How do we perform arithmetic calculations? ๐ง โ๏ธ ๐ขโฃ
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Successful calculation requires retrieving arithmetic facts from long term memory and using conceptual knowledge to correctly execute mathematical procedures.โฃ
Acalculia Treatment: Number Transcoding
๐ก๐๐บ๐ฏ๐ฒ๐ฟ ๐ง๐ฟ๐ฎ๐ป๐๐ฐ๐ผ๐ฑ๐ถ๐ป๐ด is the process in which numbers are "translated" from one format to another (i.e., converting the written word four into the Arabic numeral 4 or the spoken word "four"). ๐ข ๐ฃ๏ธ โ๐ผ โฃ
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This skill is deceptively simple, as how we say a number depends on the context it is in (e.g., the number 230 may be said as "two hundred and thirty," while 2:30 PM is said as "two-thirty").โฃ
The Neuroscience of Numbers
What are the neural correlates of number processing? ๐ ๐ง ๐ขโฃ
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Number processing in the brain is supported by a vast system of brain regions spanning across the cortex. Researchers have found that parietal lobe areas play a significant role in the calculation and processing of numbers, while frontal lobe areas play a critical role in the recall of numerical knowledge and working memory.โฃ
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Acalculia Assessment
Acalculia Classifications
Cognitive Models of Numerical Processing
How can number processing be conceptualized? ๐ข ๐ง โฃ
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Models of numerical processing are helpful tools for better understanding the types of arithmetic errors made by people with acalculia. While these errors can be seemingly random upon first glance, theoretical models help provide a framework for recognizing why certain errors are made and how treatment can be individualized to best fit the unique needs of our clients.โฃ
What is Acalculia?
Difficulty with numbers and math following neurological damage is known as acalculia ๐ง ๐ขโฃ
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Many people with aphasia experience number processing and math troubles, with recent estimates suggesting that between 30% and 60% of stroke survivors experience acalculia (Moore & Demeyre, 2022; Zukic et al., 2012). โฃ
Returning to Work with Aphasia
Assistive Technology: Electronic Spell Checkers
Looking for a mid-tech tool for your clients with agraphia? Check out electronic spellers! โ๐ผ โจ๏ธ โฃ
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When trying to correctly spell a word, electronic spellers are typically programmed to look for correct spellings that best match the ๐ฝ๐ต๐ผ๐ป๐ฒ๐๐ถ๐ฐ spelling of what your client just wrote (searching for words that ๐๐ผ๐๐ป๐ฑ similar) ๐ โฃ
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This is different than the default spell check that is installed on most computer word processors, which are programmed to find ๐ผ๐ฟ๐๐ต๐ผ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฐ spellings (searching for words that ๐น๐ผ๐ผ๐ธ similar) ๐ โฃ
Learning a New Language as an SLP
Hereโs something Iโve personally been reminded of lately: Language is complicated! ๐คท๐ผโโ๏ธ ๐ง ๐ฃโฃ
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In some of my free time this summer, Iโve recently started learning Japanese ๐ฏ๐ต โฃ
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And as much fun as it is to learn a new language and geek out over the syntactic structures and morphology of the Japanese language, it has also been really HARD for me at times ๐โฃ
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(Really wishing right now that I still had those extra neurons from my pre-synaptic pruning days ๐
)โฃ
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It has been such a good experience for me as an SLP to have a personal reminder on how complex language is though, because I feel like I am better able to sympathize with my clients who are working so hard to recover their language skills after a stroke or brain injury ๐ง ๐ฅ โฃ
Agraphia Treatment: Sentence-Level Treatment
Agraphia Assessment: Sentence-Level Assessment
Have you ever had a client who writes single words successfully, but struggles when trying to string those words together into sentences? โ๐ผโ๐ซโฃ
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Agraphia assessment at the sentence-level examines the language skills outside of spelling, such as ๐ด๐บ๐ฏ๐ต๐ข๐น and ๐ฎ๐ฐ๐ณ๐ฑ๐ฉ๐ฐ๐ญ๐ฐ๐จ๐บ ๐โฃ
The Neuroscience of Writing
What areas of the brain have been associated with agraphia when lesioned? ๐ง ๐ฅ โฃ
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Writing is a complex process, with ๐ ๐๐ก๐ฌ areas of the brain playing a role. This results in large neural networks responsible for the writing process โ๐ผ โฃ
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That being said, the traditional agraphia classifications do have lesion sites that are associated with them.
