Monday, September 23, 2013

Neuro


“Consider someone named Mr. R who has a left sided stroke.” discuss how you think the Fingertip Writing Test, Auditory Perception Test, Word Fluency, Trails A and B, and WAIS DS and tests of visual inattention such as the Line Bisection Test. These tests measure basic sensory and perceptual functions, ability to generate normal levels of speech, and also measure overall cognitive speed which is often degraded by stroke. How would those tests be impacted by a left-sided stroke?
Question2 – Minimum 250 words with reference
Discuss how pre-morbid data collected from collateral sources (relatives, friends, employers or schools) can be used to develop a more complete picture of Mr. R.’s pre-morbid status. Also discuss how comparing Mr. R.’s pre-morbid status with his current post-stroke impairments can help indicate the actual impairments caused by the stroke as well as aid in developing a rehabilitation plan and prognosis.
Week 7
Question3 – Minimum 250 words with reference
Case Study: Mr. C. is a 72-year-old retired manager previously in excellent health who has recently suffered a left-hemisphere stroke resulting in a severely limited ability to speak. He is only able to utter a few words at a time with studied effort. His wife says that he is bumping into objects on his left side and appears not to see them very well. His ability to understand speech appears intact. His physician has requested a neuropsychological consult to determine his level of speech impairment and possible visual field neglect.
Discuss the use of tests of sensory-perceptual abilities (Line Bisection Test and the Test of Visual Neglect (to measure visual field neglect), as well as verbal fluency (using the FAS test to determine the rate of spontaneous speech production and Boston Naming Test (a confrontational naming test) to test the ability to recall names of familiar objects ), to measure the impact of the left side stroke affecting Mr. C’s. visual-perceptual abilities as well as language production. How would these tests assess possible deficits? Would you administer any further tests? Explain.
Question4 – Minimum 250 words with reference
Case Study: Ms. D. is an 84-year-old housewife who sometimes gets lost and has to phone her husband to come pick her up when trying to walk back home by herself from the neighborhood grocery store. During her shopping trips, she also sometimes also forgets to take her list with her and then can’t remember all the items she needs to purchase. Mr. D. says that when talking to his wife lately, she frequently repeats herself by asking the same questions. He has brought his wife to your clinic because he is worried about her memory problems.
Discuss the use of a verbal memory test such as the California Verbal Learning Test (CVLT), as well as the use of spatial memory test such as the Rey-Osterreith Complex Figure to investigate Ms. D’s verbal memory and visual-spatial memory abilities. Also, discuss the benefit of administering the Rivermead Behavioral Memory Test (found in your text on pp. 534-536) to better understand Ms. D’s ability to perform everyday household tasks. Are there any other assessments that might provide useful data about the patient’s status? Explain.
Week 8
Question5 – Minimum 250 words with reference
Mr. S. is a 17-year-old high school student previously in excellent health who has recently suffered a traumatic brain injury in an auto accident. At the time of the accident, he was not wearing a seatbelt and, therefore, sharply struck the windshield with his forehead and was unconscious for approximately 5 hours. He was transported to the hospital ER where CAT scans indicated brain tissue damage in the orbitofrontal area and also in the dorsolateral prefrontal cortex. Following 1 week of observation in the hospital during which he seemed to improve to some extent, he was released to his family with follow-up visits scheduled with a neurologist. At home he did not seem to exhibit any obvious physical problems, although his ability to quickly respond to questions seemed reduced in speed, and he exhibited problems in planning his day when faced with several competing interests. His family has requested a neuropsychological consult to determine when he will be able to return to school. They are complaining of his lack of concern with social proprieties, as he is nonchalant and unconcerned when they try to seriously talk to him about his behavior. He also engages in hilarious laughter and crude joking with his siblings and friends. His parents have become unhappy with his recovery and would like to know when he will start being responsible again.
