Aphasia and Music Therapy

Transcription

1 Aphasia and Music Therapy Module 1 Outline I. Types of Aphasia II. Associated Impairments III. Non-musical interventions IV. Why music for aphasia? V. Music Therapy Interventions Aphasia Is: An acquired condition Impacts language abilities receptive and expressive Has a neurologic cause 1

2 Aphasia is NOT An intellectual disorder A speech disorder A psychiatric disorder Types of Aphasia 2

3 Modalities that May be Impaired Auditory Comprehension Oral Expression Reading Comprehension Written Expression Terminology Paraphasias incorrect word is substituted Literal paraphasias substitution, addition or re-arrangement of speech sounds (i.e. saying pike instead of pipe ) Anomia word finding difficulty Jargon lengthy, well-articulated utterances that make no sense to the listener Terminology (continued) Neologisms made up words Circumlocutions talking around a specific word Logorrhea excessive talkativeness 3

4 Terminology (continued) Press of speech patients speak rapidly and interrupt others Agrammatism inability to speak in a grammatically correct fashion Telegraphic speech short phrases made up of content words (i.e. chair broken instead of My chair is broken. ) Global Aphasia Severe impairment Severe impairment Symptoms may reduce in the first few months Broca s Aphasia (Non-Fluent Aphasia) Mild to severe impairment May see: Agrammatism Telegraphic speech Anomia Literal paraphasias 4

5 Broca s Aphasia (Non-Fluent Aphasia) (continued..) Often area aware of deficits, which can cause emotional distress May also see: Contralateral hemiparesis Apraxia Dysarthria Wernicke s Aphasia (Fluent Aphasia/Receptive Aphasia) Moderate to severe impairment Moderate to severe impairment Wernicke s Aphasia (Fluent Aphasia/Receptive Aphasia) (cont.) Have grammatically correct speech that doesn t make a lot of sense: Paraphasias Jargon Neologisms Circumlocutions Press of speech logorrhea Poor awareness 5

6 Conduction Aphasia Trouble with repetition Phonemic paraphasias Transcortical Sensory Aphasia Moderate to severe impairment Moderate to severe impairment Paraphasias Logorrhea Poor self-monitoring Intact repetition neologisms 6

7 Transcortical Motor Aphasia Especially with complex grammar Can repeat Literal and semantic paraphasias Telegraphic Mixed Transcortical Aphasia Difficulty with complex grammar Anomic Aphasia Trouble with finding words Mild impairment Mild to severe impairment 7

8 Primary Progressive Aphasia Language abilities are slowly and progressively lost Mild to severe impairment that is progressive Mild to severe impairment that is progressive How do people get aphasia? Etiology of Aphasia Stroke (Cerebrovascular accident (CVA)) Ischemic (occlusive) strokes blockage of artery Hemorrhagic stroke blood leaking from artery Arteriovenous malformation (AVM) malformation of artery or vein (likely occurred during brain development) Strokes often hit between ages Traumatic brain injury? lack of agreement on whether aphasia occurs after TBI 8

9 Associated Impairments Reading Comprehension Impairment Usually quantified by the SLP in terms of length (i.e. reading at the word level, reading at the sentence level, reading at the paragraph level). IMPACT ON INTERVENTION: May not be able to read cues on a white board May not be able to read lyric sheets 9

10 Writing Impairment Some people may be able to write what they want to say Others are unable to even copy letters IMPACT ON INTERVENTION: Will impact communication in the session Apraxia A motor speech disorder where the lips, tongue and oral motor movements cannot form the movements necessary to make the sounds the person is trying to make Miscommunication between the brain and the mouth Not a weakness of the oral motor muscles Apraxia (continued) IMPACT ON INTERVENTION: Repetition is usually contraindicated with apraxia The harder a person with apraxia tries, the less successful they are Automatics are easier They will need to watch your mouth You may need to adjust the tempo of your musical stimulus 10

11 Dysarthria Muscle weakness that causes words to be slurred together IMPACT ON INTERVENTION: Respond well to rhythmic stimulus to help separate words Vision Impairments May only be able to see things in one part of their visual field May have double vision IMPACT ON INTERVENTION: Make sure that any visual cues (i.e. you, the white board etc) are presented where the client can see it Hemiparesis/hemiparalysis Weakness or paralysis on one side of the body People with aphasia typically had a stroke or injury in the left hemisphere and therefore have a right hemiparesis IMPACT ON INTERVENTION: Will likely only have 1 hand available for cueing If they have pain on that side, may want to help them communicate that 11

12 Video Introduction VIDEO: Patience, Listening and Communicating with Aphasia Patients by the National Aphasia Association 12