Leslie Bilik-Thompson - Affiliated Rehab

[Pages:313]Leslie Bilik-Thompson

Skill Areas: Ages:

language, cognition, memory young adult/adult

LinguiSystems, Inc. 3100 4th Avenue East Moline, IL 61244

800-776-4332

FAX: 800-577-4555 E-mail: service@ Web:

Copyright ? 2004 LinguiSystems, Inc.

All of our products are copyrighted to protect the fine work of our authors. You may only copy the worksheets as needed for your own use with clients. Any other reproduction or distribution of the pages in this book is prohibited, including copying the entire book to use as another primary source or "master" copy.

Printed in the U.S.A.

ISBN 10: 0-7606-0522-X ISBN 13: 978-0-7606-0522-6

About the Author

Leslie Bilik-Thompson, M. A., CCC-SLP, earned her Master of Arts Degree in Speech Language Pathology at Indiana University in Bloomington, Indiana. She has worked as a speech-language pathologist in a wide variety of clinical settings, including intensive and acute care, rehabilitation, extended care hospitals, private practice, and home health care. WALC 6 is Leslie's first publication with LinguiSystems.

Dedication

It is with heartfelt sincerity that I dedicate this book to each and every client I have worked with, for they have taught me genuine lessons in courage, determination, human will, compassion, and individuality.

Acknowledgments

I would like to sincerely thank LinguiSystems, with appreciation to Lauri Whiskeyman, for making the publication of this book possible. I would also like to give special thanks to my first boss, Linda Norris-Morton, who truly valued "functional" speech language therapy, and who was always my number one advocate for the nontraditional activities I used during therapy in order to promote more meaningful and functional intervention for my clients. I would like to express special gratitude to Dr. S. M. Barlow, Ph.D., a distinguished scientist in the field of Communication Neuroscience Research, for his steadfast support and encouragement of my endeavors in the field of speech-language pathology and in life, for teaching me the great connection between science and therapy, and for always inspiring me to learn more. Lastly, I would like to thank my family for their love and for giving me extra long turns on the family computer in order to finish this book!

Illustrations by Marcy Ramsey and Margaret Warner Edited by Lauri Whiskeyman

Page Layout by Christine Buysse Cover Design by Mike Paustian

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Temporal Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Recognizing Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Understanding, Predicting, and Recalling Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Calendar Work. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Daily Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Spatial Orientation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Spatial Orientation Recall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Location and Direction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Maps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Nonverbal Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Gestures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Pantomime With or Without the Use of Objects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Expanded Pantomime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Oral Motor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Oral-Motor Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Specific Sound and Oral-Posture Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Verbal Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Verbal Phrase Completion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Word Recall from Descriptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Response to Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Rewording Illogical Sentences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Formulating Sentences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Synonyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Antonyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Dialogue Boxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Asking Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Speaking with Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Describing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Explaining Activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Role Playing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Personal Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Conversation?History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135

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Table of Contents, continued

Auditory Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Phonetic Word Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Semantic Word Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Comprehending Yes/No Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Following Auditory Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Listening to Illogical Sentences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Listening for Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Short Story?Multiple Paragraph Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 Understanding Humor In Short Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205

Reading Comprehension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Single Letter Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212 Letter Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Word Identification: Two-Word Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Word Discrimination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Word Identification: Sentence Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Sentence Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Following Written Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262 Short Sentence Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 Long Sentence Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270 Short Paragraph Comprehension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Functional Reading Comprehension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283

Written Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 Biographical Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298 Personal Interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 Writing Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303

Wordless Book List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306

Answer Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307

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Copyright ? 2004 LinguiSystems, Inc.

Introduction

The Workbook of Activities for Language and Cognition 6 (WALC 6) was developed to provide a comprehensive series of tasks and functional carryover activities allowing for integration of language and cognitive skills for neurologically-impaired adolescents and adults with diverse levels of functioning.

The activities in the following sections can be adapted for clients with a variety of functioning skill levels.

? Temporal Orientation Clients with neurological impairments often exhibit difficulty planning their days, understanding how long it takes to do something, using a calendar, and planning a schedule. The tasks in this section focus on recognizing, understanding, and using time concepts for everyday activities.

? Spatial Orientation Clients with damage to the non-dominant hemisphere can demonstrate decreased ability to localize objects in space and show diminished capacity to determine spatial orientation. This section includes tasks structured to target spatial awareness and visual awareness. These tasks can also be used to integrate memory, problem solving, verbal naming, and following written and oral directions.

