CODI 508
APHASIA IN ADULTS


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SYLLABUS
Communicative Disorders 508
APHASIA IN ADULTS
Fall 2003

Class Time:            Tuesdays & Thursdays  12:30 - 1:45pm
Location:                Burke-Hawthorne Hall 209
Instructor:              Jack S. Damico, Ph.D.
Office:                    208A Burke Hall
Phone:                    482-6551
Office Hours:        Tuesdays &Thursdays  2:00 - 4:00, Wednesday 10:00 - 12:00 or by appointment


GENERAL DESCRIPTION

The study of aphasia is an extremely interesting exercise -- made more exciting by a number of  fairly recent innovations.  While dealing with important aspects of neuroanatomy and
neurophysiology, it is also richly clinical and strikingly theoretical in a very enlightening way. The main issues revolve around four questions (Rogers, Alarcon, & Olswang (1999):
           What is the nature and scope of the impairment with respect to speech, language, and cognition?
            What are the limitations experienced by the individual with respect to communication?
            What are the emotional, psychological, and social consequences of living with aphasia for the individual as well as those playing significant roles in his or her life?
            What do we do “on Monday morning” to help overcome the impairments, limitations, and  consequences?
We will focus on these questions from both a theoretical foundation and an applied clinical orientation.

The nature of aphasia will be investigated from a clinical case studies perspective. The aim is to allow student to see videos of individuals with aphasia and to enter into a learning exercise
that will enable you to become an effective practitioner in hospitals, rehabilitation centers, community-based clinics, and various types of long-term care facilities.  As mentioned earlier,
I believe that we are currently undergoing a metamorphosis in the neuropathologies.  We are moving away from a fairly simplistic medical model and dealing with a much more complex
systems-theory/social model.  This model better approximates the needs of individuals in the neuropathologies but will require some sort of new framework.  This approach will be
handled by recognizing the important conceptual issues and then by employing the World Health Organization's newest tripartite classification system of impairments, activity limitations,
and participation restrictions.

 Specific Course Objectives

1. Provide the most current research-based information on aphasia and its impact on the cognitive, affective, social, linguistic and communicative abilities of individuals with this disorder.
2. Provide information on anatomical and physiological aspects of aphasia and how these aspects impact on recovery and prognosis.
3. Provide sufficient information and experiences to enable the student to conduct appropriate service delivery with regard to screening, collaboration, assessment, intervention, and
    professional/familial consultation and counseling in various medical and community-based settings.
4. Discuss and incorporate important variables relevant to diversity and activities of daily living and how they impact on assessment and intervention.

 Learner Outcomes

Upon successful completion of this course, the student will be able to:
1.    Compare, contrast, and discuss the relative advantages of a medical versus a social  framework of aphasia.
2.    Discuss the biological, cultural, cognitive, affective and social variables that come into play when providing service delivery to individuals with aphasia and their families.
3.    Collect authentic performance data that may be analyzed for assessment purposes from linguistic and well as social/functional perspectives.
4.    Identify, compare and contrast various types of assessment tools and techniques available within the disciplines of neuropathology.
5.    Employ effective tools and techniques for the assessment of aphasia in adults across the settings spectrum.
6.    Conduct appropriate analysis of collected data to plan appropriate and effective treatment options.
7.    Employ a wide range of materials, goals, and techniques for remediation purposes.  These will include process-oriented as well as socially-oriented treatment paradigms.
8.    Establish procedures to monitor the effectiveness and efficacy of the interventions employed.

 CLASS STRUCTURE

The lectures/discussions will be divided into a combination of cases and topics.  By introducing actual individuals with aphasia (via videotapes), Dr. Damico will weave in various
topics that are relevant to the cases being studied.  At times, more traditional topical lectures will also be employed.  Students will be shown cases and then the subject matter will
rise according to the needs at that time.  Dr. Damico will then provide some lecture material/cursory notes after each class. Each class period will center around a case study and
will include a lecture by Dr. Damico and (typically) a class discussion of assigned articles or some exercise to stimulate active learning, and a reality check at the end of class.  This
is first time that Dr. Damico has employed such an approach, and given the large numbers of students in this course this semester, changes will have to occur as the semester
progresses.  Please bear with the changes.  There will be some flexibility dependent on the class scheduling over the period of the semester.  Consequently, the topic listing provided
below is only an estimation.

COURSE REQUIREMENTS

Grades will be determined by class participation and successful completion of the class requirements.  These requirements are as follows:

1.     Complete assigned readings by appropriate deadlines listed in the syllabus.  Students may be quizzed on content of readings at any time after an assignment’s deadline.
        All assigned material may be covered on the examinations.  Readings will be placed on reserve at Dupre Library.
2.     Complete all class assignments as specified during the course.  This will involve various kinds of activities as are appropriate to the needs of this course.
3.     Perform satisfactorily on any quizzes
4.     Perform satisfactorily on a final examination.
5.     Take part in class discussions.
6.     Attend Classes.  Quizzes will be given anytime more than 10% of the students miss class.

