Treatment of Underlying forms (TUF)
What is aphasia?
An acquired language difficulty called aphasia can frequently come on by a brain injury or stroke. It has an impact on a person's capacity for language processing, usage, and comprehension. Intelligence is unaffected by aphasia.
All aspects of language, including speaking, listening, reading, and writing, can be impacted by aphasia. Both the person with aphasia and their caregiver may experience stress and frustration. Although receiving a diagnosis of aphasia is unanticipated, distressing, and unplanned, there is still hope.
The location and extent of brain damage determine the characteristics of the various forms of aphasia. The speech and language abilities are increasingly restricted the more severe the aphasia.
What is treatment of underlying forms?
Focus: Treatment of underlying forms is designed to improve sentence deficits, particularly in individuals with Agrammatic aphasia. This type of aphasia often involves difficulty with grammar and sentence structure. It targets "underlying forms," which are the abstract, grammatical structures that form the basis of sentences.Many studies have shown that when patients understand a more complex sentence structure, it generalizes: They can now say and understand simpler sentences in everyday life (Swiderski, 2021).
Approach: TUF often begins with more complex sentence structures.The idea is that by training these complex structures, generalization will occur, leading to improvements in simpler sentences as well.TUF specifically works on non-canonical sentence structures. Examples of these include:
👉Passive sentences (e.g., "The ball was kicked by the boy.")
👉Object cleft sentences (e.g., "It was the boy who kicked the ball.")
👉Wh-questions (e.g., "Who kicked the ball?")
Materials and Methods:
TUF utilizes materials like picture stimuli and word cards to help individuals practice constructing and comprehending target sentences. The therapy involves systematic steps to manipulate sentence components, guiding the individual toward producing the desired structures.TUF involves training for both sentence comprehension and production.
➤Patient Population......
treatment of Underlying Forms (TUF) is a treatment strategy to improve sentence structure. It is mostly used with people who have non-fluent aphasia, like Broca’s aphasia. People with non-fluent aphasia usually have difficulties with Agrammatism. This includes word order, sentence structure, and using “small” words like prepositions, conjunctions, and articles.
Agrammatic Aphasia:
- TUF is primarily intended for individuals with agrammatic aphasia, a type of non-fluent aphasia.
-This population typically exhibits difficulties with sentence structure, including:
* Reduced ability to produce grammatically correct sentences.
* Reliance on short, simple phrases.
* Omission of grammatical function words (e.g., prepositions, articles).
* Difficulties with comprehending complex sentence structures.
- It is important that the patient have a base level of comprehension, so severely impaired comprehension could be a reason for this treatment to be to advanced.
➤Contraindications......
1.Severe Comprehension Deficits: Individuals with severe comprehension impairments may find TUF too challenging.
2.Significant Cognitive Impairments: Significant cognitive impairments beyond aphasia may interfere with the ability to participate effectively in the therapy.
3.Lack of Motivation:As with any therapy, patient motivation is important. If a patient is not motivated, the therapy will be less effective.
➤key principals and procedure.......
This approach fosters a collaborative exploration of core beliefs, moving beyond surface-level symptoms to address root causes. Like a conversation, it encourages active participation, where both therapist and client work together to identify and modify maladaptive patterns. Through experiential techniques and cognitive restructuring, the client is empowered to "re-write" their internal narrative, developing healthier coping strategies and fostering lasting change in a practical, real-world relevant manner.
How Does Treatment of Underlying Forms Work
Steps:
1. Put Down the Picture cards.
➤Video demonstration......
➤Sample outcome measurement....
|
Step |
task |
Patient response |
Accuracy |
|
02
|
Ask the client to make a passive sentence using a target picture card |
In correct |
|
|
04 |
Move ‘the’ before to the word 'Ball' in the Sentence and ask the verb, agent and theme. |
correct |
|
|
06 |
Ask the same questions like what is the action, who did the action and who received the action to make a structured passive sentence. |
correct |
|
|
07 |
Mixed the written word cards and ask them to re-arrange the card independently. |
correct |
|
|
08 |
Remove the written cards and ask the client to make a sentence. |
correct |
|
➤Home based activity.....
1. Object Naming and Description:
-Gather a collection of everyday objects (e.g., a spoon, a key, a ball).
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- Name the object.
- Describe its features (e.g., color, size, function).
- Use it in a simple sentence.
- Arrange the cards in the correct order.
- Describe the sequence of events verbally.
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