The frontal lobe is the largest of the four major lobes of the brain in mammals, is located at the front of each hemisphere. It is separated from the parietal lobe by a groove between tissues called the central sulcus, from the temporal lobe by a deeper groove called the lateral sulcus; the most anterior rounded part of the frontal lobe is known as the frontal pole, one of the three poles of the cerebrum. The frontal lobe is covered by the frontal cortex; the frontal cortex includes the premotor cortex, the primary motor cortex – cortical parts of the motor cortex. The front part of the frontal lobe is covered by the prefrontal cortex. There are four principal gyri in the frontal lobe; the precentral gyrus, is directly anterior to the central sulcus, running parallel to it and contains the primary motor cortex, which controls voluntary movements of specific body parts. Three horizontally arranged subsections of the frontal gyrus are the superior frontal gyrus, the middle frontal gyrus, the inferior frontal gyrus.
The inferior frontal gyrus is divided into three parts – the orbital part, the triangular part, the opercular part. The frontal lobe contains most of the dopamine neurons in the cerebral cortex; the dopaminergic pathways are associated with reward, short-term memory tasks and motivation. Dopamine tends to select sensory information arriving from the thalamus to the forebrain; the frontal lobe is the largest lobe of the brain and makes up about a third of the surface area of each hemisphere. On the lateral surface of each hemisphere, the central sulcus separates the frontal lobe from the parietal lobe; the lateral sulcus separates the frontal lobe from the temporal lobe. The frontal lobe can be divided into a lateral, polar and medial part; each of these parts consists of a particular gyrus: Lateral part: lateral part of the superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus. Polar part: Transverse frontopolar gyri, frontomarginal gyrus. Orbital part: Lateral orbital gyrus, anterior orbital gyrus, posterior orbital gyrus, medial orbital gyrus, gyrus rectus.
Medial part: Medial part of the superior frontal gyrus, cingulate gyrus. The gyri are separated by sulci. E.g. the precentral gyrus is in front of the central sulcus, behind the precentral sulcus. The superior and middle frontal gyri are divided by the superior frontal sulcus; the middle and inferior frontal gyri are divided by the inferior frontal sulcus. In humans, the frontal lobe reaches full maturity around the late 20s, marking the cognitive maturity associated with adulthood. A small amount of atrophy, however, is normal in the aging person’s frontal lobe. Fjell, in 2009, studied atrophy of the brain in people aged 60–91 years; the 142 healthy participants were scanned using MRI. Their results were compared to those of 122 participants with Alzheimer's disease. A follow-up one year showed there to have been a marked volumetric decline in those with Alzheimer's and a much smaller decline in the healthy group; these findings corroborate those of Coffey, who in 1992 indicated that the frontal lobe decreases in volume 0.5%–1% per year.
The frontal lobe plays a large role in voluntary movement. It houses the primary motor cortex; the function of the frontal lobe involves the ability to project future consequences resulting from current actions. Frontal lobe functions include override and suppression of unacceptable response as well as differentiation tasks; the frontal lobe plays an important part in integrating longer non-task based memories stored across the brain. These are memories associated with emotions derived from input from the brain's limbic system; the frontal lobe modifies those emotions to fit acceptable norms. Psychological tests that measure frontal lobe function include finger tapping, the Wisconsin Card Sorting Test, measures of language and numeracy skills. Damage to the frontal lobe can result in many different consequences. Transient ischemic attacks known as mini-strokes, strokes are common causes of frontal lobe damage in older adults; these strokes and mini-strokes can occur due to the blockage of blood flow to the brain or as a result of the rupturing of an aneurysm in a cerebral artery.
Other ways in which injury can occur include head injuries such as traumatic brain injuries incurred following accidents, diagnoses such as Alzheimer's disease or Parkinson's disease, frontal lobe epilepsy. Common effects of damage to the frontal lobe are varied. Patients who have experienced frontal lobe trauma may know the appropriate response to a situation but display inappropriate responses to those same situations in "real life". Emotions that are felt may not be expressed in the face or voice. For example, someone, feeling happy would not smile, the voice would be devoid of emotion. Along the same lines, the person may exhibit excessive, unwarranted displays of emotion. Depression is common in stroke patients. Common is a loss of or decrease in motivation. Someone might not want to carry out normal daily activities and would not feel "up to it"; those who are close to the person who has experienced the damage may notice changes in behavior. This personality change is characteristic of damage to the frontal lobe and was exemplified in the case of Phineas Gage.
