Causes, Treatment, Diagnosis, and Consequences of Stroke - Assignment Example

? Discussion Questions Question Left sided stroke develops as a result of the left hemisphere of the brain being affected. Although the effect of this stroke on the individual may vary in terms of degree, most patients show symptoms such as paralysis in the right hand part of the body. The person shows symptoms of aphasia characterized by language and speech problem. This is because part of the brain responsible for language and speech both verbal and written are located on the left hemisphere of the brain. Tests used to measure mobility such as the fingertip writing test may have a lower score on the right side. This is because the person gets paralyzed on the right side and may lack the ability to wiggle the fingers and toes or fail to move the right limbs in severe conditions. The patient may also show cautionary behavior and memory loss. For this information it can be concluded that the patient will show low scores in the tests that measure language and speech perception. These include the word fluency and auditory perception tests. However, they would show a greater score in cognitive tests such as trail A and B and WAIS DS. This is because the part of the brain responsible for cognition is in the right lobe (Ruper 2006). A person suffering from right-sided stroke would have a lower score on these tests as the stroke affects part of the brain responsible for cognition. Mr. R would have a low score in the test of visual inattention. This is because left sided stroke does not affect vision not unless it is close to the back. Question 2 In the treatment of stroke, pre-morbid data collected from collateral sources such as relatives is very crucial in several ways. One is that it makes is possible for the physician to identify the lifestyle risk factors that the patient may have been exposed to and this helps in identifying the type of stroke that the person may be suffering from and therefore subject them to the right treatment. Stroke has been known to affect cognitive, language and speech abilities of a person. Some patients may also experience memory losses. As such, the individual patient may not be in a position to give a valid account of their pre-morbid state and the information can only be collected from people who know them well. A good understanding of the pre-morbid state of the individual is important in treatment as it helps the doctor to rule out the possibility of the patient suffering from any other infection or disorder. Comparison of the pre-morbid and the present state of a stroke patient would be used to gauge the level of severity of stroke. This would help in giving the patient the right medication. It can also be used to gauge the level of success of rehabilitation efforts where the patient goes through therapeutic procedures. In rehabilitation, different therapies are used to ensure the patient regains physical strength, coordination and balance (Geyer 2007). He is also supported by occupational therapist in getting back the ability to perform other daily duties among other things. Question 3 Line bisection test is used to test whether the patient has unilateral spatial negligence (USN). MR. C. would take his test by placing a pen at the centre of a succession of horizontal lines. If the patient shows a displacement of the bisection mark to the region where the brain lesion is located, this is interpreted as a sign of neglect. However, in order to confirm the results given by this test, accompanying test such as the memory for design test and symmetric drawing should be conducted. Behavioral Inattentions Test (BIT) is used in measuring visual negligence. Bit has several subtests such as the daisy drawing where a patient is told to trace the drawing of a daisy. A patient drawing will indicate which side the visual negligence is present. The Boston naming test is administered to the patient to assess their ability to find words and the cognitive function related to this task. For one to pass the tests one has to have adequate speech and vision and it would thus be easy to identify people with such problems. Nevertheless, research has concluded that the scoring on the Boston naming test can be affected by factors such as sex, race and age and this should be taken into account when scoring. Accompanying tests should be carried out to rule out the presence of other ailments such as Alzheimer (Fischer 2009). Because Mr.C. suffers from a left sided stroke, he is likely to have a low score in all these test as this strokes affects speech and language abilities. Question 4 The California Verbal Learning test is used to measure verbal memory. This test consists of 16 items that assess different aspects of verbal memory such as free recall, cued recall and long-term and short-term delay. The patient is given the 16 items which have been grouped into four different groups and their ability to recall and the time they take is taken account in the scoring. The Rey-Osterreith Complex Figure is used to measure visual-construction, visual memory, executive functioning and visual-spatial skills. This test can be administered to the patients in two ways: the pen switching method and the flowchart method. Although pen switching can affect coordination, it has not been reported to affect the scoring. The patient observes a figure and is expected to draw it from memory after about 5-25 minutes. Scoring is based on the number of correct figure recollected by the memory. These tests can be used to learn which side of the brain of Ms. D. has been affected and the level of memory loss. Administering the Rivermead Behavioral Memory Test has it many benefits. One, it can be used to measure the everyday memory functioning of the patient. Moreover, it can be used to assess and monitors changes in patient memory after treatment has been given. This makes it easy to assess the success of the treatment option early enough so that it can be switched if it is not working. It also quick ans easy to administer and can thus be given to the patient severally (Lezak et al 2004). However, it is only practical when administered to patient whose cognitive abilities have not been impaired. For patients with cognitive impairments, additional tests