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Thematic Language Stimulation Therapy

Thematic Language Stimulation Therapy. Chapter 16. Defining TLS. Type of organized aphasia therapy that improves language processing and functional communication skills by using thematically related vocabulary in multimodality stimulation.

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Thematic Language Stimulation Therapy

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  1. Thematic Language Stimulation Therapy Chapter 16

  2. Defining TLS... • Type of organized aphasia therapy that improves language processing and functional communication skills by using thematically related vocabulary in multimodality stimulation. • Based on words, contexts, tasks, and target improvements • Clinician based: determines patient’s skill level

  3. TLS Organization • Organization, 2 ways: • 1. Thematic vocabulary • personally relevant • fairly universal • units consist of 8-10 words • primarily nouns/verbs • 2. Creation of predictable linguistic stimuli for each task

  4. TLS Delivery • Stimulus Adequacy: • intended result • functionality • redundancy • Maximal Patient Response: • all modalities • Extension of Material and Language: • variety of tasks • thematic units broken down over time • Systematic and Intense Presentation: • from introductory to identification of theme, to manipulation of language in sequence

  5. TLS and Functional Communication • Transition to a functional context • Natural environments • analysis and problem solving • provides combinations of cues and strategies to facilitate improved language function • links from clinical to functional language stimulation by manipulation of the theme.

  6. TLS Assessment • Thorough assessment should derive: • which cerebral processes are impaired • the level at which performance breaks down • Formal tests may provide some info, but observation is best!

  7. Establishing Baseline • A baseline of functional communication should be obtained by consdiering: • 1. How well does the patient initiate and sustain conversation? • 2. How well does the patient express himself or herself verbally/nonverbally? • 3. How well does the patient follow conversation and directions? How complex can auditory demands be before performance breaks down?

  8. Formal Testing • Focal Points of Formal Testing: • Repetition • Sentence Construction • Automatic Language • Picture Description • Following Instructions • Yes/No Reliability • Reading Comprehension • Oral Reading • Graphic Expression

  9. Cognitive and Behavioral Considerations • Certain behaviors should be observed, described and noted: • Patient Involvement • Specific Symptom Awareness • Task Orientation and Retention • Perseveration • Visual Perception

  10. Treatment Delivery • These ?’s should be asked before therapy can begin: • 1. Is this person a good candidate for TLS? • 2. How should tasks be chosen and sequenced? • 3. What cues are most beneficial to achieve maximal success in treatment? • 4. How do I select theme and vocabulary?

  11. Insight of TLS Outcome: A study • Design Choice • single-subject studies • Looked @ whether or not TLS was more effective than a “traditional” approach. • TLS and NON TLS models alternated for 3 weeks • Subject Selection • individuals able to complete course • no regard to age, type of aphasia, etiology, duration of symptoms • Procedures • Audiotaped/videotaped • .5 hour sessions 5 days week for 3 weeks • Results • little can be confirmed b/c small # pts. In study

  12. Conclusion • TLS therapy, because of its strong dependence upon structure, may be a more organized observational environment for shared therapy insights!

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