The frontal lobe is the same part of the brain, responsible for executive functions
The Ancient Greek language includes the forms of Greek used in Ancient Greece and the ancient world from around the 9th century BCE to the 6th century CE. It is roughly divided into the Archaic period, Classical period, Hellenistic period, it is succeeded by medieval Greek. Koine is regarded as a separate historical stage of its own, although in its earliest form it resembled Attic Greek and in its latest form it approaches Medieval Greek. Prior to the Koine period, Greek of the classic and earlier periods included several regional dialects. Ancient Greek was the language of Homer and of fifth-century Athenian historians and philosophers, it has contributed many words to English vocabulary and has been a standard subject of study in educational institutions of the Western world since the Renaissance. This article contains information about the Epic and Classical periods of the language. Ancient Greek was a pluricentric language, divided into many dialects; the main dialect groups are Attic and Ionic, Aeolic and Doric, many of them with several subdivisions.
Some dialects are found in standardized literary forms used in literature, while others are attested only in inscriptions. There are several historical forms. Homeric Greek is a literary form of Archaic Greek used in the epic poems, the "Iliad" and "Odyssey", in poems by other authors. Homeric Greek had significant differences in grammar and pronunciation from Classical Attic and other Classical-era dialects; the origins, early form and development of the Hellenic language family are not well understood because of a lack of contemporaneous evidence. Several theories exist about what Hellenic dialect groups may have existed between the divergence of early Greek-like speech from the common Proto-Indo-European language and the Classical period, they differ in some of the detail. The only attested dialect from this period is Mycenaean Greek, but its relationship to the historical dialects and the historical circumstances of the times imply that the overall groups existed in some form. Scholars assume that major Ancient Greek period dialect groups developed not than 1120 BCE, at the time of the Dorian invasion—and that their first appearances as precise alphabetic writing began in the 8th century BCE.
The invasion would not be "Dorian" unless the invaders had some cultural relationship to the historical Dorians. The invasion is known to have displaced population to the Attic-Ionic regions, who regarded themselves as descendants of the population displaced by or contending with the Dorians; the Greeks of this period believed there were three major divisions of all Greek people—Dorians and Ionians, each with their own defining and distinctive dialects. Allowing for their oversight of Arcadian, an obscure mountain dialect, Cypriot, far from the center of Greek scholarship, this division of people and language is quite similar to the results of modern archaeological-linguistic investigation. One standard formulation for the dialects is: West vs. non-west Greek is the strongest marked and earliest division, with non-west in subsets of Ionic-Attic and Aeolic vs. Arcadocypriot, or Aeolic and Arcado-Cypriot vs. Ionic-Attic. Non-west is called East Greek. Arcadocypriot descended more from the Mycenaean Greek of the Bronze Age.
Boeotian had come under a strong Northwest Greek influence, can in some respects be considered a transitional dialect. Thessalian had come under Northwest Greek influence, though to a lesser degree. Pamphylian Greek, spoken in a small area on the southwestern coast of Anatolia and little preserved in inscriptions, may be either a fifth major dialect group, or it is Mycenaean Greek overlaid by Doric, with a non-Greek native influence. Most of the dialect sub-groups listed above had further subdivisions equivalent to a city-state and its surrounding territory, or to an island. Doric notably had several intermediate divisions as well, into Island Doric, Southern Peloponnesus Doric, Northern Peloponnesus Doric; the Lesbian dialect was Aeolic Greek. All the groups were represented by colonies beyond Greece proper as well, these colonies developed local characteristics under the influence of settlers or neighbors speaking different Greek dialects; the dialects outside the Ionic group are known from inscriptions, notable exceptions being: fragments of the works of the poet Sappho from the island of Lesbos, in Aeolian, the poems of the Boeotian poet Pindar and other lyric poets in Doric.
