Broca's Aphasia - Carol
Date of Observation: 11/17/2024
On the Master Clinician Network, I observed a therapy session with a 69-year-old female diagnosed with Broca's Aphasia. The session occurred in a private room that was wheelchair accessible. The client was comfortable, and there were no distractions. I noticed that the Speech-Language Pathologist, Dr. Copeland, addressed several areas of Speech and Language: Receptive Language (the patient's understanding of the language being spoken), Speech and Articulation (the patient's ability to form clear words and sentences), Pragmatic Skills (how well the patient maintains conversation or answer questions in context), among others.
Materials used:
Whiteboard with markers
Picture Cards
Goals:
The primary goal of this session was to engage the client, Carol, in structured, evident-based tasks to treat spoken language expression, including cues, sentence completion, and picture description.
Long Term Goal (LTG):
The client will convey basic needs with minimal to moderate assistance from the conversation partner, use simple words to express choices/ preferences, give accurate yes/no responses, and communicate with contextually relevant phrases.
Short Term Objective (STO):
Client will produce “yes/no” responses with 80% accuracy.
Client will verbally approximate simple choices with 80% adequacy.
Client will verbally approximate select 3 to 5-word phrases with 70% adequacy.
Client will convey at least 2 appropriate information units when describing select photos.
Client will convey meal choices with minimal prompting during community dining.
Client’s family will be educated on aphasia and techniques to support conversation.
Impression:
I was curious about this treatment intervention and did some research. She used Melodic Intonation Therapy (MIT). “It applies musical elements to speech, using melody and rhythm in an exaggerated way to make speech resemble singing.”
Reference: https://tactustherapy.com/mit-melodic-therapy-how-to/
Setting: Speech Therapy Office
On the Master Clinician Network, I observed a therapy session with a 69-year-old female diagnosed with Broca's Aphasia. The session occurred in a private room that was wheelchair accessible. The client was comfortable, and there were no distractions. I noticed that the Speech-Language Pathologist, Dr. Copeland, addressed several areas of Speech and Language: Receptive Language (the patient's understanding of the language being spoken), Speech and Articulation (the patient's ability to form clear words and sentences), Pragmatic Skills (how well the patient maintains conversation or answer questions in context), among others.
Materials used:
Whiteboard with markers
Picture Cards
Goals:
The primary goal of this session was to engage the client, Carol, in structured, evident-based tasks to treat spoken language expression, including cues, sentence completion, and picture description.
Long Term Goal (LTG):
The client will convey basic needs with minimal to moderate assistance from the conversation partner, use simple words to express choices/ preferences, give accurate yes/no responses, and communicate with contextually relevant phrases.
Short Term Objective (STO):
Client will produce “yes/no” responses with 80% accuracy.
Client will verbally approximate simple choices with 80% adequacy.
Client will verbally approximate select 3 to 5-word phrases with 70% adequacy.
Client will convey at least 2 appropriate information units when describing select photos.
Client will convey meal choices with minimal prompting during community dining.
Client’s family will be educated on aphasia and techniques to support conversation.
Impression:
I enjoyed observing Dr. Copeland’s therapy approach. She was very patient and kept encouraging the client. She praised Carol at every turn. I noticed that the faster Carol tried to answer Dr. Copeland's questions, the worse her fluency became. Dr. Copeland did an excellent job giving cues and slowing Carol down.
What I learned:
This observation introduced me to several approaches and techniques used in therapy. One of the strategies she used was asking Carol to associate familiar words, for example, girl with (boy) and stop with (stare). In addition, she had Carol complete “would you rather” questions. Dr. Copeland also did a picture exercise, asking Carol to identify famous people. I noticed the physical symptoms of Carol's right facial palsy and right hemiplegia, especially on one side of her mouth. Carol also communicated by writing down her answers and tracing words with her finger. Carol's audio comprehension was intact. Another strategy was having Carol sing the answers to her questions to create an easier rhythm for articulation. Carol had great difficulty with motor planning. It was hard for her to get the words she wanted to say out and to place her articulators in the right position. Her behavior is characteristic of Apraxia of Speech. Carol shows severe non-fluent aphasia, specifically Broca’s Aphasia.
Question:
In one of the exercises, Dr. Copeland asked Carol to sing some sentences. What is the basis of this exercise?
What I learned:
This observation introduced me to several approaches and techniques used in therapy. One of the strategies she used was asking Carol to associate familiar words, for example, girl with (boy) and stop with (stare). In addition, she had Carol complete “would you rather” questions. Dr. Copeland also did a picture exercise, asking Carol to identify famous people. I noticed the physical symptoms of Carol's right facial palsy and right hemiplegia, especially on one side of her mouth. Carol also communicated by writing down her answers and tracing words with her finger. Carol's audio comprehension was intact. Another strategy was having Carol sing the answers to her questions to create an easier rhythm for articulation. Carol had great difficulty with motor planning. It was hard for her to get the words she wanted to say out and to place her articulators in the right position. Her behavior is characteristic of Apraxia of Speech. Carol shows severe non-fluent aphasia, specifically Broca’s Aphasia.
Question:
In one of the exercises, Dr. Copeland asked Carol to sing some sentences. What is the basis of this exercise?
I was curious about this treatment intervention and did some research. She used Melodic Intonation Therapy (MIT). “It applies musical elements to speech, using melody and rhythm in an exaggerated way to make speech resemble singing.”
Reference: https://tactustherapy.com/mit-melodic-therapy-how-to/
Final presentation link: bit.ly/slpenthusiast
