Transcript Case History #4

Case History #4
Esther
Background
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72 year old female suffered a left CVA
July 5th, 1999
Received speech therapy at Polinsky
from August to December 1999
Began RFP Spring Semester 2000
– Receives Group and Individual tx
– Participates in Socialize!
Assessment
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April 2004, given the Apraxia Battery
for Adults-2 (ABA-2)
Tasks
– DDK: Unable to sequence syllables
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Severely impaired
– Increasing word length: number of
syllables correct with imprecise
articulation
Assessment Cont
– Limb Apraxia and Oral Apraxia
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No evidence of limb Apraxia
Mild oral Apraxia
– Utterance time for polysyllabic words
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Mild impairment
Misarticulation of words
– Repeated trial (amount of deterioration in
productions of words over three consecutive
trials)
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Severe articulation errors
First production more correct than last
Assessment Cont
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Inventory of Articulation
Characteristics of Apraxia
– Abnormal prosodic features
– Awareness of errors & inability to correct
– Errors highly inconsistent
– Visible/audible searching
Current Diagnosis
 Severe
Apraxia of Speech
 Mild Aphasia
 Mild Dysarthria
Treatment
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Utilizing MIT
– Produces 2+ word phrases following a
delay and intervening question with 72%
accuracy
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Increasing participation, interactions,
and ways of communicating
– Contributes to group conversation by
verbalizing, writing, gestures, or a letter
board
Treatment
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Increasing reading comprehension
– Answered multiple choice, true/false,
yes/no questions with 85% accuracy
when reading 20 pages
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Writing phrases
– Writes with no more than 2 grammatical
or spelling errors 89% of the time
Recommendations
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Improve expressive speech utilizing
MIT at the 2-4 word/phrase level
Improve writing and spelling
Improve reading comprehension
Increase participation using a variety
of communication modes
AAC Assessment
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Communication Needs
Seating and Positioning
Visual Status
Motor Control
Switch Assessment
Cognitive and Language Assessment
Communication Needs
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Interview (include family members)
– Communication partners
– Communication mode
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Strategies & word retrieval ability
– Interest in activities (computer use)
– Feelings on current communication
system
Seating and Positioning
 We
feel there are no factors to
interfere with an AAC system
Visual Status
 Baseline
vision screening
–Reading task
Motor Control
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Words per minute on computer
Direct selection and written language
will be assessed:
– name
– Copying sentences
– “prime” words (ie: cat) to dictation
Switch Assessment
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Not an area of concern for Esther
Cognition and Language
Assessment
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Informal naming tasks
Cueing- visual and semantic
Reading comprehension
Comprehension of symbols
AAC Options
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Lightwriter
Pathfinder
Discussion
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Additions, thoughts, Ideas!