About The Book

Evelyn R. Klein, PhD, CCC-SLP, BCS-CL, ASHA Fellow, is a Full Professor at La Salle University in the Department of Communication Sciences and Disorders where she teaches, supervises, and advises students pursuing degrees in speech-language pathology. She also co-directs the CASTLE Assessment Center at La Salle. Dr. Klein is a certified and licensedspeech-language pathologist and a licensed psychologist with postdoctoral training in clinical neuropsychology and cognitive behavioral therapy. She is a Board-Certified Specialist in Child Language and Language Disorders affiliated with ASHA. Dr. Klein received the Lindback Distinguished Teaching Award in 2011 and Faculty Distinguished Scholarship Award in 2018. She is also engaged in private practice. Her areas of specialization include selective mutism, autism spectrum disorders, fluency disorders, language disorders, and counseling. Dr. Klein is an editor and author of textbooks and treatment programs including EXPRESS (Expanding Receptive and Expressive Skills through Stories), More Than Fluency: The Social, Emotional, and Cognitive Dimensions of Stuttering, and Acquired Language Disorders: A Case-Based Approach, Third Edition (all published by Plural Publishing). She is on the Scientific Advisory Board of the Selective Mutism Association.

About The Authors

Evelyn R. Klein, PhD, CCC-SLP, BCS-CL, ASHA Fellow, is a Full Professor at La Salle University in the Department of Communication Sciences and Disorders where she teaches, supervises, and advises students pursuing degrees in speech-language pathology. She also co-directs the CASTLE Assessment Center at La Salle. Dr. Klein is a certified and licensedspeech-language pathologist and a licensed psychologist with postdoctoral training in clinical neuropsychology and cognitive behavioral therapy. She is a Board-Certified Specialist in Child Language and Language Disorders affiliated with ASHA. Dr. Klein received the Lindback Distinguished Teaching Award in 2011 and Faculty Distinguished Scholarship Award in 2018. She is also engaged in private practice. Her areas of specialization include selective mutism, autism spectrum disorders, fluency disorders, language disorders, and counseling. Dr. Klein is an editor and author of textbooks and treatment programs including EXPRESS (Expanding Receptive and Expressive Skills through Stories), More Than Fluency: The Social, Emotional, and Cognitive Dimensions of Stuttering, and Acquired Language Disorders: A Case-Based Approach, Third Edition (all published by Plural Publishing). She is on the Scientific Advisory Board of the Selective Mutism Association.

James M. Mancinelli, MS, CCC-SLP is the University Clinical Coordinator/Supervisor for La Salle University’s Speech-Language-Hearing Science Program. He teaches the graduate course in acquired language disorders, the introductory and advanced clinical practicum courses, as well as undergraduate courses in clinical procedures and professional issues. Mr. Mancinelli is a certified speech-language pathologist and has twenty-five years of clinical experience in medical speech-language pathology, evaluating and treating patients across the life span in acute care, rehabilitation, long-term care, and out-patient settings.

Table Of Contents

Introduction

Acknowledgements

Contributor

Chapter 1. An Overview of Neuroanatomy and Neurophysiology Related to Acquired Language Disorders (ALD)

The Neuron

Neurotransmitters

Sensory

The Brain: A Brief Review of Structure and Function

The Coverings of the Brain, Ventricles, and Cerebrospinal Fluid

Cerebral Cortex

The Brainstem

Subcortical Structures

The Cerebellum

Neural Pathways

Cerebral Blood Flow

Cerebrovascular Accidents

Brain Imaging and Selected Medical Tests for Acquired Language Disorders

CAT Scan or CT Scan

MRI

fMRI

PET Scan

SPECT Scan

ASL    9

Examination of the Carotids: Doppler Ultrasound or Auscultation of the Carotids

Endocardiography

Angiography

References

Chapter 2. Assessment and Service Delivery in Acquired Language Disorders

Approaches to Assessment in Acquired Language Disorders

Purpose of Assessment

      Assessment of Language Functions

Characteristics of Aphasia

Definitions of the Clinical Characteristics of the Major Aphasias

Areas to Consider Using the ALD Target Assessment Model

The Target Assessment Snapshot in Acquired Language Disorders

Screening and Diagnostic Assessment

Screening Tests

Diagnostic Assessment in Acquired Language Disorders: Making Sound Decisions

Selected Assessments for Acquired Language Disorders

Modifications to Standard Assessments

Goal Setting Based on Diagnostic Results

Service Delivery and the World Health Organization

The International Classification of Functioning (ICF) and Living with Aphasia: Framework for Outcome Measurement (A-FROM model)

Service Delivery for People with Acquired Language Disorders

The Acute Care Setting

The Rehabilitation Setting

The Home Care Setting

The Outpatient Setting

The Long-Term Care (LTC) Setting

Monitoring Change and Continuation of Services

Documentation of Progress

Summary

References

Appendix 2–A: Functional Communication Connections Octagon

Appendix 2–B: Quick Reference Diagnostic Chart for Acquired Language Disorders

Chapter 3. The Major Non-Fluent Aphasias

Introduction

Broca’s Type Aphasia

Characteristics

A Functional Analysis of Maurice

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals using A-FROM (Kagan, 2011)

Transcortical Motor Aphasia

Characteristics

A Functional Analysis of Vincent

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals with A-FROM (Kagan, 2011)

