Chapter 16: Cognitive-Communication Disorders in Adults

• Cognitive-Communication Disorder (Cognitive-Linguistic Impairment, Cognitive Impairment)


  difficulty with any aspect of communication that is affected by disruption of cognition. Impaired ability to process and use incoming information for memory, organization of information, reasoning, judgement, and problem-solving for adequate functioning in activities of daily living.
• Blood-brain barrier


  a semipermeable membrane barrier that prevents circulating blood in the capillaries and other blood vessels from making direct contact with the cells of the nervous system, but allows oxygen and nutrients to pass thru the membrane to supply the nervous system tissue
• Coup-contrecoup Injury


  in closed head injuries, damage to the brain at both the site of impact (coup) and the opposite side (contrecoup), because the brain "flows" and causes intense compression
• Loss of Consciousness (LOC)

  impaired responsiveness, usually caused by diffuse brain dysfunction or damage to the brainstem and the reticular activating system; duration is often used as a measure of traumatic brain injury severity
• Premorbid


  in medicine, the wellness or functioning of a patient before significant illness or an injury
• Post-concussion syndrome (PCS)


  long-lasting subtle impairments
• Chronic Traumatic Encephalopathy (CTE)


  a degenerative brain disease caused by repeated brain traumas (contact sport, military) that results in degenerative brain disease in later life that may include headaches, mood disorders, difficulty with language, etc.
• Polytrauma


  a medical term describing the condition of a person who has been subjected to multiple traumatic injuries, such as a serious head injury, severe burns, lacerations, fractures and PTSD
• Post-traumatic Stress Disorder (PTSD)


  a set of symptoms after exposure to psychologically extreme traumatic stressors that involves intense fear.
• Comatose (coma)


  a prolonged period of unconsciousness in which a patient has minimal, if any, purposeful responses to stimuli
• Semicomatose (semiconsciousness)


  partially conscious, not completely aware of sensations and stimuli
• Computed Tomography (CT)


  a radiographic technique to visualize body tissue not able to be seen on standard x-ray images (CAT scan, former name)
• Magnetic Resonance Imaging (MRI)


  an imaging study that does not expose patients to radiation and often provides images with sharper detail than those from CT.
• Mental Status Examination


  a structured interview and observations conducted by a psychologist of a patient's orientation, attention, concentration, memory, etc. to provide direction for cognitive-communication rehab (w/ an SLP)
• Working Memory


  temporary information storage that is limited in capacity and requires rehearsal; often thought of as "what is on your mind" at any given moment
• Cognitive Rehabilitation


  individualized programs focused on specific cognitive areas (e.g. improving memory & language processing) to help brain injured individuals restore abilities or compensate for cognitive deficits to promote independent functioning in daily living
• Right-hemisphere Syndrome


  damage to the right-hemisphere of the brain that may result in impairments of attention; visual-spatial abilities; orientation to person, place, time, purpose; emotions; cognition; subtle to overt communication problems; and left-side neglect
• Anosognosia


  decreased awareness of deficits or disabilities often seen in right-hemisphere damage; impairment of an individual's ability to relate to parts of his body
• Aprosodia


  difficulty recognizing, interpreting, and conveying prosody (rhythm, pitch, stress, intonation) that is usually secondary to neurological impairment
• Visual-spatial impairments


  difficulty associating seen objects with their spatial relationships – what is around the objects and the environment; often results in disorientation
• Prosopagnosia


  difficulty recognizing familiar faces, including family members and famous people
• Senility


  a medical term that refers to the normal loss of cognitive functioning with advanced age
• Cognitive Reserve


  the brain's resilience, its ability to cope with increasing damage while still functioning adequately; the brain's ability to improvise and find alternate ways to accomplish a task
• Alzheimer's Disease (AD)


  a neurological disease that causes progressive dementia that usually begins after age 65 and in many cases is related to genetic factors that cause microscopic changes to both gray and white matter. Characterized by decline in memory, intellect, disorientation, delusions, personality changes, and communication impairments
• Cortical Atrophy


  shrinkage and wasting away of cortical tissue that is common in dementia
• Board and care home


  a homelike environment where there may be a few to several elderly or physically impaired individuals residing, and meals, laundry & other services are provided
• Residential care facility


  a fairly large complex of small "apartments" where individuals live that provides communal dining, and various services
• Custodial Care


  services and care of a nonmedical nature (bathing, feeding, toileting) provided long term, usually for convalescent and chronically ill patients