Assistive Technology: Speech-to-Text Software
What kinds of technology supports are available to people with agraphia? โ๐ผ ๐ป โฃ
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๐ฆ๐ฝ๐ฒ๐ฒ๐ฐ๐ต-๐๐ผ-๐ง๐ฒ๐
๐ ๐๐ผ๐ณ๐๐๐ฎ๐ฟ๐ฒ allows spoken material captured by a microphone/headset to be transcribed into text for computer programs. ๐ โฃ
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Though many softwares exist, here are some popular options that you may consider looking into for your clients.
Combined Lexical and Sublexical Treatment
In order to correctly write a word, there are a LOT of steps involved ๐งฉ โฃ
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Therefore, for many people with agraphia there is no one single cause for their writing problems. Rather, there are a variety of language processing components that are compromised and result in difficulty writing single words. โ๐ผ โฃ
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๐๐ผ๐บ๐ฏ๐ถ๐ป๐ฒ๐ฑ ๐๐ฒ๐
๐ถ๐ฐ๐ฎ๐น ๐ฎ๐ป๐ฑ ๐ฆ๐๐ฏ๐น๐ฒ๐
๐ถ๐ฐ๐ฎ๐น ๐ง๐ฟ๐ฒ๐ฎ๐๐บ๐ฒ๐ป๐ (Johnson, Ross & Kiran, 2017) is designed to target ALL aspects of written word processing. ๐๐ผโฃ
Agraphia Treatment: Single Word-Level Treatments
What are your go-to treatment approaches for writing at the single word-level? ๐โฃ
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Though the specific treatment technique used will depend on your clientโs individual needs, itโs helpful to be familiar with a variety of approaches so that youโll always be ready to go at a momentโs notice! ๐๐ผ๐๐ผโฃ
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Here are 3 different approaches that youโll want to have in your clinical toolbox:โฃ
Agraphia Classifications
Agraphia Assessment: Single-Word Assessment
When assessing for agraphia at the single word-level, what are you looking for? ๐ต๏ธโโ๏ธ โฃ
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Written language is complicated, and there are lots of factors that go into understanding the difference between why a client may write COW for โhorseโ or spell SIGHKIK for โpsychicโ ๐ ๐ฎ โฃ
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Here are some linguistic variables youโll want to pay close attention to when assessing agraphia at the single word-level:โฃ
What Books Do Your Clients Want to Read?
๐ What books do your clients want to read? ๐ โฃ
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Iโve been working with a client who belongs to an online book club, and the most recent discussion focused on passages from Kate Andersen Browerโs โ๐๐ถ๐ฟ๐๐ ๐ช๐ผ๐บ๐ฒ๐ป: ๐ง๐ต๐ฒ ๐๐ฟ๐ฎ๐ฐ๐ฒ ๐ฎ๐ป๐ฑ ๐ฃ๐ผ๐๐ฒ๐ฟ ๐ผ๐ณ ๐๐บ๐ฒ๐ฟ๐ถ๐ฐ๐ฎโ๐ ๐๐ถ๐ฟ๐๐ ๐๐ฎ๐ฑ๐ถ๐ฒ๐โ ๐บ๐ธโฃ
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Weโve been using ๐๐๐๐ฒ๐ป๐๐ถ๐๐ฒ ๐ฅ๐ฒ๐ฎ๐ฑ๐ถ๐ป๐ด ๐ฎ๐ป๐ฑ ๐๐ผ๐ป๐๐๐ฟ๐ฎ๐ถ๐ป๐ฒ๐ฑ ๐ฆ๐๐บ๐บ๐ฎ๐ฟ๐ถ๐๐ฎ๐๐ถ๐ผ๐ป (๐๐ฅ๐๐ฆ) and the ๐ฃ๐ค๐ฅ๐ฆ๐ง ๐บ๐ฒ๐๐ต๐ผ๐ฑ to dive into the passages for the book club, allowing my client to better understand what she is reading and come up with discussion points for the group ๐ฃโฃ
What is Agraphia?
โ๐ผ A writing problem following neurological damage is known as ๐ฎ๐ด๐ฟ๐ฎ๐ฝ๐ต๐ถ๐ฎ โ๐ผโฃ
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Agraphia can have both a ๐ฎ๐ฐ๐ต๐ฐ๐ณ component and a ๐ญ๐ข๐ฏ๐จ๐ถ๐ข๐จ๐ฆ component. The motor component involves difficulties with formation of letter shapes, while the language component involves difficulties with spelling ๐โฃ