Review of new product- the Forbrain

I got the opportunity to try a product from Europe called Forbrain.

First of all the company has been so great to work with and so dedicated to their product.  They were also patient with me as I took an ETERNITY to write this review! 
The Fobrain offers auditory feedback via bone conduction!  They call it an "enhanced audio vocal loop."  It's supposed to increase your sound encoding skills.  They say it can improve your comprehension of the info you read aloud, it can help your attention to the task, your encoding it into memory, and your improved speech and voice as you listen to yourself, among other things.  Basically, while you're speaking, you can hear what you're saying more loudly and intensely as it comes back to you.  The "speaker" part of the device rests in front of your ears right on your bones and the sound is vibrated through to your ears.  The company suggested I try it out with patients working on voice, motor speech, and cognition.

I tried the device on myself first, and did some reading out loud. I could definitely hear my speech coming back to me loud and clear, and I could feel the vibrations in my bones. I immediately thought this would be great for those patients with voice issues or dysarthria who are less aware of their speech problems, or who have a hard time hearing the subtle things we are asking them to listen for. Even artic problems could benefit I'm guessing.

Of course, after wearing it myself and doing some reading, it's very hard for me to judged accurately whether or not it improved my attention and memory, etc.  There are some clinical trials going on in Europe right now to test those things.  It will be interesting to see the results.  If the company can still stand to work with me after me being so slow and annoying, I'll keep you posted.  :)

I then tried the device with several of my patients, since it is obviously not harmful, and since any additional potential help to my dysarthria and voice therapy skills is welcome. My patients have all commented that the device is comfortable, seems to be helping.  I did notice with two particularly quiet and dysarthiric patients, their speech did seem to improve mildly after placement of the device.  I think I will hang onto it and continue to use it with patients who need a little something more than traditional tx, or who are not responding to my cues well.  I tried it with a couple of patients working on memory and attention, and again, they said the device seemed helpful in staying on task and remembering what they were reading. Again, I don't see why this couldn't be used by me experimentally to help give patients a "boost."

Several of my colleagues are considering using the device experimentally, and we even considered doing a simple research project and presenting a poster at ASHA.  This could be a future research project!

In conclusion, I think the deice has some great potential.  I love to try to things, and will continue to use it with dysarthria and voice patients who need more help with listening, perceptual skills, changing subtle thinks in their speech, resonance, voice, etc.  And I'll be watching for the results of these trials in Europe.  If you are interested in the device, you can leave a comment below and I'll ask my contact person if they would like to contact you for beta testing, reviewing, research, or purchasing. I don't know if they are currently available for purchase in the US. 

Orientation and calendar task

Ohhh my goodness, I have not blogged in an eternity!!  Sorry.  I had a baby and life got too crazy.  She is an adorable baby!!!  I'll post pictures.  In the mean time, here's a little orientation task I just created since working on orientation can feel kinda...repetitive and boring.  :)

Orientation and calendaring exercise for Inpatient Rehab

• Number each day in this month
• Place a small post-it on today’s square.
• Write the word “today” on the post-it. 
• Are there any holidays (or family birthdays) this month- fill them out.
• What events or appointments are coming this week?  Point to them or fill them in.
• Which is the first day of the week this month?
• Count how many days from today to the end of the month.
• How many Sundays are there in this month?
• On which day of the week does the 14^th fall?
• Which day did you arrive in Rehab?
• How many days have you been here?
• Which day will you be leaving?
• How many days until you discharge?
• How many days (total) will you have been in Rehab by the time of your discharge?
• What season(s) is/are this month? (summer, fall, winter, spring)

For home

Each day:

• Ask a family member or caregiver to join you in doing your orientation exercise. 
• Try to say the date without looking at the calendar.
• Move the “Today” post it forward one day.
• Say the date now, looking at the calendar. 
• Cross of the previous day (all days that have passed should be crossed off).
• Look at upcoming appointments/events.
• Write any to-dos, appointments, events that you learn about today.
• Make any preparations you need to make for those events (e.g., if there is a family birthday tomorrow, do you need to get a gift or card?  If there is a therapy appointment this morning, do you need to shower, dress, etc.?)
• Say the date without looking at the calendar.

Therapy task ideas for working on impulsivity and other pragmatic deficit areas

Dear fellow SLPs,

To me, this is the hardest area to target.  When a patient is impulsive, they are often both unaware of it, and not receptive to education and training in this area.  

Common patient reactions to pragmatic therapy:

Yes, it's easy to want to shy away from taking the bull by the horns and addressing these things, but...

 I have a few commonly used phrases when talking to patients about these potentially sensitive areas.  I often say something like this:

          "One of the things I watch for closely during my evaluation are subtle social changes in patients' behavior which can be very common after [an injury like yours].  Many times these are things that can go unnoticed, or even ignored.  I would like to be very frank with you when and if I ever notice these things in you- if you are open to my feedback."

