Learning objectives
The course 'The speech therapy in patients with severe brain' is part of the integrated course of Pathology and Clinical Communication and aims to enable the student to know and understand the essential elements of the pathophysiology of swallowing adult neurological elements of assessment and rehabilitation of neurogenic dysphagia and elements of etiopathology, symptomatology, evaluation, and treatment of major aphasia syndromes. The student must acquire the ability to use this knowledge and understanding in order to identify the best approach to severe brain injury, to put into practice in the various stages of recovery of consciousness and responsiveness, in order to facilitate the resumption supply and the capacity of communication
Prerequisites
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Course unit content
The first lessons introduce the pathophysiology of swallowing adult suffering from brain damage. They lay the etiology of severe brain injury and mentions the main consequences of the hemispheric lesions. We enter the neurogenic dysphagia explaining the causes, symptoms, complications. Discusses the evolution of the cognitive-behavioral patient's neurological bearer of the tracheostomy tube in cross reference to the phases (LCF course). We proceed with the explanation of the protocols for the assessment of dysphagia (first and second level), emphasizing the work in multidisciplinary teams. Discusses the tracheostomy and their management. There is talk of diagnostic exams. Mention is made of the rehabilitation techniques, including adaptive measures, facilitating maneuvers and postures.
In the second part of the class introduces the main characteristics of aphasia syndromes. It explains the clinical examination and the formal investigation, with particular reference all'Aachener Aphasie Test It mentions the conversational therapy with aphasic subject. We describe the protocols for the assessment of other disorders of the phono articulation (articulatory apraxia, dysarthria) and bucco-facial apraxia.
Full programme
- Neurogenic Dysphagia:
Symptoms and complications. The neurological patient bearer of the tracheostomy tube. Features of the cannulae, management. Assessment of the level of consciousness in neurological patients (LCF). Evaluation of swallowing (first and second level). Instrumental exams. Rehabilitation of dysphagia (adaptive measures, maneuvers, posture)
- Aphasia:
Aphasia syndromes (characteristics, etiology). Formal examination of language (AAT). Clinical examination. The communication with the aphasic subject.
Bucco-facial apraxia and apraxia articulatory:
Evaluation.
dysarthria:
Rating (test Robertson)
Bibliography
C. Reverberi, F. Lombardi (2007): Tracheostomia e disfagia nel grave cerebroleso. Scegliere, valutare, riabilitare. Pisa, Ed. del Cerro
A. Basso (2005): Conoscere e rieducare l’afasia. Il Pensiero Scientifico editore
Teaching methods
Lessons include the presentation in video projection content with the help of footage to support the theoretical content of the course. The last minutes of class are reserved to requests for clarification from the students. It includes discussion of a clinical case emblematic
Assessment methods and criteria
The assessment of the achievement of the objectives of the course consists of an oral examination. Through questions about the contents of the course will be determined whether the student has achieved the goal of knowledge and understanding of the content. Through questions regarding strategies for taking charge of the severe brain injury will be determined whether the student has achieved the aim of applying the acquired knowledge.
Other information
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