Thematic Language Stimulation - USHA

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! Principle of maximal patient response, achieved by – Extending language and materials – Emphasis on task repetition, re-ordering, adaptation – Meaningful context Schuell’s Neurobiological Stimulation Morganstein & Certner-Smith, 2011 Schuell’s Neurobiological Stimulation ! Systematic and Intense Presentation – Organized – Programmed for success – Repetition Schuell’s Neurobiological Stimulation ! Principle of stimulus adequacy, achieved via – Intensity – Focus – Linguistic bombardment – Multiple presentations – Varied context Morganstein & Certner-Smith, 2011 Building on Schuell’s model: The TLS advantage ! Use of thematically-related vocabulary, rather than isolated high-frequency words. – Provides a “hook” upon which to hang language: natural context. – Provision of linguistic context allows transition to meaningful conversation. Morganstein S.Morganstein & Certner-Smith, & M.Certner-Smith 2011 Morganstein & Certner-Smith, 2011 Building on Schuell’s model: The TLS advantage ! Provides inherent redundancy, depth and breadth. ! Fosters connection with language, with feelings, ideas, history. ! Educational/training component and metacognitive exploration for PWA and/or others Morganstein S.Morganstein & Certner-Smith, & M.Certner-Smith 2011 Research with TLS Morganstein & Certner-Smith, 2011 4
TLS: Preliminary Research ! Defining Success – finding a functional communication measure: content unit analysis proposed by Yorkston and Beukelman. ! Design Choice – single subject, reversal. ! Subject selection – no significant vision or hearing deficits; able to participate in a 3 week course of 5 day/week therapy. Communicative Efficiency 14 12 10 8 6 4 2 0 12 3.1 0.9 Morganstein & Certner-Smith, 2011 Treatment Effects ofTLS 6.4 2.7 1.8 1 2 3 4 Morganstein & Certner-Smith, 2011 Test Intervals 7.4 4.9 0.9 Assessment ! The PWA’s preferences for treatment and goals is where is all begins. Morganstein & Certner-Smith, 2011 S.Morganstein & M.Certner-‐Smith 10.8 2.1 1.6 LS RE JS TLS: Preliminary Research ! Procedures – CU analysis (cookie theft picture) – One week in a randomly assigned module – Repeat CU analysis – Reversal of module – Repeat CU analysis – Reversal of module – Repeat CU analysis Morganstein & Certner-Smith, 2011 Beginning with TLS: Assessment Morganstein & Certner-Smith, 2011 Assessing at the Impairment Level ! Determine the severity of the aphasic symptoms ! The type of aphasia ! The adequacy of conversation and communication Morganstein & Certner-Smith, 2011 S.Morganstein & M.Certner-‐Smith 5
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