Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 197–210)

1. Which of the following is discussed in the article as a potential cause for age-related hearing loss?

   • Noise exposure.

   • Metabolic changes in the fluid in the cochlea.

   • Damage to the outer hair cells.

   • Aging and resultant loss of spiral ganglion cells.

   • All of the above.

2. Which of the following terms is not used to describe a potential link between hearing loss and dementia?

   • Common cause hypothesis.

   • Cognitive load hypothesis.

   • Cognitive-auditory pathway hypothesis.

   • Cascade hypothesis.

   • None of the above.

3. What do the authors list as possible contributors to neuropsychiatric symptoms seen in patients with dementia?

   • Disease-related factors.

   • Social/environmental factors.

   • Hearing loss, resulting in change to social engagement.

   • All of the above.

   • None of the above.

4. Which of the following describes an impairment-based approach in addressing age-related hearing loss in individuals with dementia?

   • Use of hearing aids to improve speech in noise performance.

   • Use of hearing aids to amplify signal.

   • Training caregivers to employ supported communication techniques.

   • Using sound absorbing materials in the listening environment.

   • All of the above.

5. Preliminary evidence shows that the use of hearing aids may do which of the following?

   • Help improve cognition in older adults including those with dementia.

   • Help improve cognition in older adults but not those with dementia.

   • Not make any difference to cognition in either older adults or those with dementia.

   • No studies have been conducted to date relating to the effect of hearing aids on cognition.

   • None of the above.

   Article Two (pp. 211–222)

6. The International Classification of Functioning, Disability, and Health, developed by the World Health Organization, consider external memory aids to be included in which component of the model?

   • Environmental factors.

   • Personal factors.

   • Activity limitations.

   • Participation restrictions.

   • Body functions.

7. What is necessary to consider when using a person-centered care approach?

   • Impairments of the individual.

   • Assessment scores.

   • Doctor diagnosis.

   • Strengths of the individual

   • Prognosis.

8. Which is not an example of an external memory aid?

   • Calendar.

   • Timer.

   • Notepad.

   • Mnemonic.

   • Whiteboard.

9. What is an example of a preference characteristic of strategies for individuals with probable mild neurocognitive disorder?

   • Impairment-based strategies.

   • Portability of strategy.

   • Stationary strategies.

   • Low-volume strategies.

   • Nonpersonalized strategies.

10. What is an example of incorporating the evidence from preference literature into the development phase of external memory aids?

    • Developing the strategy without consulting the individual.

    • Providing the individual with multiple strategies to trail during the development phase to create a personalized aid.

    • Using a preconstructed nonpersonalized strategy.

    • Using the same strategy without modifications for several individuals.

    • Skipping the development phase and starting with training.

    Article Three (pp. 223–230)

11. What does the movement of person-centered care focus upon?

    • The disease.

    • The person.

    • The neuroimaging.

    • The differential diagnosis.

    • The standardized measure.

12. Which type of decisions should elders with dementia play an active role in?

    • Routine and difficult.

    • Only routine.

    • Only difficult.

    • Only clothing.

    • Elders with dementia are not capable of playing in active role in decision making.

13. Which type of environment did Dr. Montessori recommend for optimal living?

    • Cluttered and messy.

    • Spotlessly clean.

    • Orderly and prepared.

    • Safe and risk free.

    • Dusty and cold.

14. What is a necessary area of assessment for an elder with dementia to support person-centered care?

    • Repetition of multiple word lists.

    • Short-term memory of digits.

    • Word and digit-span tasks.

    • The physical environment.

    • Visual-spatial construction tasks.

15. What is an example of an evidence-based practice that naturally supports a Montessori philosophy?

    • Visual and graphic cues.

    • Workbooks.

    • Sudoku puzzles.

    • Crossword puzzles.

    • Word searches.

    Article Four (pp. 231–241)

16. Purposes of assessment in primary progressive aphasia include all but the following:

    • To aid in differential diagnosis.

    • To aid in planning treatment goals.

    • To confirm that aphasia is not worsening over time.

    • To help determine clinical subtype of PPA (semantic, nonfluent/agrammatic, logopenic).

    • To determine spared and impaired cognitive, linguistic, and motoric domains.

17. Use of standard aphasia batteries in PPA:

    • Is never appropriate.

    • Can help establish language profile and aphasia severity.

    • Is ideal for diagnosing the mildest PPA cases.

    • Can identify presence of Broca's, conduction, or anomic aphasia in PPA.

