Scenario Sarah Year Explained for Students (Easy Guide)
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Original Question
Scenario: Sarah is a 33-year-old female who had an ischemic attack secondary to embolization 2 years ago. A CT scan indicated a large infarction in the posterior-lateral margins of the frontal lobe and temporal-parietal lobes on the left. A speech therapy examination revealed some right-side facial asymmetry. She followed one-step commands. Orientation was difficult to determine due to limited language output. Her attempts at speech were characterized by groping and off-target sound selection. She was intelligible when she produced single-word monosyllabic words. However, beyond this, her speech was characterized by errors such as sound and syllable transpositions, articulatory groping, and sound additions. Her presentation is consistent with Broca’s aphasia and moderate-severe apraxia of speech. Sarah is married with three girls and worked in insurance sales until she had the CVA. Her husband is very involved with her care but often gets frustrated with not being able to communicate with her. She has been receiving speech/language therapy ever since the incident. However, her doctor recently told her that she is unlikely to make any further improvements in her communication skills. QUESTION: If you were her SLP, would you agree with this prognosis and discharge her from therapy? (Choose the BEST answer and ensure the rationale is also true). A. Yes because the doctor is the medical professional and knows more about communication prognosis. B. No because someone with severe deficits should always have therapy. C. Yes because it has been two years, which means the patient is in the chronic stage. Also, it is clear that the patient has tried absolutely every type of treatment. D. No because patients in the chronic stage can show improvement, even several years after their stroke. Also, the patient has other positive prognostic factors, such as her age.
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