Archways--Aphasia Rehab

Acalculia Treatment: Arithmetic Fact Retrieval and Calculation

How do we perform arithmetic calculations? ๐Ÿง  โš™๏ธ ๐Ÿ”ขโฃ
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Successful calculation requires retrieving arithmetic facts from long term memory and using conceptual knowledge to correctly execute mathematical procedures.โฃ

Acalculia Treatment: Number Transcoding

๐—ก๐˜‚๐—บ๐—ฏ๐—ฒ๐—ฟ ๐—ง๐—ฟ๐—ฎ๐—ป๐˜€๐—ฐ๐—ผ๐—ฑ๐—ถ๐—ป๐—ด is the process in which numbers are "translated" from one format to another (i.e., converting the written word four into the Arabic numeral 4 or the spoken word "four"). ๐Ÿ”ข ๐Ÿ—ฃ๏ธ โœ๐Ÿผ โฃ
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This skill is deceptively simple, as how we say a number depends on the context it is in (e.g., the number 230 may be said as "two hundred and thirty," while 2:30 PM is said as "two-thirty").โฃ

The Neuroscience of Numbers

What are the neural correlates of number processing? ๐Ÿ” ๐Ÿง  ๐Ÿ”ขโฃ
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Number processing in the brain is supported by a vast system of brain regions spanning across the cortex. Researchers have found that parietal lobe areas play a significant role in the calculation and processing of numbers, while frontal lobe areas play a critical role in the recall of numerical knowledge and working memory.โฃ
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Cognitive Models of Numerical Processing

How can number processing be conceptualized? ๐Ÿ”ข ๐Ÿง  โฃ
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Models of numerical processing are helpful tools for better understanding the types of arithmetic errors made by people with acalculia. While these errors can be seemingly random upon first glance, theoretical models help provide a framework for recognizing why certain errors are made and how treatment can be individualized to best fit the unique needs of our clients.โฃ

What is Acalculia?

Difficulty with numbers and math following neurological damage is known as acalculia ๐Ÿง  ๐Ÿ”ขโฃ
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Many people with aphasia experience number processing and math troubles, with recent estimates suggesting that between 30% and 60% of stroke survivors experience acalculia (Moore & Demeyre, 2022; Zukic et al., 2012). โฃ

Assistive Technology: Electronic Spell Checkers

Looking for a mid-tech tool for your clients with agraphia? Check out electronic spellers! โœ๐Ÿผ โŒจ๏ธ โฃ
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When trying to correctly spell a word, electronic spellers are typically programmed to look for correct spellings that best match the ๐—ฝ๐—ต๐—ผ๐—ป๐—ฒ๐˜๐—ถ๐—ฐ spelling of what your client just wrote (searching for words that ๐˜€๐—ผ๐˜‚๐—ป๐—ฑ similar) ๐Ÿ‘‚ โฃ
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This is different than the default spell check that is installed on most computer word processors, which are programmed to find ๐—ผ๐—ฟ๐˜๐—ต๐—ผ๐—ด๐—ฟ๐—ฎ๐—ฝ๐—ต๐—ถ๐—ฐ spellings (searching for words that ๐—น๐—ผ๐—ผ๐—ธ similar) ๐Ÿ‘€ โฃ

Learning a New Language as an SLP

Hereโ€™s something Iโ€™ve personally been reminded of lately: Language is complicated! ๐Ÿคท๐Ÿผโ€โ™‚๏ธ ๐Ÿง  ๐Ÿ—ฃโฃ
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In some of my free time this summer, Iโ€™ve recently started learning Japanese ๐Ÿ‡ฏ๐Ÿ‡ต โฃ
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And as much fun as it is to learn a new language and geek out over the syntactic structures and morphology of the Japanese language, it has also been really HARD for me at times ๐Ÿ˜“โฃ
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(Really wishing right now that I still had those extra neurons from my pre-synaptic pruning days ๐Ÿ˜…)โฃ
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It has been such a good experience for me as an SLP to have a personal reminder on how complex language is though, because I feel like I am better able to sympathize with my clients who are working so hard to recover their language skills after a stroke or brain injury ๐Ÿง  ๐Ÿ’ฅ โฃ

