Caseload at an outpatient rehabilitation center
You get 2 clients on your caseload at an outpatient rehabilitation center. They both have had a
left MCA CVA in the last 6 months, but in different areas of the brain. They received
speech/language therapy for a month in the hospital following their stroke but haven’t received
any further services since. They both express to you that they would like more help with their
communication skills.
During your assessment, you get a narrative language sample from each talking about the
“birthday party” picture. Here are the transcripts of their language sample, which are typed
without punctuation. The number of dots indicates the relative durations of pauses.
*Ms. Kim’s Transcript (105 words per minute)
And..oh, okay…what do you call it…well I guess the cat got into it and the..uh..he’s hiding under
the sitter and the mother is gonna…trying to get him out of there…and he cleaned up the rug
with a..hm..well ….those ones there…children…boys and girls…are arriving and it’s …um not
too good a deal I’d say.
*Mr. Smith’s Transcript (40 words per minute)
Um…um…uh….cake…and…um…and…and dog….dog ate cake..and..and…trouble…..mom is
mad….and..and..um..um..kid is crying…and..and…neighbors…..neighbors is coming
* Source: Brookshire, R.H., (2007). Introduction to Neurogenic Communication Disorders, St.
Louis: Mosby.
QUESTION: List and describe three mechanisms of brain changes following a stroke or
brain injury that would apply to Ms. Kim and Mr. Smith. Please use the format provided
below. (3 pts)
Ms. Kim:
1.
2.
3.
Mr. Smith:
1.
2.
3.
QUESTION 9
What principles of neuroplasticity would drive your treatment with these clients? (2
points)
● What principles of neuroplasticity would drive your treatment with Ms. Kim? Why?
● What principles of neuroplasticity would drive your treatment with Mr. Smith?
Why?
Sample Solution
Because entry-level Doctor of Physical Therapy programs aim to prepare graduates for clinical physical therapist practice1, the assessment tool used to evaluate student physical therapists’ (‘students’) clinical performance must be objective and represent the reality of the clinical setting. The American Physical Therapy Association (APTA) recognizes patient-centered outcomes as the ultimate measure of quality care for patients2 and condemns unethical productivity quotas in its Consensus Statement on Clinical Judgement in Health Care Settings. 2,3 The reality of clinical practice, however, is that productivity metrics pervade the field. According to Tammany et al.4, more than 70% of respondents worked in environments where productivity targets were set.