After the conquests of Alexander the Great in the late 4th century BCE, a new international dialect known as Koine or Common Greek developed based on Attic Greek, but with influence from other dialects. This dialect replaced most of the older dialects, although Doric dialect has survived in the Tsakonian language, spoken in the region of modern Sparta. Doric has passed down its aorist terminations into most verbs of Demotic Greek. By about the 6th century CE, the Koine had metamorphosized into Medieval Greek. Ancient Macedonian was an Indo-European language at least related to Greek, but its exact relationship is unclear because of insufficient data: a dialect of Greek; the Macedonian dialect (or l
Occupational therapy is the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. It is an allied health profession performed by occupational therapists and Occupational Therapy Assistants. OTs work with people with mental health problems, injuries, or impairments; the American Occupational Therapy Association defines an occupational therapist as someone who "helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. Common occupational therapy interventions include helping children with disabilities to participate in school and social situations, injury rehabilitation, providing supports for older adults experiencing physical and cognitive changes."Typically, occupational therapists are university-educated professionals and must pass a licensing exam to practice. Occupational therapists work with professionals in physical therapy, speech therapy, nursing, social work, clinical psychology, medicine.
The earliest evidence of using occupations as a method of therapy can be found in ancient times. In c. 100 BCE, Greek physician Asclepiades treated patients with a mental illness humanely using therapeutic baths, massage and music. The Roman Celsus prescribed music, travel and exercise to his patients. However, by medieval times the use of these interventions with people with mental illness was rare, if not nonexistent. In 18th-century Europe, revolutionaries such as Philippe Pinel and Johann Christian Reil reformed the hospital system. Instead of the use of metal chains and restraints, their institutions used rigorous work and leisure activities in the late 18th century; this was the Moral Treatment era, developed in Europe during the Age of Enlightenment, where the roots of occupational therapy lie. Although it was thriving in Europe, interest in the reform movement fluctuated in the United States throughout the 19th century, it re-emerged in the early decades of the 20th century as Occupational Therapy.
The Arts and Crafts movement that took place between 1860 and 1910 impacted occupational therapy. In the US, a industrialized country, the arts and crafts societies emerged against the monotony and lost autonomy of factory work. Arts and crafts were used as a way of promoting learning through doing, provided a creative outlet, served as a way to avoid boredom during long hospital stays. Eleanor Clarke Slagle is considered to be the “mother” of occupational therapy. Slagle, one of the founding members of the National Society for the Promotion of Occupational Therapy, proposed habit training as a primary occupational therapy model of treatment. Based on the philosophy that engagement in meaningful routines shape a person's wellbeing, habit training focused on creating structure and balance between work and leisure. Although habit training was developed to treat individuals with mental health conditions, its basic tenets are apparent in modern treatment models that are utilized across a wide scope of client populations.
In 1915 Slagle opened the first occupational therapy training program, the Henry B. Favill School of Occupations, at Hull House in Chicago. Slagle went on to serve as secretary. In 1954, AOTA created the Eleanor Clarke Slagle Lectureship Award in her honor; each year, this award recognizes a member of AOTA “who has who has creatively contributed to the development of the body of knowledge of the profession through research, and/or clinical practice.” The health profession of occupational therapy was conceived in the early 1910s as a reflection of the Progressive Era. Early professionals merged valued ideals, such as having a strong work ethic and the importance of crafting with one's own hands with scientific and medical principles; the National Society for the Promotion of Occupational Therapy, now called the American Occupational Therapy Association, was founded in 1917 and the profession of Occupational Therapy was named in 1921. William Rush Dunton, one of the founders of NSPOT and visionary figure in the first decades of the profession struggled with "the cumbersomeness of the term occupational therapy", as it lacked the "exactness of meaning, possessed by scientific terms".
