University:
Boston University
Course:
SAR HS 201 | Introduction to Nutrition
Academic year:

2020
Views:

425

Pages:

12
Author:

vaigarlyw9

Discussion: Why is change not related? • What needs to happen for change correlations to be significant? • In the same individual, both skills need to improve to a certain degree and this same pattern of improvement must be observed across several PWA PWA 1 FUNCTIONAL COMMUNICATION SKILLS Naming Reading Writing Naming Food Items PWA 2 Naming Food Items Problem Solving Memory Ordering in a Restaurant Making a Grocery List Discussion: Why is change not related? • Impairment measures • Objective • Performance-based • Continuous scales • ASHA FACS • Subjective • Based on rater’s perception with input from family members/caregivers • Ordinal scales • Real-word emphasis Summary of Study Results 1 3 Single Time Point Correlations 2 Accounting for Severity: Change in Impairment AND Functional Communication Measures 4 Change on Impairment Measures Only Very Few Change-Score Correlations Discussion: Interim Take-Homes • A global assessment of impairment can provide insight into PWA’s functional communication skills and vice versa • Global measures of cognitive-linguistic skills/impairment capture improvement as a function of therapy • The ASHA FACS appears to be effective at capturing change in PWA with more severe aphasia but may be less well-suited for mild PWA due to ceiling effects • Because cognitive-linguistic and functional communication appear to be distinct (though related) constructs, it is best to assess both areas separately to definitively capture changes over time What may be the relationship between impairment and function? Participation in life situations Reading Single Words Executive Functions Communication and language environment Living with Aphasia Personal identity, attitudes and feelings Visual Scanning Reading a Menu Basic Calculations Language and related impairments What may be the relationship between impairment and function? Reading Single Words Executive Functions Visual Scanning Basic Calculations Participation in life situations Language and related impairments Reading a Menu What may be the relationship between impairment and function? PARTICIPATION VerbSingle Retrieval Reading Words Passive Sentence Executive Functions Comprehension Selective Attention Visual Scanning Basic Calculations Ordering at a Restaurant Participation in life situations Introducing a Topic Language and related impairments Reading a Menu Future Directions • Investigate the relationship in change pre- to post-therapy by targeting… • Functional communication specifically • Combined impairment- and functionbased skills • Expand the battery of assessments • Measure additional domains within A-FROM/ICF Did the outliers improve in outcomes? BUMA55--24 Years Post Onset BUMA55--24 Years Post Onset 1.4 1.2 1 0.8 0.6 0.4 0.2 0 60 40 20 0 -20 -40 -60 BUMA73--30 Years Post Onset BUMA73--30 Years Post Onset 5 0.6 0 0.4 -5 0.2 -10 0 -15 -0.2 -20 -0.4 -25 -0.6 Questions we might get from others • Proxy measure vs PRO • Why did we keep in the people who didn’t improve in tx? • Did Frattali say anything about who the ASHA FACS is most appropriate for in terms of severity • How did we select the instruments? • Did the outliers on slide 12 improve if they were in the tx sample? Review of what FACS dimensions mean • -Adequacy: frequency with which the PWA understands the gist of a message and gets a point across • -Appropriateness: frequency with which the PWA’s communication is both relevant and done under the right circumstances • -Promptness: frequency with which the PWA responds without delay and in an efficient manner • -Communication Sharing: extent to which the PWA’s communication poses a burden to the communication partner because the PWA talks excessively or not enough • -Overall QDC: Composite measure of overall Quality/Effectiveness in expressive and receptive communication in functional situations Discussion: Other factors