Lisa Marie Catanoso Clinic Observation Assignment CSD 146 Michael P. Boyle April !

th" #11

$%&%'AL A&D BAC($'O)&D *&+O'MA,*O& -ane .patient pse/0onym 1or con1i0entiality2" an a0/lt aro/n0 the age o1 si3ty41ive" 5as in a clinical session 1or alternative an0 a/gmentative comm/nication. ,his session 5as precisely an ho/r long. -ane has aphonia. Aphonia is the loss o1 the ability to spea6 .Boyle2. 7ence" -ane m/st /se a comprehensive a/gmentative comm/nication comp/ter to spea6 1or her. Also" -ane s/11ers 1rom 0ementia. Dementia is a chronic an0 progressive 0ecline in memory" cognition" lang/age" an0 personality .Boyle2. -ane is partic/larly har0 o1 remembering the meaning o1 5or0s. Accor0ing to her h/sban0" she remembers 1aces an0 people b/t is slo5ly losing concept o1 lang/age an0 ob8ects. She has been receiving therapy since October" an0 has sho5n little improvement beca/se o1 her min04crippling 0isease. D%SC'*P,*O& O+ ,7% S%SS*O& A1ter str/ggling to 1in0 the observation room in Speech an0 7earing Clinic at the +or0 b/il0ing" * 5al6e0 in" 6ic6e0 o11 my heels in or0er not to be hear0 by the client on the other si0e o1 the one45ay mirror" an0 commence0 my observation. On the other si0e o1 the mirror 5as an ol0er co/ple. ,he clinician" very /pbeat an0 easy to tal6 to" 5as as6ing them abo/t their 5ee6. ,hey tal6e0 brie1ly o1 visiting relatives. ,hen" the session starte0.

,he clinician 5ent thro/gh 0i11erent programs on -ane9s comp/ter" rea0 her a list o1 5or0s" an0 as6e0 her simple :/estions. -ane 5o/l0 then respon0 to her :/estions by p/shing the ans5er o1 her comp/ter 5ith a styl/s. ,he clinician 5o/l0 as6" ;<hat 0o 5e 5ear on o/r hea0=; ,he obvio/s ans5er to this :/estion 5o/l0 be >hat.? Many simple :/estions li6e this 5ere as6e0. Since -ane has 0ementia an0 is constantly 1orgetting the meanings o1 5or0s" she gave the give 5rong ans5ers. She 5o/l0 ans5er the :/estion above 5ith >soc6s? or >(ashi"? m/ltiple times. Altho/gh -ane9s ans5ers 5ere 5rong" the clinician still persiste0 to as6 the same :/estion /ntil -ane got them right. ,his type o1 session is 6no5n as a cycle o1 learning 4 a type o1 e0/cational reen1orcement. ,his reen1orcement is /se0 beca/se -ane e3ec/tes a perservative behavior. She repeats things 5itho/t stim/l/s. +or e3ample" 5hen the clinician 5o/l0 as6 a :/estion" even a1ter ans5ering correctly" -ane 5o/l0 contin/e to p/sh irrelevant b/ttons on her comp/ter. (aren@s h/sban0 notes to the clinician" ;As her 0ementia gets 5orse" the things yo/ are teaching her 0rops o/t o1 her li1e.; 7e goes on to e3plain that she /se0 to 0rive an0 carry the car 6eys aro/n0 5ith her. She 0oes not 0rive anymore" so she 0oes not remember the /se o1 a 6ey or 5hat it is. ,his is same 5ith items li6e the re1rigerator an0 television. ,he p/rpose o1 -ane9s therapy is to simply stim/late her brain activity an0 1oc/s o1 improving her 1/nctional comm/nication s6ills. ,he therapist is simply trying to test the patient9s cognitive an0 ling/istic s6ills .Boyle2. Beca/se -ane has aphonia" her comm/nication s6ills are e3tremely limite0. Also" beca/se she has 0ementia" there is no promise that this therapy 5ill even help her improve any s6ills 5hatsoever. Accor0ing to AS7A " the American Speech4Lang/age 7earing Associating" therapy 1or a person 5ith 0ementia /s/ally consist o1 repeating in1ormation to maintain 1oc/s" as6ing

:/estions as choices .+or e3ampleA ><o/l0 yo/ li6e apple 8/ice or orange 8/ice=?" rather than ><hat 0o yo/ 5ant to 0rin6=?2" an0 training caregivers ho5 to comm/nicate better 5ith the patient .AS7A2. Also" 0aily activities o1 the patient sho/l0 be recor0e0 in or0er to vie5 their progress. *9ve note0 all o1 this in my observation as the therapist 5or6e0 5ith -ane. Accor0ing to the s/pervisor in the observation room 5ith me" -ane an0 her h/sban0 are paying o/t o1 poc6et 1or therapy. *ns/rance 0oes not cover this therapy beca/se he illness is irreversible. ,he s/pervisor also note0 that there is an obvio/s ethical iss/e 5ith this practice beca/se o1 the 1act that -ane 5ill sho5 little to no res/lts as her 0ementia gets 5orse" an0 as therapy becomes more 1re:/ent.

'%AC,*O&S As a st/0ent ma8oring in Comm/nication Sciences an0 Disor0ers" * 5ent into this observation 5ith an open min0. $oing into an Alternative an0 A/gmentative Comm/nication * 6ne5 that more than li6ely the patient 5o/l0 not be able to spea6. 7o5ever" * 5as s/rprise0 to learn that this partic/lar patient ha0 0ementia" an0 5as :/estioning ho5 the therapy session 5o/l0 go. ,he session" at 1irst 5as interesting" b/t a1ter a 5hile became tiring 5hen it seeme0 to have Bero e11ect on the patient. ,his session opene0 my min0 /p to the 1le3ibility o1 speech lang/age pathologists. ,hey really can 5or6 5ith anyone" 1rom pre4schoolers 5ith lisps" to ol0er a0/lts s/11ering stro6es. ,here is a 5hole spectr/m o1 patients that are in nee0 o1 speech lang/age services. ,his partic/lar session" beca/se o1 the patient9s aphonia an0 0ementia" ma0e me realiBe ho5 val/able comm/nication is in 0ay to 0ay li1e. &ot being able to spea6 is one thing. &ot

being able to remember 5hat yo/ are conveying or 5hat yo/ mean is another. *t ma0e me realiBe that so many people ta6e comm/nication 1or grante0" /ntil they 0evelop a 0isor0er themselves. Overall" this e3perience 5as very e0/cational 1or me. * am e3cite0 to observe more patients 5ith 0isor0ers in the 1/t/re" an0 hope1/lly one 0ay help themC

'%+%'%&C%S Boyle" Michael. >'7D" ,B*" Dementia.? CSD 146. )niversity Par6" PA. 6 April #11. Boyle" Michael. >Aphasia.? CSD 146. )niversity Par6" PA. 6 April #11. D e m e n t i a . . # 11 2 . ' e t r i e v e 0 1 r o m h t t p A D D 5 5 5. a s h a . o r g D p / b l i c D s p e e c h D 0isor0ersD0ementia.htm