Other titles such as "work-cure","ergo therapy", "creative occupations" were discussed as substitutes, but none possessed the broad meaning that the practice of occupational therapy demanded in order to capture the many forms of treatment that existed from the beginning. The emergence of occupational therapy challenged the views of mainstream scientific medicine. Instead of focusing purely on the medical model, occupational therapists argued that a complex combination of social and biological reasons cause dysfunction. Principles and techniques were borrowed from many disciplines—including but not limited to physical therapy, psychiatry, self-help and social work—to enrich the profession's scope. Between 1900 and 1930, the founders developed supporting theories. By the early 1930s, AOTA had established educational guidelines and accreditation procedures; the early twentieth century was a time in which the rising incidence of disability related to industrial accidents, World War I, mental illness brought about an increasing social awareness of the issues involved.
The entry of the United States into World War I was a crucial event in the history of the profession. Up until this time, occupational therapy had been concerned primaril
Acquired brain injury
Acquired brain injury is brain damage caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, emotional, or behavioural impairments that lead to permanent or temporary changes in functioning; these impairments result from either traumatic brain injury or nontraumatic injury derived from either an internal or external source. ABI does not include damage to the brain resulting from neurodegenerative disorders. While research has demonstrated that thinking and behavior may be altered in all forms of ABI, brain injury is itself a complex phenomenon having varied effects. No two persons can expect resulting difficulties; the brain controls every part of human life: physical, behavioral and emotional. When the brain is damaged, some part of a person's life will be adversely affected. Consequences of ABI require a major life adjustment around the person's new circumstances, making that adjustment is a critical factor in recovery and rehabilitation.
While the outcome of a given injury depends upon the nature and severity of the injury itself, appropriate treatment plays a vital role in determining the level of recovery. ABI has been associated with a number of emotional difficulties such as depression, issues with self-control, managing anger impulses and challenges with problem-solving, these challenges contribute to psychosocial concerns involving social anxiety and lower levels of self esteem; these psychosocial problems have been found to contribute to other dilemmas such as reduced frequency of social contact and leisure activities, family problems and marital difficulties. How the patient copes with the injury has been found to influence the level at which they experience the emotional complications correlated with ABI. Three coping strategies for emotions related to ABI have presented themselves in the research, approach-oriented coping, passive coping and avoidant coping. Approach-oriented coping has been found to be the most effective strategy, as it has been negatively correlated with rates of apathy and depression in ABI patients.
Passive coping has been characterized by the person choosing not to express emotions and a lack of motivation which can lead to poor outcomes for the individual. Increased levels of depression have been correlated to avoidance coping methods in patients with ABI; these challenges and coping strategies should be kept in consideration when seeking to understand individuals suffering from ABI. Following acquired brain injury it is common for patients to experience memory loss. However, because some aspects of memory are directly linked to attention, it can be challenging to assess what components of a deficit are caused by memory and which are fundamentally attention problems. There is partial recovery of memory functioning following the initial recovery phase. In order to cope more efficiently with memory disorders many people with ABI use memory aids. Research has found that ABI patients use an increased number of memory aids after their injury than they did prior to it and these aids vary in their degree of effectiveness.
One popular aid is the use of a diary. Studies have found that the use of a diary is more effective if it is paired with self-instructional training, as training leads to more frequent use of the diary over time and thus more successful use as a memory aid. In children and youth with pediatric acquired brain injury the cognitive and emotional difficulties that stem from their injury can negatively impact their level of participation in home and other social situations, participation in structured events has been found to be hindered under these circumstances. Involvement in social situations is important for the normal development of children as a means of gaining an understanding of how to work together with others. Furthermore, young people with ABI are reported as having insufficient problem solving skills; this has the potential to hinder their performance in various social settings further. It is important for rehabilitation programs to deal with these challenges specific to children who have not developed at the time of their injury.
