Group Members

Crystal Brown

Robin Carter

Jamie Davis

Amanda Fowler

Historical Information

62 year old male, eight months post onset CVA with resulting aphasia characterized by fluent, empty speech with phonemic paraphasias and neologisms (home health)

Treatment Goals

Impairment

1. To improve receptive and expressive language skills (which includes phonological, morphological, syntactical, and semantic processing)

Activity

1. Effectively communicate basic wants and needs

2. To appropriately respond to yes/no questions and engage in meaningful conversation

3. To use compensatory strategies when communicating with others

Participation

1. To contribute to communication goals and treatment planning

2. To participate in social activities with family and friends

Treatment Activities

1. For expressive language, the clinician will use word retrieval strategies such as confrontational naming – objects, pictures, and/or gestural cues to elicit the correct word. For receptive language (auditory comprehension), the clinician will give simple commands, 2-3 step commands with the same verb, and 2-3 step commands with different verbs.

2. The clinician will develop strategies for appropriately responding to yes/no questions and engaging in meaningful conversations. Strategies will include verbal and nonverbal cues, such as head nod/shake and/or squeezing hand to answer personal information, familiar information (answer in view/not in view), and general to specific standard information.

3. To improve social interactions with family members, biweekly therapy sessions with patient and family members will be held to incorporate speaker compensations, such as alerting signals, and modifying content and form. Progress will be monitored and discussed each week to document improvement and responsiveness to therapy activities.

Extra Credit (SOAP note)

S: When SLP arrived at patient’s home, he was responsive and eager to participate in therapy; O: Using objects, such as a key, ball, pen, watch, button, and pictures of a duck, shoe and a cup, patient was asked to name each object, performing at 75% accuracy (6/8); patient appropriately responded to yes/no questions by giving both verbal responses and shaking his head; next, the clinician began with giving patient simple commands, progressing to 2-3 step commands; patient consistently followed all of the simple commands but demonstrated great difficulty when different verbs were added; for example, patient had to touch his nose then raise his hand, he showed signs of confusion and lack of comprehension; the session ended with patient and family consultation pertaining to compensations used when communicating with patient;

A: Patient continues to exhibit receptive and expressive language difficulties characterized by fluent, empty speech; P: Continue with word retrieval strategies, following commands, responding to yes/no questions, and incorporating speaker compensations in his daily living.