GRADING

Grades will be determined by class participation, class assignments, quizzes, and the final examination. The requirements will include both written and oral communicative
tasks to ensure appropriate application of presented material.  Grades will be assigned based on the following percentages:

Class Participation            15%
Quizzes                               10%
Class assignments              35%
 Final examination            40%
Students will accumulate points for all assignments, quizzes, a participation grade and the final examination.  The final grade will be based on the total number of points
accumulated by the student and expressed as a percentage (%) of the total points possible during the semester (400 - 500).  Points will be deducted for all assignments
that are turned in late unless the student presents a written excuse that is acceptable to Dr. Damico.  Letter grades will be assigned using the following percentage scale:
                   91  - 100       -    A
                   82  -   90       -    B
                   73  -   81       -    C
                   65  -   72       -    D
                   Below 65      -     F
Please be advised that for students in their first full semester of graduate school that one designated class assignment will be graded and placed within your Student
Portfolio as a demonstration of your practical clinical progress.  As such, this will be part of your formative assessment here at the University of Louisiana - Lafayette.  You
will be told which activity will be used when it is assigned.

COURSE EVALUATION

Students will have the opportunity to evaluate the course by completing the student evaluation of instruction administered by the University toward the end of the semester.

CLINICAL APPLICATIONS SECTION

At times during the semester, there will be an opportunity for students to see more direct and “hands-on” demonstrations and applications of procedures and methodologies
discussed in this course.  These “clinical applications laboratories” will not be required but may help your grade if you are in need of extra credit.  Again, attendance is not
mandatory.  The actual scheduling for these demonstrations will be determined once the semester begins.

EMERGENCY EVACUATION PROCEDURES

A map of this floor is posted near the elevator marking the evacuation route and the Designated Rescue Area.  This is an area where emergency service personnel will go first
to look for individuals who need assistance in exiting the building.  Students who may need assistance should identify themselves to the teaching faculty.

CURSORY NOTES ON THE LECTURES

After each lecture,  set of “cursory notes” may be provided via the university Blackboard system. However, you may want to take notes in class as well since this course
will involve more “give-an-take” between the instructor and the students. The cursory notes provided will be reduced versions of class discussions and will provide most
of the significant content of the lecture (but not necessarily all of the important content).  You may duplicate any of the material in those packets for your own use.  Use
of the provided “Cursory Notes” in highly recommended (but not required).

READINGS

We will not use a textbook in this course.  Rather, a set of articles/chapters will be utilized.  These are the required readings for the course.  Each student is required to
read these articles/chapters and you will be responsible for them on the examinations -- regardless of whether they are discussed in class.  These readings are available in
the Reserve Room at Dupre Library.

ACADEMIC MISCONDUCT

Academic misconduct guidelines are strictly upheld.  Cheating on an examination or permitting someone to cheat will result (at least) in a zero on the assignment or
examination.  Greater penalties will be assessed by Dr. Damico if possible.  Similarly, plagiarism will not be tolerated and will carry similar penalties.  Students missing
examinations must have a legitimate excuse and must contact Dr. Damico immediately.  If you have any questions, consult your Graduate Bulletin under "Academic
Honesty" or contact Dr. Damico.