          At this point the patient usually says they are very open to any feedback and frankness.

I then say something along these lines:

         "Let's talk about the most common social and behavioral changes that go along with [this type of 'injury"] and some of the things I have noticed during our evaluation/interactions.  And any time in therapy when I notice these things, I will very frankly point them out.  I don't want to make you feel embarrassed- in fact you shouldn't!  This is why we are here.  And I always say, 'No one is going to be honest with you like you speech therapist is," at least with regard to these subtle social things.  Actually, people will often feel uncomfortable bringing them up with you, so I would rather we discuss it all openly while you're here so you are aware and you can start using strategies and techniques to help you when you interact with others, go back to work, etc."

This tends to create more openness and at least provides a way for me to point out behaviors as they occur.  

Can you add anything to this list below?  Does anyone else have any great materials for working on this area?  Leave your comments below- I would love to hear from you!

Here are all the ideas I could think of today, plus a couple from my fellow SLPs.  What else can you add?

Tasks for pragmatic/social skill areas such as:  Self-Awareness, Self-Monitoring, Self-Regulation, Impulse Control, Disinhibition:

·  Video the patient and have him analyze his behavior/performance

·  Have the patient list his deficits/goals

·  Have the patient predict how they WILL perform on a given task, and then assess how they DID perform afterward (scale of 1-10 or percentage).  

·  Have the pt. take data for themselves

·  Practice social role-plays

·  Give scenarios of “wrong” behavior and have them identify it and propose a solution

·  Descriptions of self (“What motivates me?”, “What do I imagine myself doing in a year from now?”, “What are things I like to do?”)

·  Social interaction role-plays including discussion of compensatory strategies and behaviors

·  Role play job interview questions (i.e., “What is your greatest strength?”) (There are good example is this workbook-- Focus on Function p. 299)

·  Develop tactile cue system for patients with tangential conversation to let them know they have been talking too long/off topic

·  Before starting any task, ask the patient how they think they will perform.  Discuss any differences in expected vs. real performance

Apps: 

·  Moron Test (if you're too impulsive, you'll mess up!)

·  Doodle Pro

What else, SLPs?  Add your ideas in the comments below!

Convergent Thinking Speech Therapy Task Ideas

Here's my next cognitive area in this series of posts adapted from my old student Janelle Barret's  "student project." Convergent thinking tasks! 

First of all, to better understand Convergent Thinking (CT), read my previous post HERE on the differences between CT and DT (Divergent Thinking).  It can be a tricky topic to understand in some ways.

Still having trouble understanding the differences?  Here are a couple of simple posts and quizzes I found on a blog about teaching children.

• http://imaginationsoup.net/2012/01/quiz-yourself-examples-of-divergent-and-convergent-thinking/
• http://imaginationsoup.net/2012/01/chimera-vs-stickman-the-difference-between-convergent-and-divergent-thinking/
• http://education-portal.com/academy/lesson/creativity-and-divergent-thinking.html#lesson
• http://chriscorrigan.com/parkinglot/?p=1265
• http://mrsaley.edu.glogster.com/divergent-and-convergent-thinking/
• Linear thinking, or convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.
• Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.
• - See more at: http://imaginationsoup.net/2012/01/quiz-yourself-examples-of-divergent-and-convergent-thinking/#sthash.rSdTZJ2c.dpuf
• http://bouncingideas.wordpress.com/2011/09/02/when-to-let-go/
• http://www.bing.com/images/search?q=divergent+thinking&FORM=HDRSC2&id=C11770466133B1ACFA59DA365BE002DAF3F7E1F1&selectedIndex=126#view=detail&id=C11770466133B1ACFA59DA365BE002DAF3F7E1F1&selectedIndex=0
• http://www.thinkingdimensionsglobal.com/problem-solving-through-divergent-and-convergent-thinking/
• A Test of DT: Break Point and Beyond

And without further ado:

Convergent Thinking Therapy Task Ideas:

• Identifying the “best” solution to a problem
• Given 4-5 examples, have patient name the category they belong to
• Basically any task with a SINGLE correct target answer.  General information questions, naming a target word based on a description.
• Name similarities between 2 items (this is an interesting cross between CT and DT!)
• Elimination tasks (which of these is not like the other?). WALC 2 has some good ones.
• List several foods with one ingredient in common- have the patient name the common ingredient (e.g., eggs, sugar, meat, etc.)
• Games and Apps:
• 20 Questions
• Riddles
• Crossword puzzle apps
• Analogies for Kids app
• Giving clues for figuring out the described object
• Taking several pieces of information and then making the best educated decision
• Following Directions tasks of all kinds (verbal, written, etc.).  Yes- this is convergent thinking too!
• Category and first letter grids (animal that beings with "O")
• Crossword puzzles

What do you do to target convergent thinking? 