Agraphia Treatment: Sentence-Level Treatment

What are specific areas to target for writing treatment at the sentence-level? ๐Ÿคท๐Ÿผโ€โ™‚๏ธ๐Ÿ–‹โ“โฃ
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When treating agaraphia at the sentence-level, syntax and morphology are areas that may be contributing to writing difficulties โœ๐Ÿผ โฃ

Agraphia Assessment: Sentence-Level Assessment

Have you ever had a client who writes single words successfully, but struggles when trying to string those words together into sentences? โœ๐Ÿผโ“๐Ÿšซโฃ
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Agraphia assessment at the sentence-level examines the language skills outside of spelling, such as ๐˜ด๐˜บ๐˜ฏ๐˜ต๐˜ข๐˜น and ๐˜ฎ๐˜ฐ๐˜ณ๐˜ฑ๐˜ฉ๐˜ฐ๐˜ญ๐˜ฐ๐˜จ๐˜บ ๐Ÿ“โฃ

The Neuroscience of Writing

What areas of the brain have been associated with agraphia when lesioned? ๐Ÿง  ๐Ÿ’ฅ โฃ
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Writing is a complex process, with ๐— ๐—”๐—ก๐—ฌ areas of the brain playing a role. This results in large neural networks responsible for the writing process โœ๐Ÿผ โฃ
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That being said, the traditional agraphia classifications do have lesion sites that are associated with them.

Assistive Technology: Speech-to-Text Software

What kinds of technology supports are available to people with agraphia? โœ๐Ÿผ ๐Ÿ’ป โฃ
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๐—ฆ๐—ฝ๐—ฒ๐—ฒ๐—ฐ๐—ต-๐˜๐—ผ-๐—ง๐—ฒ๐˜…๐˜ ๐˜€๐—ผ๐—ณ๐˜๐˜„๐—ฎ๐—ฟ๐—ฒ allows spoken material captured by a microphone/headset to be transcribed into text for computer programs. ๐ŸŽ™ โฃ
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Though many softwares exist, here are some popular options that you may consider looking into for your clients.

Combined Lexical and Sublexical Treatment

In order to correctly write a word, there are a LOT of steps involved ๐Ÿงฉ โฃ
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Therefore, for many people with agraphia there is no one single cause for their writing problems. Rather, there are a variety of language processing components that are compromised and result in difficulty writing single words. โœ๐Ÿผ โฃ
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๐—–๐—ผ๐—บ๐—ฏ๐—ถ๐—ป๐—ฒ๐—ฑ ๐—Ÿ๐—ฒ๐˜…๐—ถ๐—ฐ๐—ฎ๐—น ๐—ฎ๐—ป๐—ฑ ๐—ฆ๐˜‚๐—ฏ๐—น๐—ฒ๐˜…๐—ถ๐—ฐ๐—ฎ๐—น ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ (Johnson, Ross & Kiran, 2017) is designed to target ALL aspects of written word processing. ๐Ÿ‘Š๐Ÿผโฃ

Agraphia Treatment: Single Word-Level Treatments

What are your go-to treatment approaches for writing at the single word-level? ๐Ÿ“โฃ
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Though the specific treatment technique used will depend on your clientโ€™s individual needs, itโ€™s helpful to be familiar with a variety of approaches so that youโ€™ll always be ready to go at a momentโ€™s notice! ๐Ÿ™Œ๐Ÿผ๐Ÿ‘Š๐Ÿผโฃ
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Here are 3 different approaches that youโ€™ll want to have in your clinical toolbox:โฃ