    • Will confirm the presence of apraxia of speech.

18. Assessment of written language in PPA:

    • Should include a variety of stimulus types, including regular words, irregular words, and non-words.

    • Has no bearing on differential diagnosis by variant.

    • Should only be conducted in semantic variant PPA.

    • Should only be conducted in nonfluent variant PPA.

    • Will often reveal deficits that are distinct from spoken language deficits.

19. Assessments designed specifically for PPA:

    • Do not exist.

    • Include the WAB and BDAE.

    • Can identify deficits but do not track progression.

    • Should be administered by a neurologist.

    • May help differentiate among clinical variants.

20. Assessment of syntactic ability in PPA:

    • Is not possible in patients with motor speech impairment.

    • Is most relevant in logopenic variant PPA.

    • Can help distinguish semantic variant PPA from Alzheimer's disease.

    • May comprise tests of production as well as comprehension.

    • Must be conducted via connected speech sample.

    Article Five (pp. 242–256)

21. The figures in this article summarizing growth in research on lexical retrieval treatment in PPA since 1995 illustrate which of the following points:

    • The number of studies utilizing telemedicine has grown steadily over this period.

    • There were one to three studies per year until the year 2000, followed by a steady rise.

    • There were one to three studies per year until 2008, with an increase in 2009 that has been generally sustained since then.

    • The majority of individuals in behavioral studies have had nf/avPPA.

    • The majority of individuals in noninvasive brain stimulation studies have had svPPA.

22. Which of the following can provide evidence about whether any of the behavioral techniques are more successful than the others?

    • The number of individuals who do not show immediate treatment effects.

    • A comparison of outcomes in studies using one technique with outcomes in studies using a different technique.

    • Research on generalization outcomes in PPA treatment.

    • Head-to-head comparisons of different techniques within the same study.

    • All of the above.

23. In a study by Hameister et al (2016), two individuals with nf/avPPA carried out constraint-induced aphasia therapy, in which they retrieved nouns and verbs in verb phrases or sentences in the course of a card game. This would be an example of which behavioral treatment technique?

    • Lexical retrieval in context.

    • Look, Listen, Repeat.

    • Semantically focused treatment.

    • A cueing hierarchy.

    • Standard naming treatment.

24. Which of the following is a noninvasive brain stimulation treatment that has been used to treat lexical retrieval in PPA?

    • rTMS over the left parietal cortex.

    • Anodal tDCS.

    • Cathodal tDCS.

    • Cathodal rTMS.

    • Anodal rTMS.

25. Which of the following combination of participant characteristics would best indicate suitability for piloting a lexical retrieval treatment?

    • Frustration with lexical retrieval difficulty, clinical levels of depression and anxiety, mild phonological and semantic impairments, early in disease course.

    • Significant impairment on picture naming but not word comprehension tasks, reduced episodic memory and attention, early in disease course.

    • Poor word retrieval in picture naming, marked word comprehension impairments, advanced disease.

    • Frustration with lexical retrieval difficulty, high motivation to carry out treatment activities, normal mood, good attention, episodic memory and executive functioning, early in disease course.

    • Concern about lexical retrieval difficulty, obsessive commitment to completing home treatment activities, good episodic memory, early in disease course.

    Article Six (pp. 257–269)

26. Which of the following is not true about PPA?

    • It is a form of tempo-parietal lobar degeneration.

    • The mean age at onset is late 50s.

    • PPA is caused by several types of neuropathologic disease.

    • PPA is currently classified into three variants.

    • Aphasia rehab, dementia management, and AAC are fields from which strategies for PPA are drawn.

27. Which of the following may be an unexpected challenge due to the early average onset of PPA?

    • Financial and legal implications of leaving the workforce.

    • Lack of PPA-specific community resources and long-term care services.

    • An increase in probability of depression.

    • Change in life expectancy.

    • All of the above.

28. Which is not an example of a mode of communication that a pwPPA and their communication partner may utilize in a multimodal communicative interaction?

    • Remnants.

    • Communication books.

    • Communication partner training.

    • Key wording.

    • Scripts.

29. What is an example of a benefit of providing SLP group therapy specifically for pwPPA?

    • Being around others who understand.

    • Learning strategies in advance of need.

    • Exploring other ways of communicating and practicing them.

    • Connecting and developing community.

    • All of the above.

30. Which of the following is not an attribute of communication partner training (CPT)?

    • CPT's goal is to enhance social participation.

