Intervention for Anomic Aphasia From a Functional Perspective

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Intervention for Anomic Aphasia From a Functional
Perspective

• Jacqueline J. Hinckley, Ph.D., CCC-SLP
• Board Certified Neurogenic Communication
  Disorders
• University of South Florida
• Tampa, FL

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Three Key Elements of Any Functional
Approach(Worrall, 2000, Holland Hinckley, 2002)

• Focus on how the individual functions in his/her
  typical environments
• Focus on communicating the content and social
  meaning of the message in any way possible
• Transactional and interactional communication
• Any element in the environment can be considered
  a potential target or agent of change

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Individual
Messages Communication strategies
Profile of impairments
Environment Contextual Factors
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Additional assessments

• Cognitive
• Nature of the individual-environment interaction
• Contextual factors
• Social and life pursuits

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Assessment WSs Abilities

• Premorbid abilities (what WS brings with him to
  the situation)
• Literate, educated
• Professional skills
• Social support
• Current language status (where the stroke has
  left him at the moment)
• Conversation is impaired
• Unknown reading abilities (self-report difficulty
  with newspaper)

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Assessment WSs abilities

• Current cognitive status (non-language cognitive
  abilities)
• We dont know much that will help us understand
  his potential for
• Performance in distracting environments
  (attention, executive function)
• Ability to learn new information, including
  communication strategy development and usage
  (attention, memory, executive function)
• Ability to participate in social role (home
  management, vocational/avocational pursuits,
  civic responssibilities)

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Assessment WSs environment

• What home management tasks/roles would he
  typically play? What skills currently available?
• What social tasks/roles would he typically play?
  What skills currently available?
• What kinds of things does he want to say? What
  topics does he want to talk about/likely to talk
  about?
• Hobbies reading, politics, movies, travel

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Intervention for anomia

• Talking about travel, politics, whats in the
  newspaper
• Conversational coaching
• Self-cues
• Script training

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Conversational Coaching
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Self-cues
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Script training
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Outcome Measurement

• Comprehensive
• Impairment, activity, participation
• Individually-relevant
• Environment-specific

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Happy ending

• Hoped for outcomes

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Intervention for Anomic Aphasia Convergences and
Divergences

• Jacqueline J. Hinckley
• Nadine Martin

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Convergences

• Need to understand individuals cognitive profile
  along with aphasia/language impairment
• Attention and working memory affect treatment
  procedure selection and stimuli selection
• Memory and executive functions may affect
  communication strategy development and deployment

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Convergences

• Self-selected cues
• Share aspects of impairment and functional
  approaches
• Cues for a more generalized naming practice
• Personal relevance and personal control in
  cue/strategy selection

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Divergence

• Bottom-up building blocks
• Top-down enfvironment and individual choice are
  starting points

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Do bottom-up approaches and top-down
approaches ultimately meet in the middle?Could
they produce the same outcomes'?