Agraphia Classifications

Do you know the different agraphia classifications? โœ๐Ÿผโ“๐Ÿ‘€โฃ
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When diagnosing an agraphia, there are 2 major types of classifications: ๐—–๐—ฒ๐—ป๐˜๐—ฟ๐—ฎ๐—น ๐—”๐—ด๐—ฟ๐—ฎ๐—ฝ๐—ต๐—ถ๐—ฎ๐˜€ and ๐—ฃ๐—ฒ๐—ฟ๐—ถ๐—ฝ๐—ต๐—ฒ๐—ฟ๐—ฎ๐—น ๐—”๐—ด๐—ฟ๐—ฎ๐—ฝ๐—ต๐—ถ๐—ฎ๐˜€โฃ

Agraphia Assessment: Single-Word Assessment

When assessing for agraphia at the single word-level, what are you looking for? ๐Ÿ•ต๏ธโ€โ™‚๏ธ โฃ
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Written language is complicated, and there are lots of factors that go into understanding the difference between why a client may write COW for โ€œhorseโ€ or spell SIGHKIK for โ€œpsychicโ€ ๐Ÿ„ ๐Ÿ”ฎ โฃ
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Here are some linguistic variables youโ€™ll want to pay close attention to when assessing agraphia at the single word-level:โฃ

What Books Do Your Clients Want to Read?

๐Ÿ“š What books do your clients want to read? ๐Ÿ“š โฃ
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Iโ€™ve been working with a client who belongs to an online book club, and the most recent discussion focused on passages from Kate Andersen Browerโ€™s โ€œ๐—™๐—ถ๐—ฟ๐˜€๐˜ ๐—ช๐—ผ๐—บ๐—ฒ๐—ป: ๐—ง๐—ต๐—ฒ ๐—š๐—ฟ๐—ฎ๐—ฐ๐—ฒ ๐—ฎ๐—ป๐—ฑ ๐—ฃ๐—ผ๐˜„๐—ฒ๐—ฟ ๐—ผ๐—ณ ๐—”๐—บ๐—ฒ๐—ฟ๐—ถ๐—ฐ๐—ฎโ€™๐˜€ ๐—™๐—ถ๐—ฟ๐˜€๐˜ ๐—Ÿ๐—ฎ๐—ฑ๐—ถ๐—ฒ๐˜€โ€ ๐Ÿ‡บ๐Ÿ‡ธโฃ
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Weโ€™ve been using ๐—”๐˜๐˜๐—ฒ๐—ป๐˜๐—ถ๐˜ƒ๐—ฒ ๐—ฅ๐—ฒ๐—ฎ๐—ฑ๐—ถ๐—ป๐—ด ๐—ฎ๐—ป๐—ฑ ๐—–๐—ผ๐—ป๐˜€๐˜๐—ฟ๐—ฎ๐—ถ๐—ป๐—ฒ๐—ฑ ๐—ฆ๐˜‚๐—บ๐—บ๐—ฎ๐—ฟ๐—ถ๐˜‡๐—ฎ๐˜๐—ถ๐—ผ๐—ป (๐—”๐—ฅ๐—–๐—ฆ) and the ๐—ฃ๐—ค๐—ฅ๐—ฆ๐—ง ๐—บ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ to dive into the passages for the book club, allowing my client to better understand what she is reading and come up with discussion points for the group ๐Ÿ—ฃโฃ

What is Agraphia?

โœ๐Ÿผ A writing problem following neurological damage is known as ๐—ฎ๐—ด๐—ฟ๐—ฎ๐—ฝ๐—ต๐—ถ๐—ฎ โœ๐Ÿผโฃ
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Agraphia can have both a ๐˜ฎ๐˜ฐ๐˜ต๐˜ฐ๐˜ณ component and a ๐˜ญ๐˜ข๐˜ฏ๐˜จ๐˜ถ๐˜ข๐˜จ๐˜ฆ component. The motor component involves difficulties with formation of letter shapes, while the language component involves difficulties with spelling ๐Ÿ“โฃ