Rehabilitation following an acquired brain injury does not follow a set protocol, due to the variety of mechanisms of injury and structures affected. Rather, rehabilitation is an individualized process that will involve a multi-disciplinary approach; the rehabilitation team may include but is not limited to nurses, physiotherapists, occupational therapists, speech-language pathologists, music therapists, psychologists. Physical therapy and other professions may be utilized post- brain injury in order to control muscle tone, regain normal movement patterns, maximize functional independence. Rehabilitation should be patient-centered an
Augmentative and alternative communication
Augmentative and alternative communication is an umbrella term that encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. AAC is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment and autism, acquired conditions such as amyotrophic lateral sclerosis and Parkinson's disease. AAC can be a permanent addition to a temporary aid. Modern use of AAC began in the 1950s with systems for those who had lost the ability to speak following surgical procedures. During the 1960s and 1970s, spurred by an increasing commitment in the West towards the inclusion of disabled individuals in mainstream society and developing the skills required for independence, the use of manual sign language and graphic symbol communication grew greatly, it was not until the 1980s. Rapid progress in technology, including microcomputers and speech synthesis, have paved the way for communication devices with speech output and multiple options for access to communication for those with physical disabilities.
AAC systems are diverse: unaided communication uses no equipment and includes signing and body language, while aided approaches use external tools. Aided communication methods can range from paper and pencil to communication books or boards to speech generating devices or devices producing written output; the symbols used in AAC include gestures, pictures, line drawings and words, which can be used alone or in combination. Body parts, adapted mice, or eye tracking can be used to select target symbols directly, switch access scanning is used for indirect selection. Message generation is much slower than spoken communication, as a result rate enhancement techniques may be used to reduce the number of selections required; these techniques include "prediction", in which the user is offered guesses of the word/phrase being composed, "encoding", in which longer messages are retrieved using a prestored code. The evaluation of a user's abilities and requirements for AAC will include the individual's motor, cognitive and communication strengths and weaknesses.
The evaluation requires the input of family members for early intervention. Respecting ethnicity and family beliefs are key to a family-centered and ethnically competent approach. Studies show that AAC use does not impede the development of speech, may result in a modest increase in speech production. Users who have grown up with AAC report satisfying relationships and life activities; the Convention on the Rights of Persons with Disabilities defines augmentative and alternative communication one of communications as well as display of text, large-print, tactile communication, plain language, accessible multimedia and accessible information and communications technology. Augmentative and alternative communication is used by individuals to compensate for severe speech-language impairments in the expression or comprehension of spoken or written language. People making use of AAC include individuals with a variety of congenital conditions such as cerebral palsy, intellectual disability, acquired conditions such as amyotrophic lateral sclerosis, traumatic brain injury and aphasia.
Prevalence data vary depending on the country and age/disabilities surveyed, but between 0.1 and 1.5% of the population are considered to have such severe speech-language impairments that they have difficulty making themselves understood, thus could benefit from AAC. An estimated 0.05% of children and young people require high technology AAC. Well-known AAC users include physicist Stephen Hawking, broadcaster Roger Ebert and poet Christopher Nolan. Award-winning films such as My Left Foot and The Diving Bell and the Butterfly, based on books by AAC users Christy Brown and Jean-Dominique Bauby have brought the lives of those who use AAC to a wider audience; the field was called "Augmentative Communication". The addition of "alternative" followed when it became clear that for some individuals non-speech systems were their only means of communication. AAC users utilize a variety of aided and unaided communication strategies depending on the communication partners and the context. There were three independent, research areas in the 1960s and 1970s that lead to the field of augmentative and alternative communication.
First was the work on early electromechanical writing systems. The second was the development of communication and language boards, lastly there was the research on ordinary child language development. Unaided AAC systems are those that do not require an external tool, include facial expression, vocalizations and sign languages and systems. Informal vocalizations and gestures such as body language and facial expressions are part of natural communication, such signals may be used by those with profound disabilities. More formalized gestural codes exist that lack a base in a occurring language. For example, the Amer-Ind code is based on Plains Indian Sign Language, has been used with children with severe-profound disabilities, adults with a variety of diagnoses including dementia and dysarthria; the benefits of gestures and pantomime are that they are always available to the user understood by an educated listener, a
A gesture is a form of non-verbal communication or non-vocal communication in which visible bodily actions communicate particular messages, either in place of, or in conjunction with, speech. Gestures include movement of face, or other parts of the body. Gestures differ from physical non-verbal communication that does not communicate specific messages, such as purely expressive displays, proxemics, or displays of joint attention. Gestures allow individuals to communicate a variety of feelings and thoughts, from contempt and hostility to approval and affection together with body language in addition to words when they speak. Gesture processing takes place in areas of the brain such as Broca's and Wernicke's areas, which are used by speech and sign language. In fact, language is thought by some scholars to have evolved in Homo sapiens from an earlier system consisting of manual gestures; the theory that language evolved from manual gestures, termed Gestural Theory, dates back to the work of 18th-century philosopher and priest Abbé de Condillac, has been revived by contemporary anthropologist Gordon W. Hewes, in 1973, as part of a discussion on the origin of language.