? Nonverbal Communication The tasks in this section focus on developing strategies to facilitate nonverbal expressive communication for those clients who have lost the ability to produce speech or verbalize in a meaningful and effective manner. Specific gesture and pantomime exercises are included as well as activities for functional carryover and expansion of these skills.

? Oral Motor This section is designed for those clients who demonstrate dysarthria (a weakness or incoordination of the speech muscles) or verbal apraxia (an impairment in the sequencing of speech sounds). Specific oral-motor exercises are included, along with sound specific exercises, ranging from the single word level through the sentence level.

? Verbal Expression Verbal expression encompasses content (vocabulary concepts), form (how words are formed and linked into phrases/sentences), and use (what the speaker wants to get from using language). Many of the tasks in this section can be used two ways: you can either focus on one target area at a time (e.g., speech intelligibility or word finding) or you can integrate skills to focus on a number of target areas within the same task (e.g., speech intelligibility and word finding or speech intelligibility, word finding, and expressing emotions). The tasks are broken down to target a wide range of skill levels, ranging from the single word level through the structured and unstructured conversation levels.

? Auditory Comprehension Following neurological trauma, clients will often show deficits in understanding spoken language. The tasks in this section cover a wide and diverse range of receptive abilities, and provide for flexibility by using a continuum of skill levels. Exercises progress from single word comprehension and discrimination to comprehending and recalling multiple paragraph information. Attention and concentration, memory, reasoning, problem solving, and deduction can also be integrated in many of these exercises.

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Copyright ? 2004 LinguiSystems, Inc.

Introduction, continued

? Reading Comprehension Clients may have problems reading due to comprehension impairments, visual deficits, or both. It is important to determine which deficit is affecting a client's ability to read, and to target tasks accordingly. Tasks cover the isolated letter level all the way through the paragraph and functional reading level, with an incremented progression of reading comprehension and visual field awareness skills. These tasks can also be used to integrate cognitive skills, including attention, concentration, and memory.

? Written Expression When evaluating a client's ability to use written language, think about the underlying causes of the deficit. Impairments in vision, motor control, auditory and reading comprehension, and cognition can each play a role in a client's ability to write. Tasks may be broken down to more simplified levels in order to meet each client's individual needs and to allow for individual impairments.

For Auditory Comprehension and Reading Comprehension, you can vary the method of response based on the client's level of functioning (e.g., client points to or circles the target letter; client verbalizes, uses eye blinks, or makes another physical signal to indicate identification of the target letter as you point to it).

I recommend that you take a close look at the "Suggested target areas" within each section, and to always consider which target areas might be integrated to maximize the functionality of each task. In addition, I strongly encourage you to look at the "Functional Carryover Activity" sections throughout WALC 6, as I feel that making therapy individualized, functional, motivating, and meaningful is paramount to each client's potential and success.

It is my hope that you find the tasks in this book to be practical and effective. I also hope that the tasks stimulate the development of your own ideas for functional carryover activities to meet each of your client's individual needs.

Although many clients are diagnosed with the same "textbook" communication deficit, I urge you to remember that each client is unique and speech-language therapy should be adapted to meet each one's individuality. It was the unique qualities of my clients that prompted me to write WALC 6, and to them I am thankful and honored to have experienced speech, language, and cognitive rehabilitation with them.

Leslie

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Copyright ? 2004 LinguiSystems, Inc.

TEMPORAL ORIENTATION

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Copyright ? 2004 LinguiSystems, Inc.

Recognizing Time

Suggested target areas: temporal orientation, visual neglect and awareness, memory

Task 1: Construct a cardboard clock, draw clock faces on paper, use a clock with hands, or use a digital clock to help the client with time concepts. Set the clock or draw the hands at different times for the client to identify.

Task 2: Have the client set a clock to various times given verbally or written. Alter this task as needed (e.g., change the size of the clock, use different types of writing implements, use different kinds of clocks, verbal response vs. physical response), based on the client's visual, gross, and fine motor skills.

Functional Carryover Activities

? Practice setting an alarm clock for specific times. Set times for mock occasions such as waking up, eating lunch, catching a bus, watching a television show, walking the dog, etc.

? Throughout a therapy session, ask the client to tell you what time it is. Set up instances where people who are in daily contact with the client ask him what time it is.

Temporal Orientation WALC 6

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Copyright ? 2004 LinguiSystems, Inc.

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