First, discuss the use of tests of executive functioning such as the Wisconsin Card Sorting Test (to test for perseveration and ability to change focus), the Trails A and B (test of ability to hold several tasks in mind at the same time as well as a test of cognitive speed), and the picture arrangement test from the WAIS-IIII Battery (test of social skills ability indicating whether the orbitofrontal area is damaged or not) to determine the extent of Mr. S.’s changes in frontal lobe functionality. Within your answer, discuss how these tests indicate how decision-making and planning is affected by brain injury and how cognitive speed can be measured following frontal lobe injury. Finally, discuss the impact of orbitalfrontal injury-caused social problems.
Then, discuss the prognosis and course of rehabilitation for Mr. S.
Question6 – Minimum 250 words with reference
Ms. A. is an 18-year-old female with cerebral palsy. She suffers from almost complete left-side hemiplegia (unilateral disability when attempting to use her left leg, hand, and arm) which serves to confine her except for brief periods to a wheelchair. Ms. A. can be understood with some effort; however her speech is not completely normal in tone and articulation. She is able to write with effort using her unaffected hand and possesses above-average intelligence, but she has been home-schooled due to her disability. She usually presents with a good attitude towards her disability and towards life in general, and she is trying to decide if she should seriously consider attending college.
Discuss the selection of tests and/or batteries to assess Ms. A. to determine the extent of her strengths and deficits. Briefly discuss why you have chosen these instruments. The functions to consider assessing are Ms. A.’s sensory-perceptual abilities, two and three dimensional constructional abilities, intelligence and achievement measurement, working and long-term memory performance, and the measurement of personality as well as information from collaterals such as the person who has home-schooled her.
Learning
Week 5
Question7 – Minimum 250 words with reference
Many experts argue that operant conditioning does not take into account a client’s “free will.” Using choice theory, develop an example where a client/individual might choose to engage in a behavior that does not appear to be positively reinforced.
Question8 – Minimum 250 words with reference
Choose one of the following examples:
• Working with an autistic child to develop making eye contact with others
• Working with a first grade classroom to stay quiet during meeting time
• Working with a client to reduce smoking
Describe how you would address the behavior through the use of one of the schedules of reinforcement that we have learned about this week. In your discussion, make sure to provide a detailed rationale for your selection.
Week 6
Question9 – Minimum 250 words with reference
After completing the reading and the Perone article, discuss the following:
• Describe your thoughts on the role of punishment in shaping behavior. Is punishment always less effective than positive reinforcement? Why or why not
• Describe at least one instance where punishment might be desirable to apply as a consequence. Fully discuss your rationale.
• What ethical and legal issues might arise when the use of punishment is considered?
Question10 – Minimum 250 words with reference
Select one of the following:
• Learned helplessnes
• Superstitious behavior
• Self awareness
• Creativity
• Self control
Provide an original example of your selected behavior topic and then describe how operant conditioning may apply in the development and/or maintenance of the behavior.
Week 7
Question11 – Minimum 250 words with reference
Is it possible to learn a visually-based task without the use of modeling? Select an example such as learning to tie shoes, to ride a bike, or a dance step (or choose another example). Can this task be taught without the use of observational learning? Clearly discuss your position and rationale.
Question12 – Minimum 250 words with reference
Discuss how you could influence a fad-like behavior in children, teens, or adults. Fad behaviors might include extreme clothing selections, dieting /eating behavior, or consumption of a new product (iPads, etc). Describe the “fad” and the elements of observational learning are involved.
Week 8
Question13 – Minimum 250 words with reference
Consider the case of a smoking addiction or other maladaptive behavior. How can therapists use their understanding of generalization, discrimination, and stimulus control to devise an effective treatment plan?
Question14 – Minimum 250 words with reference
Describe a situation where you need to teach an adult or child a task that needs to be generalized. Some examples might include teaching a toddler to get dressed, a child to read, or an adult to send an email. Discuss the elements of generalization training that will be most important in developing the transfer of learning to new situations.

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