Gestures have been studied throughout time from different philosophers. Marcus Fabius Quintilianus was a Roman Rhetorician who studied in his Institution Oratoria on how gesture can be used on rhetorical discourses. One of his greatest works and foundation for communication was the "Institutio Oratoria" where he explains his observations and nature of different oratories. A study done in 1644, by John Bulwer an English physician and early Baconian natural philosopher wrote five works exploring human communications pertaining to gestures. Bulwer analyzed dozens of gestures and a provided a guide under his book named Chirologia which focused on hand gestures. In the 19th century, Andrea De Jorio an Italian antiquarian, a considered a of research about body language published an extensive account of gesture expressions. Andrew N. Meltzoff an American psychologist conducted who's internationally renown on infant and child development conducted a study in 1977 on the imitation of facial and manual gestures by new born.
The study concluded that "infants between 12 and 21 days of age can imitate the facial and manual gestures of parents". In 1992, David Mcneill a professor of linguistics and psychology at the University of Chicago wrote a book based on his ten years of research and concluded that "gestures do not form a part of what is said, but have an impact on thought itself." Meltzoff argues that gestures directly transfer thoughts into visible forms, showing that ideas and language cannot always be express. A peer-reviewed journal Gesture has been published since 2001, was founded by Adam Kendon and Cornelia Müller; the International Society for Gesture Studies was founded in 2002. Gesture has been taken up by researchers in the field of dance studies and performance studies in ways that emphasize the ways they are culturally and contextually inflected. Performance scholar, Carrie Noland, describes gestures as "learned techniques of the body" and stresses the way gestures are embodied corporeal forms of cultural communication.
But rather than just residing within one cultural context, she describes how gesture migrate across bodies and locations to create new cultural meanings and associations. She posits how they might function as a form of "resistance to homogenization" because they are so dependent on the specification of the bodies that perform them. Gesture has been taken up within queer theory, ethnic studies and their intersections in performance studies, as a way to think about how the moving body gains social meaning. José Esteban Muñoz uses the idea of gesture to mark a kind of refusal of finitude and certainty and links gesture to his ideas of ephemera. Muñoz draws on the African-American dancer and drag queen performer Kevin Aviance to articulate his interest not in what queer gestures might mean, but what they might perform. Juana María Rodríguez borrows ideas of phenomenology and draws on Noland and Muñoz to investigate how gesture functions in queer sexual practices as a way to rewrite gender and negotiate power relations.
She connects gesture to Giorgio Agamben's idea of "means without ends" to think about political projects of social justice that are incomplete and legibile within culturally and defined spheres of meaning. Within the field of linguistics, the most hotly contested aspect of gesture revolves around the subcategory of Lexical or Iconic Co-Speech Gestures. Adam Kendon was the first linguist to hypothesize on their purpose when he argued that Lexical gestures do work to amplify or modulate the lexico-semantic content of the verbal speech with which they co-occur. However, since the late 1990s, most research has revolved around the contrasting hypothesis that Lexical gestures serve a cognitive purpose in aiding the process of speech production; as of 2012, there is research to suggest that Lexical Gesture does indeed serve a communicative purpose and cognitive only secondary, but in the realm of socio-pragmatic communication, rather than lexico-semantic modification. Humans have the ability to communicate through language, but they can express through gestures.
In particular, gestures can be transmitted through movements of body parts and body expressions. Researchers Goldin Meadow and Brentari D. conducted research in 2015 and concluded that communicating through sign language is no different from spoken language. The first way to distinguish between categories of gesture is to differentiate between communicative gesture and informative gesture. While most gestures can be defined as happening during the course of spoken utterances, the informative-communicative