a probe question with normal prosody after a 6 sec delay; let the client respond with normal prosody.
Semantic Feature Analysis
By using a map or grid, organize a connection between words based on a subject or concept you are trying to get your patient to name or identify.
| semanticfeatureanalysis.doc |
Voluntary Control of Involuntary Utterances
An approach to improving verbal output in severely non-verbal patients, whose speech is limited to stereotypical production of few real words. The more automatic, emotional or contextual the nature of the task, the more likely they will produce appropriate utterances.
Treatment for Aphasic Persevervation
Persevervation means, "Getting stuck" or repeating words/movements etc
“Set” before each stimuli. Monitor rate between stimuli 5-10 seconds
Raise awareness with the patient: write it down, identify it as incorrect, and use it as a cue for incorrect responses- cognitively aware or not.
“Set” before each stimuli. Monitor rate between stimuli 5-10 seconds
Raise awareness with the patient: write it down, identify it as incorrect, and use it as a cue for incorrect responses- cognitively aware or not.
Conversational Script Therapy
Theory of automatization. To practice a script in a situation that they want to be able to do. Start at the single word level and move to conversation level. Patient writes their own script in their own chosen context. Clinician cues through the script
Sentence Production Program for Aphasia
Show a picture with the corresponding sentence below and they fill in the blank. This is used to increase proper use of grammar at the sentence level.
Visual Action Therapy
Increase the ability of patients with poor verbal skills to produce representational gestures for purposes of functional communication
Cognitive Communication Techniques
The most common evidence-based practices are validation therapy, graphic and written cues, Montessori-based interventions, spaced retrieval training, and FOCUSED caregiver training programs.
Strategies to facilitate communication between caregiver and the aphasic patient
Aphasia Assessments
A Comprehensive
Adult Speech & Language Evaluation
The Speech & Language Comprehensive Evaluation for Adult patients is a complete assessment that includes all aspects needed when assessing an adult patient for Speech & Language. The parameters being assessed include:
1. Patient History & Observations
2. Oral Speech Mechanism
3. Clinical Evaluation of Voice
4. Motor Speech
5. Memory
6. Expressive Language
7. Receptive Language & Auditory Comprehension
8. Reading Comprehension
9. Problem Solving, Planning & Sequencing
10. Attention
11. Writing
There are five appendices included which give the clinician room for overall clinical findings, client response when needed, Norms, as well as a copy of the Cookie Theft Picture. As in the picture posted above taken from the Expressive Language section, most sections include much room for written response of the client should you choose to record on that page, record of error type and any cues used/needed for use in later treatment. Each section also has space for comments and clinical findings for each modality being evaluated.
Speech & Language Adult Evaluation Form for SNF/LTC
For purchase is an easy to use, time saver Speech and Language Evaluation form mainly for use in Adult Rehabs/Skilled Nursing Facilities or Long Term Care Facilities. This form is structured the same way as the Adult Bedside Swallow Exam as it has all of the necessary content needed when doing these evaluations, but is available on this form provided for you so all you need to do is check off/cross off/ and fill in the necessary information, rather than writing up an entire evaluation. If you work in a facility that now uses EMR, this form is consistent with the information needed to fill in EMR's as well. The parameters being assessed include:
General Observations
Clinical Evaluation of Speech
Voice
Motor Speech
Receptive Language
Expressive Language
Cognitive Evaluation
Oral Speech Mechanism
Impressions
Rehab Potential
Functional Goals: Short Term & Long Term
Plan/Recommendations
Speech & Language/Cognitive Treatment Plan