 LECTURE TOPICS
8/19          A cursory look at several cases
                   FOCUS: Assertions about aphasia
8/21          Four cases of Aphasia : Christine, Ed, Bob, Bill
                   FOCUS:  Describing Aphasia
                         Definitions
                         Epidemiology
                         Pathophysiology of Aphasia
8/26          Four cases of Aphasia : Christine, Ed, Bob, Bill
                       FOCUS:  Describing Aphasia
                             Classification of Aphasia
                             Aphasia without Adjectives
                             Unitary Deficit
                             Manifestations by modalities
8/28          Four cases of Aphasia: Christine, Ed, Bob, Bill
                       FOCUS: Descriptions of Deficit
                            Manifestations by modalities
9/2            Case Foci:   Christine and Ed
                       FOCUS: Descriptions of Deficit
                            Manifestations by patterns
                                 Communicative Patterns
                                  Deficits
                                  Handicaps
                                  Adaptations
9/4              Case Foci:   Christine and Ed
                       FOCUS: Descriptions of Deficit
                                 Manifestations by patterns
                                 Communicative Patterns
                                  Adaptations
9/9              Case Foci:   Bob and Bill
                       FOCUS: Descriptions of Deficit
                                 Manifestations by patterns
                                 Psychosocial Patterns
                                  Deficits
                                  Handicaps
                                  Recovery Patterns in Aphasia
                                          A restricted view
                                          An expanded view
                                  Pathophysiology of Recovery
9/11              Overview of Assessment
                          FOCUS: Authenticity
                                 General Guidelines
                                 Answering Questions
                                 Quantification and Description
9/16              Overview of Assessment
                           FOCUS: Descriptiveness
                                 Modality-oriented
                                 Skills-focused
                                 Processing-focused
                                 Assessment Batteries
9/18               In-Depth Case Study: Bill
                            FOCUS: Assessment
9/23               In-Depth Case Study: Bill
                           FOCUS: Assessment
9/25               In-Depth Case Study: Bill
                           FOCUS: Interpretation
9/30               Overview of Intervention
                           FOCUS: Guidelines and Principles
10/7               Overview of Intervention
                           FOCUS: Structure and Techniques
10/9               In-Depth Case Study: Bill
                           FOCUS: Intervention
10/14             In-depth Case Study: Bill
                           FOCUS: Intervention
10/16             In-depth Case Study: Bill
                           FOCUS: Intervention
10/21             In-depth Case Study: Bob
                           FOCUS: Assessment
10/23             In-Depth Case Study: Bob
                           FOCUS: Assessment
10/28             In-Depth Case Study: Bob
                            FOCUS: Intervention
10/30             In-Depth Case Study: Bob
                           FOCUS: Intervention
11/4               In-Depth Case Study: Alice
                            FOCUS: Assessment
11/6               In-Depth Case Study: Alice
                           FOCUS: Assessment
11/11             In Depth Case Study: Alice
                           FOCUS: Intervention
11/13             In Depth Case Study: Alice
                           FOCUS: Intervention
11/18             In-Depth Case Study: John
                           FOCUS: Assessment
11/20             In-Depth Case Study: John
                           FOCUS: Intervention
11/25             In-Depth Case Study: John
                            FOCUS: Intervention

REQUIRED READINGS

8-26
                Darley F.L. (1982). Aphasia without adjectives. (pp. 1-54) in F.L. Darley, AphasiaPhiladelphia:  W. B. Saunders Company.

8-28
                Simmons-Mackie, N.N. & Damico, J.S. (1997).  Reformulating the definition of compensatory strategies in aphasia.
                            Aphasiology, 11, 761-781.

9-2
               Simmons-Mackie,  N.N. & Damico,  J.S. (1996). The contribution of discourse markers to communicative competence
                            in aphasia.  American Journal of Speech-Language Pathology, 5: 37-43.
                Goodwin, C. (1995).  Co-constructing meaning in conversations with an aphasic man.  In S. Jacoby & E. Ochs (Eds.)
                            Research in Language and Social Interaction (Special issue of Construction). 28, 233-260.

9-4
               LaPointe, L. (1997).  Adaptation, Accommodation, Aristos.  In L. LaPointe (Ed.) Aphasia and related neurogenic
                            language disorders (2nd Edition). (Pp. 265-287) New York: Thieme.
                Parr, S. (1994).  Coping with aphasia: Conversations with 20 aphasic people. Aphasiology, 5, 457-466.

9-9
                LeDorze, G. & Brassard, C. (1995).  A description of the consequences of aphasia on aphasic persons and their
                            relatives and friends, based on the WHO model of chronic diseases. Aphasiology, 9, 239-255.
                Holland, A. (1982). Observing functional communication of aphasic patients. Journal of Speech and Hearing
                            Disorders, 47, 50-56.

9-11
               Porch, B.E. (1971).  Multidimensional scoring in aphasia testing. Journal of Speech and Hearing Research, 14, 777-792.

9-16
               Rosenbek, J.C., LaPointe, L.L., & Wertz, R.T. (1997).  Appraisal, diagnosis, and Prognosis.  In Aphasia: A clinical approach.
                            (pp. 55-103).  Austin, TX: Pro Ed.
               Davis, G. A. (2000).  Functional communication and discourse.  In G. A. Davis. Aphasiology: Disorders and clinical practice.
                            (pp. 139-157).  Boston: Allyn and Bacon.

9-18
              Oelschlaeger, M.L. & Thorne, J. (1999).  Application of the correct information analysis to the naturally occurring conversation
                            of a person with aphasia.  Journal of Speech, Language, and Hearing Sciences, 42, 636-648.

9-23
               Simmons-Mackie, N.N. & Damico, J.S. (2001). Intervention outcomes: Clinical applications of qualitative methods. Topics in
                            Language Disorders, 22, 21-36.

9-25
               Holland, A.L., & Halper, A.S. (1996).  Talking to individuals with aphasia: A challenge for the rehabilitation team.  Topics
                            in Stroke Rehabilitation, 2(4), 27-37.

9-30
               Simmons-Mackie, N.N., Damico, J.S., & Damico, H.L. (1999).  A qualitative study of feedback in aphasia treatment.
                           American Journal of Speech-Language Pathology, 8, 218-230.