Global Aphasia

Characteristics

A Functional Case Analysis for Elizabeth

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals with A-FROM (Kagan, 2011)

References

Chapter 4. The Fluent Aphasias

Introduction

Wernicke’s Type Aphasia

Characteristics

A Functional Analysis of Mildred’s Wernicke’s Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

Transcortical Sensory Aphasia

Characteristics

A Functional Analysis of John’s TSA

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

Conduction Aphasia

Characteristics

A Functional Analysis of Miriam’s Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM (Kagan, 2011)

Anomic Aphasia

Characteristics

A Functional Analysis of Sophie’s Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals using A-FROM

References

Chapter 5. Other Aphasic Syndromes

Subcortical Aphasia

Introduction

Characteristics of Subcortical Aphasias

A Functional Analysis of Winnie’s Subcortical Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

Primary Progressive Aphasia

Introduction

Characteristics

A Functional Analysis of Luis’s Primary Progressive Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

Acquired Alexia and Agraphia

Characteristics

Alexia

Agraphia

A Functional Analysis of Sue’s Alexia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

Aphasia in the Bilingual Person

Recovery Patterns in Bilingual Aphasia

Cognitive Control in Differential Aphasia

A Functional Analysis of Hamid’s Bilingual Aphasia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

References

Chapter 6. Right Hemisphere Disorder

Introduction

Characteristics

Communication Deficits

RHD and Pragmatic Impairment

Visual-Perceptual Deficits

Visuomotor Deficits

Auditory Perceptual Deficits

Cognitive Deficits

A Functional Analysis of Debra

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

References

Chapter 7. Traumatic Brain Injury

Introduction

Characteristics

Types of Brain Injury

Symptoms Related to Localization of the TBI

Prognostic Considerations in Head Injury

Premorbid Intelligence

Age at the Time of Injury

Duration of Coma

Posttraumatic Amnesia

Medical Complications

Posttraumatic Seizures

Hydrocephalus

Spasticity

Cognitive-Linguistic Impairment Due to TBI

Establishing Goals for the Therapeutic Course

Postconcussive Syndrome

Mild TBI (mTBI)

Rating Scales for Functional Outcomes

Rancho Los Amigos (RLA)

Disability Rating Scale (DRS)

General Treatment Issues

Errorless Learning

A Note about Generalization in People with TBI

A Functional Analysis of Samuel’s TBI

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

References

Chapter 8. Dementia

Introduction

Characteristics

Diagnostic Factors

The Stages of Dementia

Memory Systems and Dementia

Types of Dementia

Vascular Dementia (VaD)

Parkinson’s Dementia

Fronto-Temporal-Parietal Dementias (FTP)

Creutzfeldt-Jakob Disease

Huntington’s Disease

Overview of Research on Treatment for Dementia

A Functional Analysis of Max’s Dementia

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

References

Chapter 9. Encephalopathy

Introduction

Characteristics

Drug and Alcohol Intoxication: Two Common Etiologies for Encephalopathy

A Functional Analysis of Tommy

Critical Thinking/Learning Activity

Treatment Considerations

Therapeutic Goals Using A-FROM

References

Chapter 10. Selected Treatment Programs and Approaches

Historical Overview of Efficacy and Evidence in the Treatment of Acquired Language Disorders (ALD) in Adults

Randomized Controlled Trials (rCTs) and Aphasia Treatment

Trends in Treatment for Acquired Language Disorders

Biological and Pharmacologic Interventions

Using Neuroimaging to Predict Recovery in People with Aphasia

Intensity of Treatment

Computer-Assisted Technology and Treatment of Aphasia

AAC for Adults with ALD: Aphasia, PPA, TBI, and Dementia

The Use of Applications (Apps) in the Rehabilitation of the ALD Patient

Selected Treatment Programs for Acquired Language Disorders

A Treatment Sequence for Phonological Alexia/Agraphia

Anagram, Copy, and Recall Therapy (ACRT)

Concurrent Treatment for Reading and Selling in Aphasia: Oral Reading Treatment (ORT) and Copy and Recall Treatment (CART)

Constraint-Induced Language Therapy (CILT)

Conversational Coaching

Divergent Word Retrieval

Life Participation Approach to Aphasia (LPAA)

Lingraphica®

Mapping Therapy

Melodic Intonation Therapy (MIT)

MossTalk Words (MTW)

Narrative Story Cards

Nonsymbolic Movements for Activation of Intention (NMAI)

Normal Sentence Production

Oral Reading for Language in Aphasia (ORLA) and ORLA with Virtual Therapist (ORLA-VT)

Promoting Aphasics’ Communicative Effectiveness (PACE)

Response Elaboration Training (RET)

Schuell’s Stimulation Approach

Semantic Feature Analysis (SFA)

Sentence Production Program for Aphasia (SPPA)

SentenceShaper®

Speech Entrainment

Treatment of Underlying Forms (TUF)

Verb Network Strengthening Treatment (VNeST)

Visual Action Therapy (VAT)

References

Appendix A. Case History Form

Appendix B. Seven Domains Assessment Summary Sheet

Appendix C.  Cognitive-Linguistic Evaluation

Appendix D. The World Health Organization and the International Classification of Functioning, Disability, and Health

Appendix E. The Octogon Worksheet for Functional Communication

Appendix F. Test Your Knowledge

Index

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