such as the mild cognitive impairment tests should be carried. Question 5 Wisconsin Card Sorting Test has been used to measure basic cognitive abilities such as the abstract reasoning and the capability to change cognitive strategies with changes in the environment. In this test, Mr. S. is presented with cards which is supposed to march but is not shown how this is done. Scoring is based on the correct matches that he makes. The A and B trail tests are used to measure cognition and memory. In trail A. Mr. S. is presented with 25 circles with each circle having numbers 1-25. He is then required to join the circles with lines depending on the number such that circles wit consecutive numbers are joined. In trail B, there are 24 circles which are grouped into two halves. The first have contained circles with numbers 1-12 and the other has letters A-L. The patient then joins the numbers but separate them with a circle with a letter i.e. 1-A-2-B-3-C and so on. The patient is given the instructions and I he fails to complete the test in five minutes then this is an indication of problems in cognition. Brain injury results in impairment of cognitive functions of the brain such as memory and reasoning. Trail A measures rote memory and B test multiple abilities in the patient. If he takes a long time, it means that the brain injury affected his reasoning speed. The picture arrangement test of WAIS-IIII Battery assesses the patient social intelligence where they are able to link cause to effect. It consists of 3-6 picture cards where the patient is told to observe them and tell a story. If the ventromedial of the frontal lobe of the brain is injured, it may result in profound disruption of social behavior. This is because damage of the frontal lobe of the brain increases irritability which makes it hard to regulate behavior and changes the mood making the person unstable. The patient may have moral behavioral problem as the fail to respond independently to social stimuli. Depending on the results, different treatment can be used to treat the brain injury including the electric shock and drug administration such as the use of antidepressants (Zasler & Zafonte 2013). Tests should be administered to measure the treatment progress. The frontal lobe is the part of the brain responsible for a person making right or wrong choices and the ability to recognize the consequences of different actions. When it is injured, the person’s ability to recognize consequences and hence make good decisions is impaired (Panteliadis & Strassburg 2004). It impairs different functions of the brain such as planning, initiation, goal selection, monitoring, goal selection and self-correction. Question 6 Various tests can be undertaken to determine Ms. A. preparedness for college. These tests would assess her intelligence capabilities, sensory perceptual abilities, memory performance, constructional dimensions and personality tests. The reitan-klove sensory perceptual examination could be conducted to assess Ms. A. auditory, visual and tactile functions. This instrument is important because since Ms. A. had been schooled at home, being at the college could present several challenges as she would have to move from one place to another. This test would gauge her ability to cope with these new challenges. In areas where she would show deficit such as vision corrective measures could be taken to ensure she schools with less difficulty. This could also help in defining the kind of vocation she chooses depending on her abilities. The block mosaic design that incorporate the three dimension model can be used to assess Ms. A. dimension construction abilities. This can help to detect whether her visual perception has been affected considering that patients with cerebral palsy construction is usually affected by visual perception. The A and B trail test can be used to assess Ms. A. memory abilities. This is because it tests both the short term memory in the A trail (rote memorization) and long-term recall in the B trail. The SAT should be administered in measuring intelligence. This test is appropriate because it measures intelligence and Ms. A preparedness for college as it measures on general intelligence. The big five personality test should be administered to Ms. A. This would help in identifying the vocation that she would most fit and help her in selecting her subject major. It would also test how fit she was to study in a college as this would involve interacting and working with a diverse group of people (Panteliadis & Strassburg 2004). This could be a challenge considering she has been home schooled all her life limiting the number of people she has interacted with. Question 7 According to operant conditioning, individuals engage in certain activities or behaviors depending on the kind of reinforcement they get. Positive reinforcement results in the behavior being repeated over and over again. Negative reinforcement on the other hand is expected to result in deterrence of the behavior. However, this does not always happen because individuals may choose to do a certain action despite being negatively reinforced. Take the case of people who have been convicted of crimes and have been imprisoned for the same. In most cases, after finishing their jail term and being set free, these people commit the same crimes and are sent back to prison. According to choice theory, people make choices on how to act by weighing their options by looking at the cost and benefits involved. This involves a process of individualization where the person sees themselves as being at the centre of the universe. The choices made should thus benefit them. According to choice theory, crime is seen as a method designed by the individual to meet their needs such as excitement, sexual pleasure, money and status. Meeting of these needs requires the person to make decisions that are limited by abilities, available information and other constraints. The perception of the individual of the possible punishment for a certain behavior affects their choices (Vito & Maahs 2012). For instance, a bank robber may reckon that if they were involved in a crime with high chances of being caught, they would have stacked away enough money to last for a lifetime. When they are caught which could be after