CODI 508
APHASIA IN ADULTS


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SYLLABUS
Communicative Disorders 508
APHASIA IN ADULTS
Spring 2001

Class Time:       Tuesdays & Thursdays 11:00 - 12:15pm
Location:           Burke-Hawthorne Hall 209
Instructor:          Jack S. Damico, Ph.D.                                       Office: 208A Burke Hall
Phone:               482-6551
Office Hours:    Tuesday 9:00 - 11:00 or by appointment


GENERAL DESCRIPTION

The study of aphasia is an extremely interesting exercise. It is 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 livingwith
           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 perspective. The aim is to provide both theoretical and practical information necessary for the practicing clinician. 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.

CLASS STRUCTURE

The lectures/discussions will be divided into topic areas which will roughly approximate the number of classes in the semester. Although these topics are listed separately, they will overlap to some extent. 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 anytime 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 two examinations (a mid-term examination and a final exam).
5. Take part in class discussions.
6. Complete the clinical applications section of the course to specified level.
7. Attend Classes. Quizzes will be given anytime more than 10% of the students miss class.
                                                  GRADING
Grades will be determined by class participation, two examinations, completion of clinical applications section, and successful completion of several additional reaction papers or projects. Each class period will center around a topic area 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. Grades will be assigned based on completion of the clinical applications section and on the following percentages:
Class Participation 15%
Mid-term examination 30%
Additional (short) projects 20%
Final examination 35%

Students will accumulate points for all assignments, projects, papers, and exams. The final grade will be based on the total number of points accumulated by the student on all assignments and examinations 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

                                                    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.

                                     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

A set of cursory notes for most of the lectures will be supplied during the semester. These are reduced versions of class notes, providing most of the significant content of the lecture (but not necessarily all of the important content). These notes are intended to help the students follow the lecture and to only take notes that they feel are necessary. These notes will be placed on Dr. Damico's Web Site and each section of notes will remain for at least two weeks. His Web Site address is
http://www.ucs.louisiana.edu/~jsd6498/damico/damicohomepage.html

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).

                                          CLINICAL APPLICATIONS SECTION

There will be a demonstration/application requirement for this course that must be met. While not considered within the grading criteria directly, this section will indirectly affect your grade. Since this section is considered a minimum requirement, your total course grade will be affected as follows: If you attain above 85%, then your course grade is unaffected. If you attain 75% to 85%, then your course grade is dropped one entire letter grade. If you attain less than 75%, then your course grade is dropped two entire letter grades. There are two ways to complete this section:

1. Attend 10 Clinical Laboratory meetings. These will be one hour meetings held during the semester during which Dr. Damico or another professional will demonstrate specific clinical techniques or strategies and take questions. Attendance of at least 7 of 8 earns 87.5%. The lab will begin the third full week of the semester and are scheduled for one hour each week.
2. Complete a specific set of readings on various clinical techniques and complete three scheduled examinations on the readings. You cumulative score on the three examinations will provide your percentage score.
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. Please note that Dr. Damico will provide a complete set of readings to the Reserve Room at the beginning of the semester.  After that time, however, you will be responsible for going to the stacks for any articles that have been lost or misplaced by your fellow students.  Consequently, you should respect the needs of the other students and take care to return the materials to the reserve room in order and in good condition.

