Person-Centered Focus on Function: Acquired … - acquired apraxia of speech exercises

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PERSON-CENTERED FOCUS ON FUNCTION:
Acquired Apraxia of
Speech
What are person-centered
functional goals?
? Goals identified by the client, in
partnership with the clinician and
family, that allow participation in
meaningful activities and roles
ICF: International Classification
Why target person-centered functional goals? of Functioning, Disability
? To maximize outcomes that lead to functional and Health
improvements that are important to the
individual Health Condition
? To optimize the individual's potential to disorder or disease
participate in meaningful activities that informs predicted
comorbidities and
? To facilitate a partnership that ensures the prognosis
individual and family have a voice in the care
received and outcomes achieved
? To demonstrate to the payers the value of Body Functions Activities and
and Structures Participation
skilled services anatomical parts execution
and their of tasks or
What is the ICF, and how does it help? physiological involvement in
functions life situations
The International Classification of Functioning,
Disability and Health (ICF)--developed by
the World Health Organization (WHO)--is a Environmental and
framework to address functioning and disability Personal Factors
related to a health condition within the context physical, social, attitudinal,
of the individual's activities and participation in and environmental factors
everyday life. and factors within the
individual's life
ADDITIONAL RESOURCES: asha.org/slp/icf/ ? who.int/classifications/icf/en/
Person-Centered Focus on Function: Acquired Apraxia of Speech
Case study: Mr. B
Health Condition: Moderate to Severe Apraxia of Speech
With Broca's aphasia
Assessment Body Functions and Activities and Environmental and
Data Structures Participation Personal Factors
Spoken Language Function (ALA-2d, interview) (CCRSAe, interview)
(WAB-R)a
? Reduced participation in ? Age: 63
? Aphasia quotient: 62.0 activities outside of the ? Comorbid chronic health
ABA-2b home (e.g., church social conditions: history of left
groups) CVA 3 years ago, right
? Mod-severe AOS ? Difficulty engaging hemiparesis, hypertension
McNeil Checklistc in conversations with ? High level of motivation
? Slow rate: present doctors relating to his ? Relatively preserved
? Prolonged segment/ medical and safety needs reading comprehension
intersegment duration: ? Increased withdrawal ? Desire for greater
present from social interaction independence in social
? Distortions/distorted ? Daughter (primary interactions
sound substitutions: caregiver) reports ? Reduced confidence
present difficulty understanding in communication with
? Errors consistent in type: his attempts to familiar and unfamiliar
present communicate needs at speakers
? Prosodic abnormalities: home ? Supportive family &
present friends
Clinical
Reasoning What impairments most What activities are What personal/environmental
affect function in the current most important to the characteristics help or hinder
setting or at discharge, based individual in the current participation in activities or
on clinician assessment and setting or discharge situations in the current or
the individual's self-report? setting? discharge setting?
Goal Setting Mr. B's Functional Goals
Long-Term Goal:
Mr. B will initiate communicative turns to participate in at least two community based activities
of choice using customized scripts and gestures, as well as thematic vocabulary and picture lists
with 90% success as measured by self and partner report.
Short-Term Goals:
? Mr. B will utilize 25 self-identified high-frequency words via verbal or nonverbal modalities
with 90% consistency to improve communicative success when indicating home, community,
medical and safety needs with familiar and unfamiliar speakers.
? Mr. B will utilize functional conversational scripts to effectively respond to questions from
familiar and unfamiliar speakers relating to self and immediate needs with 90% accuracy with
written cues.
? Mr. B will utilize augmentative methods (e.g., communication book and gestures) to expand
on/supplement conversational scripts with no external cues in 90% of practice trials with
familiar and unfamiliar speakers during treatment sessions.
a WAB-R: Western Aphasia Battery--Revised (Kertesz, 2006)
b ABA-2: Apraxia Battery for Adults--2nd edition (Dabul, 2000)
c McNeil Checklist (McNeil, Robin, & Schmidt, 1997)
d ALA-2: Assessment for Living with Aphasia--2nd edition (Kagan et al., 2007)
e CCRSA: Communication Confidence Rating Scale for Aphasia (Babbitt, Heinemann, Semik, & Cherney, 2011)
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For clinical and documentation questions, contact healthservices@asha.org.
The interpretation of ICF and examples above are consensus based and provided as a resource for members of the
American Speech-Language-Hearing Association.


Does apraxia have a cure? Can apraxia of speech be cured? Some children with developmental speech disorders outgrow them. But CAS is not outgrown and there is no cure. Children with childhood apraxia of speech can, however, make great progress with lots of hard work and support. Click to see full answer.

• Prepared By: Nayiri Adessian Nancy Sedat and Associates
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