they have taken the money to a safe place, they get a few years in jail and enjoy the rest of their life with the money they stole. The punishment offered by the law enforcers is thus seen as a small price to pay for the big reward of wealth. This explains why most criminals are not afraid of going back to jail. Question 8 Working with an autistic child to develop making eye contact with others Autism children usually process every face as a potential threat and have thus developed a habit of avoiding eye contact. This became a problem in their social development since facial recognition is an important part of developing social interaction and creation of social ties. There are several things that one can do to help an autistic child overcome the fear of eye contact. One would be through holding items close to the eyes and this will make the child learn to look up to other people’s eyes. Even if you are not referring to the item you are holding, it will always attract the attention to the other eye. Another way one can improve eye contact is by calling the child name one and waiting for them to look up. The silence break will make them curious to know what you are talking about. Another way is through having the child give you a makeover on the face or even paint the face. As he does this it would be hard for them not look into the eyes and would soon create the confidence to do this more often. Another way would be through blowing bubbles to the child by taking turns. Touching the child’s face and letting him touch yours also helps in increases the chances the child makes eyes contact (Richman 2006). It is also important to positively reinforce the child every time they make eye contact through praises. Question 9 Punishment which is a negative reinforcement is not as effective as positive reinforce and should only be used as a last option. This is because it can be a form of negative modeling where the punished person uses the punishment on other individuals. An example is in school where students who receive corporal punishment end up molesting other students. Punishment does not also intend to teach any appropriate behavior. It can also arouse some negative reactions on the punished such as aggression or even the person become emotional in anticipation of the punishment. Being rude to older people should be faced with a punishment. This is because there is no positive reinforcement that can work on this situation. Positive reinforcement here would only result in the person engaging further in the rude behavior. Punishment for being rude would be a good example of the consequences that a child would face if they engaged in that behavior and suppresses the negative behavior immediately. It also makes the environment comfortable by immediately stopping the behavior. Corporal punishment has been prohibited and if it happens it is a violation of the children’s rights. Children are also not supposed to engage in labor meant for adult as this would be a crime of child labor. Punishment should therefore be limited to activities that do not cause any physical harm to the child, cannot be termed as child labor and should not violate any of the children and human rights (Perone 2003). A parent or teacher who gives children punishment s that are not considered ethical may find themselves being arraigned in court for committing crime. Punishment is meant to correct behavior but not harm the offender. Question 10 Operant conditioning can be used in self control for people who want to overcome cigarette smoking addition. Operant condition is a situation where positive reinforces are used to reinforce positive behavior which in this case is avoiding smoking. Negative reinforcement (punishment) is used to deter negative behavior which in this case is smoking. Operant conditioning is based on the theory of learning where behavior which is positively reinforced by the environment is retained (Galanter 2011). In stopping smoking, it is the role of cigarette addict to decide which rewards they get when they overcome the temptation to smoke. One way to reinforce this behavior could be through reading health pamphlet that has information on the negative effects of smoking. The patient could also take the dog for a walk. Some of the positive reinforcement that the person can reward themselves could be through treating themselves to coffee with a friend every time they fail smoke. They could also use the money spent on smoking to buy something they have been wanting for a long time. This is called positive reward where one gets something pleasurable. It could also be negative reward that involves removal of something unpleasant. For instance the person may opt to sleep in a more comfortable environment after stopping smoking. The patient could also use punishment as a way of deterring smoking ((Mitcheson & Meynen 2010). In case they happen to smoke, they can carry out punishment activities of their own choice such as cleaning away the garbage in their compound if it is a chore they hate doing. Soon smoking comes to be associated with the undesirable punishment and not smoking is associated with reward and can help the person to stop smoking completely. Question 11 It is not possible to learn how to perform visually based task such as riding a bike without modeling. This kind of knowledge which has been labeled as tacit knowledge is not easy to share from one person to the other through the use of language. As a matter of fact, it can be learnt through visual observation only. This is the kind of knowledge transferred in apprenticeship. Experience is crucial in learning tacit knowledge where learning takes place when people repeatedly carry out the act such as riding a bike. Even with modeling not everyone is able to carry out these visually –based tasks such as playing a piano. Muscle memory also plays an important role in this learning. Continued consolidation of the neurons that are responsible for carrying out of a certain task are important for a person to perform that task after practice has been performed. This form of learning is deep and requires a close interaction between learner and the person they are learning from. It is not possible to just read guidelines on how to perform the task and be in a position to do it (Busch 2008). One requires on-training that cannot be written down. For instance, one may have read guidelines on how to ride a bike but when actually riding a bike there is no time to remember what the written directions were requiring the help of a person who already has this skill. It thus hard to learn such skills without observing it being done and being guided through it several times before one can have the confidence to perform it on their own. Question 12 People acquire and fads through observational learning. Teens and even adults develop a form of identity by identifying themselves with certain characters. These are mostly people that they see on the internet and the television. For instance, one can influence the mode of dressing of the youth by dressing their icons in a certain way. For instance, if one wants to promote a cloth line such as skinny jeans, one pays celebrities such as pop music artists and actors to wear this line. Soon people who are pop music fans will seek to wear such kind of clothing. It can be observed that people act or behave in a way that reflects the affiliations that they have. The way in which one influences fad depends on the financial ability of the target population (Cai et al 2007). For instance, teens coming from affluent families are easily affected by fads because they are exposed to TVs and internet. They also have money to buy the new clothing line. Teens from poor family backgrounds may not be as exposed and may not even afford to but the new fads as they develop. The fads are used as a way of branding oneself and are an important aspect in the creation of social groupings. Individuals who choose to adopt a certain image are expected to keep up with it and failure to adapt to new developments may lead to them being ridiculed for adhering to a passing fad. Fads are thus a way the devotees seek acceptance in certain social groups and leads to creation of social norms of what is acceptable and what is unacceptable. Question 13 Generalization occurs when a certain stimulus R elicit a response A and another different stimulus L results in the same response A. Stimulus discrimination is where stimulus R results in response A while stimulus L result is a different response B or no response at all. Stimulus discrimination is important in the treatment of maladaptive behavior such as smoking. In this case, aversive therapy is used to treat the smoking addiction. Stimulus control is based on classical conditioning. Stimulus control is where an individual react in a certain way in presence of a stimuli and another way in its absence. An unpleasant behavior which in this case is drinking of alcohol is matched with an aversive stimulus. For instance, every time smoker smokes, he is exposed to an unpleasant smell. The brain then starts to associate smoking with this unpleasant smell reading to reduce smoking and the person may stop drinking altogether. This type of conditioning could also work through explaining to the person how the act of taking smoking or smoking may affect the individual and the people around them. If they love their family the thought of the consequences of this behavior may act as a deterrent to this behavior. Family members can also help in reinforcing the desired behavior by letting the person sleep outside even when it is snowing if they smoke. They would soon associate smoking with the undesirable experiences and eventually stop (Mitcheson & Meynen 2010). This method thus uses generalization to associate two stimuli which are completely unrelated to result in change in behavior. The stimulus of the urge to drink comes to be associated with the unpleasant response. In this case, the individual associates the unpleasant smell with smoking and this is generalization of stimuli. Question 14 Generalization which is also known as transfer of learning is a takes place where a behavior that has been reinforced and learned in one situation is depicted in another totally different situation. For permanent changes in behavior to be observed in this type of learning, there are certain elements that need to be put in place. The change in behavior should be observed in different settings, under different trainers, at different times and in absence of the programmed stimuli. The elements of generalization learning that are important for the transfer of learning include different times, individual, settings and responses (Parente? & Herrmann 2003). An example of a situation where generalization can be applied is teaching a child how to play read. On e way generalization can be used in this could be using pictures where teaching new words. The child comes to associate the pictures with the words making learning much easier. The child should also draw the pictures themselves so that they are able to transform the mental pictures they have into drawings and help the teacher know what concepts they have understood. Moreover, the teacher can use an object in the physical environment to teach new concepts. For instance, if the child is fascinated by trains, the teacher can try to use a train in giving illustrations as much as possible. (Parente? & Herrmann 2003). In this way, the child learns to associate two things are not related but which they are familiar with. This makes learning possible as the learner is able to move from the known to the unknown. References Busch, P. (2008). Tacit knowledge in organizational learning. Hershey, PA: IGI Pub. Cai, H., Chen, . Y., & Fang, H. (2007). Observational learning: Evidence from a randomized natural field experiment. Cambridge, Mass: National Bureau of Economic Research. 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Encouraging appropriate behavior for children on the autism spectrum: Frequently asked questions. London: Jessica Kingsley Pub. Encouraging appropriate behavior for children on the autism spectrum: Frequently asked questions. London: Jessica Kingsley Pub. Ruper, G. D. (2006). New developments in stroke research. Hauppauge, N.Y: Nova Science Publishers. Vito, G. F., & Maahs, J. R. (2012). Criminology: Theory, research, and policy. Sudbury, Mass: Jones & Bartlett Learning. Zasler, N. D., Katz, D. I., & Zafonte, R. D. (2013). Brain injury medicine: Principles and practice. New York: Demos Medical. Read More