Leave us a comment below!

Speech Therapy Task Ideas for Divergent Thinking

Here's my next cognitive area in this series of posts adapted from my old student Janelle Barret's project. This blog post was an exercise in divergent thinking! Ha ha ha. It took me a lot of work, so I hope you enjoy!

Not all of these tasks are as strictly divergent thinking as others, but for lack of a more specific category (or post) I am going to lump them in together. Don't forget to comment and add your own ideas!

What exactly is Divergent Thinking or DT 

(aka: lateral thinking)?

How is it different from Convergent Thinking 

(aka: linear thinking)??

With many questions and problem-solving scenarios in life, we start with DT to create ideas, options, possible solutions, more questions, more ways of LOOKING at or interpreting the problem or question...
Then we use Convergent Thinking to make the actual choices and decisions.  DT is not the same as Creative Thinking, but is required for creative thinking!  (Convergent thinking typically involves situations in which there is ONE right answer or one right way of doing things.  Learning facts, and following directions also fall under the umbrella of convergent thinking.)
Do you have a hard time remembering which is which?  With divergent thinking you take a question and DIVERGE into many thoughts and possibilities.  Or a good memory association is that you have to "dive in" and think of various possibilities.  

Linear thinking, or convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.

Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.

- See more at: http://imaginationsoup.net/2012/01/quiz-yourself-examples-of-divergent-and-convergent-thinking/#sthash.rSdTZJ2c.dpuf

Linear thinking, or convergent thinking, is about learning facts, follow instructions, and solving problems with one right answer.

Divergent thinking is generating unique solutions and seeing various possibilities in response to questions and problems.

- See more at: http://imaginationsoup.net/2012/01/quiz-yourself-examples-of-divergent-and-convergent-thinking/#sthash.rSdTZJ2c.dpuf

Divergent Thinking Task Ideas:

• List of 4-5 words: which does not belong? (i.e., dog, cat, bowl, bird, fish) 
•  Catch phrase: describe a word without saying it 
•  Multiple definitions of a word, WALC 
• Apps and Games:
• Tetris
• Jumbline 2 (very addictive!) :)
• Boggle 
• Goo
• Multiple/non-traditional uses of an object 
• I encourage extreme creativity here - a paperclip can be twisted into different shapes and each of those shapes can do various things.  A paperclip could also be enormous and become an artistic sculpture in the park, or a heavy anchor for a ship)
• Sorting task 
• Name several words in a given category, or do Brainstorming tasks
• WALC 2
•  Can get really abstract and creative for patients who need more difficulty tasks (my hubby, Matt came up with all of the following!  Nice job, Babe.)
• Ways to wake someone up in the morning)
• Name a cooking ingredient and name all the dishes that can be made with it
• Name a body part or muscle and name all the uses you can think of
• Name a significant number and have them name all the ways that make that number significant (e.g., 3.  Three's a crowd, three's company, a trilogy, Goldilocks and the 3 bears, the 3 little pigs, 3 strikes and your out...etc.) (10 ones make $10 10 tens make $100, based 10 numbering system, 10 fing4rs, then toes, count down from 10 when a rocket is launching, etc.) 42: 4/2 = 2 Jackie Robinson's number, both even numbers)
• Name a color and have the patient tell you as many things of that color as they can think of.
• Give the patient a word and ask them to think of all the songs with that word in it (e.g., love, baby, tonight, stars, heart, sleep, can't).
• Etc! 
• Categorize a list of words into sub-groups
• Take a list of things that are all related to each other in different ways.  Have the patient organize that list in as many types of organizational ways they can thing of
• E.g., take a list of flowers and have them organize it by:  color, look of the petals, alphabetically, number of letters, vowels, etc, etc,
• Mind mapping
• Journaling
• List-making
• Take a word
• Give the definition
• Homonym
• Synonym
• Antonym
• Examples
• Break down a word or idea
• What is it for?
• How valuable is it/
• How is it used?
• When is it used?
• Who would use it?
• Where?
• Etc.
• Breaking down a task
• Simple
• Planning a trip
• Planning a meal
• Plannning a party 
• How to catch a fish
• Make a paper airplane
• Do your makeup
• Tie a tie or tie your shoes
•  More Complex 
• How to write an essay (and I'll have them actually write one, especially if they areplanning to return to school)
• How to make a Powerpoint (if they are familiar witht his.  Again, If they do this for work, I will have them actually prepare one)
• For that matter (Lawyer- prepare a case or argument, etc.)

Comment below- what do you do to target DT with your patients?