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

I.     1-11-01       Introduction
                                A look at Aphasia
                                Assertions about aphasia
                            FOCUS: A DIRECT EXPERIENCE WITH APHASIA
II.     1-16-01     Theoretical Foundations
                                Language and Communication as Synergy
                                Foundation: Semiotics and Pragmatic Mapping
                                        Internal Synergy - Vygotsky: Language as the PRIME MEDIATOR
                                        External Synergy - Bateson: Systems Theory and Complex Social
                                            Phenomena
                                Implications for Aphasia
                                Orientation to Language/Semiotics
                                World Health Organization Definitions:
                                        Impairments
                                        Activity limitations
                                        Participation restrictions
                                  Why this tripartite Division is important
                                  Contextual Zeitgeist
                                  Clinical Implications for Aphasia
                               FOCUS: SYNERGY AND ITS IMPLICATIONS
III.     1-18-01      Describing Aphasia
                               Definitions
                                    Epidemiology
                                    Pathophysiology of Aphasia
IV.     1-23-01      Descriptions of Deficit
                               Classification of Aphasia
                                     Aphasia without Adjectives
                                     Manifestations
                                   FOCUS: UNITARY DEFICIT
V.      1-25-01         Manifestations (Continued)
                         Communicative Patterns
                                    Deficits
                                    Handicaps
                                    Adaptations
VI.      1-30-01         Psychosocial Patterns
                                    Deficits
                                    Handicaps
                                Recovery Patterns in Aphasia
                                    A restricted view
                                    An expanded view
                                    FOCUS: FUNCTIONAL/SOCIAL
VII.     2-1-01        Assessment Issues
                                    The Tripartite Structure in practice
                                    General Guidelines
                                     FOCUS: AUTHENTICITY
VIII.     2-6-01       Assessment Issues
                                      Answering Questions
                                      Quantification and Description
IX.         2-8-01      Traditional Assessment Tools
                                   Modality-oriented
                                        Skills-focused
                                        Processing-focused
                                        Assessment Batteries
                                    FOCUS: WHERE WE HAVE BEEN
X.          2-13-01     Traditional Assessment Tools
                                        Assessment Batteries (Continued)
                                        Targeted Tools and Procedures
                                    FOCUS: STATE OF THE ASSESSMENT ART
XI.         2-15-01     Traditional Assessment Tools
                                        Targeted Tools and Procedures (Continued)
XII.        2-20-01             Innovative Assessment Tools
                                        Functional Measures
                                    FOCUS: PUTTING THEORY INTO PRACTICE
XIII.       2-22-01     Innovative Assessment Tools
                                        Pragmatic Measures
****       2-27-01   Mardi Gras!!!!
XIV.       3-1-01       Innovative Assessment Tools
                                        Pragmatic Measures (Continued)
                                        Sociolinguistic approach
                                        Conversational Profiling
                                  FOCUS: RICH DESCRIPTION
XV.         3-6-01        Midterm examination
XVI.        3-8-01       Innovative Assessment Tools (Continued)
XVII.       3-13-01     Intervention Issues
                                   The tripartite Structure
                                        General Guidelines
                                    FOCUS: CHARTING TREATMENT COURSE
XVIII.     3-15-01      Intervention Issues
                                        Prioritizing Needs
                                        Family Inclusion
                                        The overall plan and structure of intervention
XIX.        3-20-01     Intervention Strategies (Disability-oriented)
                                        Remediation of Language Deficits
                                        Procedures
                                    FOCUS: THE TYPICAL STATE OF THE ART
XX.          3-22-01    Intervention strategies (Disability-oriented)
                                        Remediation of Processing Deficits
                                        Various Procedures
                                        PICA Therapy
XXI.         3-27-01    Intervention Strategies (Disability-oriented)
                                        Remediation of Processing Deficits
                                        PICA Therapy (Continued)
                                      FOCUS: BRAIN AS A CYBERNETIC SYSTEM
XXII.       3-29-01     Intervention Strategies (Disability-oriented)
                                        Compensations for Deficits
XXIII.      4-3-01       Intervention Strategies (Handicap-oriented)
                                        Conversational Coaching
                                          FOCI: FUNCTIONAL/AUTHENTIC CONCERNS
XXIV.      4-5-01       Intervention Strategies (Handicap-oriented)
                                        Changing the Social Environment
                                          FOCUS: THE SOCIAL DYNAMIC
XXV.       4-10-01     Intervention Strategies (Handicap-oriented)
                                        Conversational Partners
****        4-12-01     Easter Holidays
XXVI.      4-17-01     Intervention Strategies
                                        Spousal Interaction
XXVII.     4-19-01     Intervention Strategies
                                    FLOW and its relevance
                                    FOCUS: CREATING OPTIMAL EXPERIENCES
XXVIII.    4-24-01     Intervention Strategies
                                        Positive Everyday Routines
XXIX.       4-26-01     Intervention Strategies
                                        Aphasia Group Treatment
XXX.         5-1-01             Make up Day

                                                 REQUIRED READINGS

There are 25 required readings. There are also supplemental readings that have been used to structure Dr. Damico's lectures. They are with cursory notes.

1-23-01
                Darley F.L. (1982). Aphasia without adjectives. (pp. 1-54) in F.L.
                Darley, Aphasia. Philadelphia: W. B. Saunders Company.
1-25-01
                Simmons-Mackie, N.N. & Damico, J.S. (1997). Reformulating the definition
                of compensatory strategies in aphasia. Aphasiology, 11, 761-781.

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. 1-30-01
              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.

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.

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.

2-6-01
                Holland, A. (1982). Observing functional communication of aphasic patients.
                Journal of Speech and Hearing Disorders, 47, 50-56.

2-13-01

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. 2-15-01
                Porch, B.E. (1971). Multidimensional scoring in aphasia testing. Journal of
                Speech and Hearing Research, 14, 777-792.

3-1-01

Simmons-Mackie, N.N. & Damico, J.S. (1996). Accounting for handicaps in Aphasia: Communicative Assessment from an authentic social perspective. Disability and Rehabilitation. 18, 540-549. 3-15-01 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.

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.

3-20-01 Simmons-Mackie, N.N. & Damico, J.S. (1998). Social role negotiation in aphasia therapy: Competence, incompetence, and conflict. In D. Kovarsky & J. Duchan (Eds.) The social construction of incompetence. Erlbaum Press. Collins, M.J. (1997). Global Aphasia. (pp. 133-150). In L.L. LaPointe (Ed.) Aphasia and related neurogenic language disorders. New York: Thieme Medical Publishers. 3-22-01 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. 3-27-01 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. 3-29-01 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. 4-3-01 Holland, A.L. (1996). Pragmatic assessment and treatment for aphasia. In G. Wallace (Ed.) Adult aphasia rehabilitation (pp. 161-173). Boston: Butterworth-Heinemann. 4-5-01 Lubinski, R. (1994). Environmental systems approach to Adult aphasia. In R. Chapey (Ed). Language Intervention Strategies in Adult Aphasia. (3rd Edition). (pp. 269-291). Baltimore: Williams & Wilkins. 4-10-01 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.

4-17-01 Oelschlaeger, M. & Damico, J.S. (1998). Joint productions as a conversational strategy in aphasia. Clinical Linguistics and Phonetics. 12, 459-480. 4-24-01 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.


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                                                      This site is maintained by Jack S. Damico, Ph.D., Dept. of Communicative Disorders
                                                                   Document last revised Sunday 18-February-2001 10:35:23 CST.
                                                                       ©Copyright 2001 by the University of Louisiana at Lafayette.
                                                                  CommunicativeDisorders Dept., P.O. Box 43170, Lafayette LA 70504
                                                            Phone:318/482-6721 · Fax: 318/482-6195 mailto: jsdamico@louisiana.edu