    • CPT is a compensatory strategy.

    • CPT addresses attitudes, knowledge, and skills.

    • CPT is an environmental strategy.

    • A and D.

    Article Seven (pp. 270–283)

31. What gap in the literature concerning PPA is identified in the article?

    • Treatment approaches to improve communication across the stages of progression.

    • People with PPA have specific QoL concerns, which are not fully reflected in the dementia or aphasia literatures.

    • How an SLP/researcher can implement augmentative alternative communication to improve interviewing techniques.

    • Communication between marital partners when one of them is living with aphasia.

    • All of the above.

32. In what way do aphasia camps incorporate principles of the Life Participation Approach for Aphasia (LPAA)?

    • Family members are invited to attend with the person with aphasia.

    • Therapeutic activities address specific language impairments.

    • A supported communication environment can improve self-confidence.

    • A and C.

    • All of the above.

33. What was one of the positive outcomes of camp participation identified by Susan and Robert in this study?

    • Reduction of perceived PPA stigma.

    • Continuing participation in activities introduced at camp.

    • Increased advocacy with new communication partners.

    • Decreased reports of depression.

    • All of the above.

34. What themes have been identified by PWAs, families, and caregivers that contribute to living successfully with aphasia?

    • Meaningful relationships.

    • Positivity.

    • Communication.

    • Support.

    • All of the above.

35. What suggestion do the authors make for aphasia camps that are considering including people with PPA in their future camps?

    • Consider the personalities of the campers.

    • Educate campers on different types of aphasia.

    • Separate campers into stroke-based aphasia and PPA groups.

    • Don't include individuals with PPA in camps with stroke-based aphasia.

    • A and B.

    Article Eight (pp. 284–296)

36. Primary progressive aphasia can be caused by__________?

    • Alzheimer's disease.

    • Tumor.

    • Stroke.

    • Excessive alcohol consumption.

    • Vitamin deficiencies.

37. Michelle Bourgeois's “Flip the Rehab” model states:

    • Assessment and treatment is client-directed rather than clinician-directed.

    • The assessment should start with motivational interviewing of the client, family members, and staff members to determine their primary concerns, along with observation and informal, dynamic assessment to investigate how preserved strengths might be used to compensate.

    • Impairment-based standardized testing may be used near the end of the assessment to further investigate strengths and weaknesses impacting each functional area of concern and to obtain a score for insurance reimbursement.

    • Functionally focused standardized tests and scales may be more helpful to demonstrate progress for this population.

    • All of the above.

38. What is the life participation approach for aphasia—LPAA (applied to primary progressive aphasia)?

    • The life participation approach utilizes drills and worksheets to increase a client's overall language and cognitive ability.

    • The life participation approach indicates that treatment is always provided in the client's place of residence, where they are carrying out life activities.

    • The life participation approach aims to go beyond the patient's language or nonlanguage cognitive impairment by formulating goals that aim to increase engagement in desired life activities.

    • The life participation approach states that only activity-based therapy interventions should be utilized in speech–language therapy.

    • The life participation approach is a holistic, person-centered model that is used only by social workers.

39. How should a speech–language pathologist determine what combination of impairment-based versus compensatory strategies should be used for a client living with PPA?

    • In the early stages, treatment should focus upon impairment-based strategies, while compensatory strategies should be introduced in the moderate and later stages.

    • Impairment-based interventions should never be used with individuals living with PPA since they are incapable of learning new information.

    • A tailored blend of impairment-based and compensatory strategies should be incorporated into the plan of care of each individual living with PPA, with strategies aiming to increase life participation in meaningful activities.

    • There are standardized tests that determine what type of impairment-based versus compensatory strategies an SLP should recommend.

    • SLPs should stage their clients with PPA, which will determine what combination of impairment-based versus compensatory strategies to implement in treatment.

40. What is an example of the use of a compensatory communication intervention applied to a person-centered, life participation goal?

    • Using supportive conversation approaches to train client and care partner on how to more easily communicate during daily conversations.

    • Training a client's care partner to use “key wording” to write key words and phrases on a “Boogie board” during daily conversation exchanges.

    • Formulating a personalized communication board displaying objects needed for leaving home (phone, keys, wallet, hat, gloves).

    • Formulating a personalized communication wallet or book that depicts personal choices for daily activities (food items, household chores, activities around a memory community)and training care partners to provide moderate gestural cues to facilitate communication.

    • All of the above.