10-7
               Porch, B.E. (1994).  Therapy subsequent to the PICA.  In R. Chapey (Ed).   Language Intervention Strategies in Adult Aphasia.
                            (3rd Edition). (pp. 178-183).  Baltimore:  Williams &  Wilkins.

10-9
               Holland, A. L. & Fridriksson, J. (2001).  Aphasia management during the early phases of recovery following stroke. American Journal
                            of Speech-Language Pathology, 10, 19-28.
                Peach, R.K. (2001).  Further thoughts regarding management of acute aphasia following stroke.  American Journal of Speech-Language
                            Pathology, 10, 29-36.
                Fridriksson, J. & Holland, A.L (2001).  Final thoughts on management of aphasia in the early phases of recovery following stroke.
                           American Journal of Speech-Language Pathology, 10, 37-39.

10-14
               Thompson, C.K. (1994).  Treatment of nonfluent Broca’s aphasia.  In R. Chapey (Ed.), Language intervention strategies in adult aphasia
                          (pp.  407-428).  Baltimore, MD: Williams & Wilkins.

10-21
               Simmons-Mackie, N. (2001).  Social approaches to aphasia intervention.  In R. Chapey (Ed). Language Intervention Strategies in Aphasia
                            and Related Neurogenic Communication Disorders. (4th Edition). (pp. 246-268).  Baltimore:  Williams &  Wilkins.

10-23
                 Holland, A.L. (1996).  Pragmatic assessment and treatment for aphasia.  In G. Wallace (Ed.)  Adult aphasia rehabilitation (pp.  161-173).
                            Boston: Butterworth-Heinemann.

10-28
                 Marshall, R.C. (1994).  Management of fluent aphasic clients.   In R. Chapey (Ed.), Language intervention strategies in adult aphasia.
                            (pp.  389-406).  Baltimore, MD: Williams & Wilkins.

10-30
                Lubinski, R. (2001).  Environmental systems approach to Adult aphasia.  In R. Chapey (Ed). Language Intervention Strategies in Aphasia
                            and Related Neurogenic Communication Disorders. (4th Edition). (pp. 269-296).  Baltimore:  Williams &  Wilkins.

11-4
                Kagan, A. (1995).  Revealing the competence of aphasic adults through conversation: A challenge to health professionals.  Topics in Stroke
                            Rehabilitation, 2 (1), 15-27.
                Lyon, J.G. (1997).  Volunteers and Partners: Moving intervention outside the treatment room.  In B. Shadden & M.A. Toner (Eds.)
                           Aging and Communication, (pp. 299-323), Austin, TX: PRO-ED.

11-6
                Routman, R. & Butler, A. (1998).  How do I actually teach reading now that I am using literature?  In C, Weaver (Ed.),  Practicing
                            what we know: Informed reading instruction.  (Pp. 175-183). Urbana, IL: National council of Teachers of English.

11-11
                 Oelschlaeger, M. & Damico, J.S. (1998).  Joint productions as a conversational strategy in aphasia.  Clinical Linguistics and
                            Phonetics. 12, 459-480.
                 Lyon, J.G. & Shadden, B. (2001).  Treating life consequences of aphasia’s chronicity.  In R. Chapey (Ed). Language Intervention
                            Strategies in Aphasia and Related Neurogenic Communication Disorders. (4th Edition). (pp. 297-314).  Baltimore:
                            Williams &  Wilkins

11-13
                Simmons-Mackie, N. & Kagan, A. (1999).  Communication strategies used by ‘good’ versus ‘poor’ speaking partners of individuals
                            with aphasia.  Aphasiology, 13, 807-820.

11-18
                Lyon, J.G. (1996).  Optimizing communication and participation in life for aphasic adults and their prime caregivers in natural settings: A
                            use model for treatment.  In G. Wallace (Ed.), Adult Aphasia Rehabilitation (pp. 137-160).  Boston: Butterworth-Heinemann.
                Lyon, J.G. (1997).  Treating real-life functionality in a couple coping with severe aphasia. In N. Helm-Estabrooks & A. Holland (Eds).
                           Approaches to the treatment of Aphasia. (pp.203-239).  San Diego, CA: Singular Publishing Group.

11-20
                Collins, M.J. (1997).  Global Aphasia.  .  In L.L. LaPointe (Ed.)  Aphasia and related neurogenic language disorders. (pp. 133-150)
                            New York: Thieme Medical Publishers.

11-25
                Kearns, K.P. & Elman, R.J. (2001).  Group therapy for aphasia: Theoretical and practical considerations. In R. Chapey (Ed).
                           Language Intervention Strategies in Aphasia and Related Neurogenic Communication Disorders. (4th Edition). (pp. 316-337).
                            Baltimore:  Williams &  Wilkins.


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