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?

Strategies and tasks for people with Dementia or Alzheimers

This is my next installment in the series of cognitive therapy task ideas taken in part from a student project by Janelle Barrett). Have you read my ideas for Orientation therapy tasks HERE, Left Attention and Left Neglect HERE, Memory HERE, and Attention HERE.

Without further ado, I give you all the dementia treatment ideas I could think of today:

• Make a personalized memory book
• Include information about the patient themselves, what they like, their age, etc.
• Include photos of the family, the home, etc.
• Example: 
• Page 1: My page
• Consider including name, address, birthday...
• Page 2: My parents
• Page 3: My wife
• Page 4-7?: My kids
• Page 8: My grandkids
• Page 9: My dogs
• Page 10: My house
• Page 11-14: My history
• Page 15: My hobbies

 *I should add here that one of my old students- Melissa Kirby from a few years ago, made me an AWESOME example memory book to show to patients and families and to help them create their own.  It's been really nice to have an example to show them isntead of just explaining it.  It usually helps them spark other ideas.  I try to have them start working on it right away and get it done early so we can use it in therapy before the patient discharges.  
 

• Reminiscence therapy
• Spaced Retreival
• Have patient write out steps for specific tasks (ie. taking medications)--place around patient’s room
• Place labels around the room where certain objects should be kept (ie toothbrush, keys, shoes, etc.).
• Family training for use of strategies
• Creating a daily schedule - teaching family how to assist patient with it daily.
• Create a daily log notebook or a journal.  Have patient and family contribute daily.
• Research shows that in patients with dementia, the brain is still capable of new learning, so cognitive tasks and cognitive stimulation continue to be beneficial.
• Place orientation information around the room
• A (large-print) calendar 
• Photos of family and even staff if appropriate
• A note on the mirror (or in a location that will be most helpful) to help with confusion in the morning, for example.
• This depends on the patient's needs, but could include something about who they are, where they are, where to find the information they need, etc. 

Other helpful tips:

• Familiar music can be comforting
• Staying active and going for walks is good too!
• Keeping a calm positive therapy atmosphere

 So what do you do for patients with dementia?  Many of you may have MUCH more experience with this population than I do!  

Tasks Ideas for Visual attention, Left Neglect/Inattention

Portions of Janelle Barrett's student project continued...

Visual Inattention or Visual Neglect are such a bizarre phenomenon.  I remember when I was a beginner clinician and saw my first patient with left neglect.  It was hard to wrap my head around the fact that it's not a VISUAL problem.  The patient absolutely could not see things on the left, only because they were "not looking."  Totally blew my mind as I watched the patient struggle to find my eyes, bang into the wall on the left, and eat only the food on the right side of his plate.  The patient was just as baffled as I was (I mean, I had learned about this in school, but seeing it in real life was so wacky!)  Of course, left neglect is most common, but despite those non-believers, I HAVE seen true right-sided inattention or neglect as well!

People seem to make relatively quick progress in this area if they work really hard on it.

There has been some argument about whether or not the word "neglect" is truly correct, versus inattention, etc.  Call it what you want- but how do you attack it.  Here are some ideas from a few SLPs and SLP students.  The high- and low-level are all mixed together.  What about your ideas?  Leave me a comment!

Image courtesy of: cognitiveneuro.wordpress.com

• Of course I always sit to the patient's neglected side, and try to ask them to look at me all throughout the session.  
• I also ask staff and family to always sit to the neglected side
• I have their TV put on the left, or shift the bed around if needed so that they are looking to the left
• A couple of my patients have loved looking out their window or out into the hallway, so I have had the bed switched around so those things are on the left. 
• I will literally hold the patient's head to the left in severe cases (where they cannot sustain a left sided turn of the head and they instantly "sprinkler" back to the right or non-nelgected side).
• I put all therapy tasks on the neglected side (if the patient can do it)
• Cancellation and cross out tasks 
• For really severe cases this can be as simple as having two pictures on a page and having the patient find the one on the left
• Letter cancellation tasks (large or small print, full or part-page)
• Symbol cancellation can be even tougher.
• I think it's important to make sure the patient goes line by line, left to right. No jumping around.  That will not help them with reading in the future.
• Reading tasks
• Newspapers, magazine articles, large print if needed
• Can use colored line on side of neglect or inattention if needed
• Can use colored index card to follow lines of writing
• I usually have them follow along with their finger
• Can also number the lines if needed 
• My co-worker has patient follow along as she reads
• Writing tasks
• Keyboarding/typing tasks
• Web navigation
• Google searches
• Email
• Reading and typing
• Apps: 
• Dr. Ben
• Doodle Pro
• Little Things
• Reading and typing tasks on iPad
• Games: 
• Memory or concentration 
• Cooking tasks: keep necessary items on side of neglect
• Visual search tasks 
• Find all the similar symbols
• Where's Waldo
• I Spy 
• Fruit Ninja
• "Oops, you missed that bomb. It must have been on the left side!"
• Going for a walk or an outing 
• I'll have them look for things on the neglected side
• Post-its or pictures on the wall
• Hidden clues 
• Ask about details in the pictures on the wall, etc.
• Sometimes we place obstacles on the neglected side
  

• Having the patient read and follow a map
• We have really liked some of the tasks and worksheets in the book Focus on Function (among many other great cog books) and have used everything from check writing, to maps, to filling out forms, to reading a TV guide from this book.  
• Hide things in the drawers of the room (on the left side of the drawer (e.g., Where's your chap-stick?).
• Some of the Lumosity games are great (we have a staff log-in we can all use which has worked well.
• Tic-tac-toe
• Mazes
• There is a task we like that is hard to describe- it has a poem at the top, and then the poem below with many similar and extraneous words throughout.  We have the patient circle the correct words as they read along.  In the end you have the poem in order once again.
• Kitchen tasks 
• Have the patient find the ingredients or utensils they will need
• Have them search for safety problems (my OT co-worker sets up an awesome room full of hazards, including cords ready to trip someone, running water, a burner left on, a knife placed precariously, etc.) 

 Happy Left-Scanning!

Kristin

Therapy Task Ideas for Orientation

This post is a continuation of the series of cognitive therapy ideas taken from a student project by Janelle Barrett (who is not a student anymore!). These are ideas gathered from several SLPs and students.  Comment and let us know what you do for orientation!

• O-Log worksheet.  Do this before showing them their calendar and memory aides. (This is a standardized little task with 10 questions.  They are worth up to 3 points per question for a total of 30 points.  Practice "calendaring"
• Have the pt. fill out a blank calendar (numbering the days, labeling the month)
• Have the pt. cross out days that have past
• Write all holidays and important upcoming family events and birthdays
• Write all significant hospital-related days (surgeries, accidents, date of admission to Rehab, discharge date, last day of therapies, etc.)
• Have the patient answer questions (e.g., "According to your calendar, how long have you been here in the hospital?  In Rehab?  How much longer will you be here?  How long until the next holiday?  How long will your total Rehab stay be?") 
• Jot down up-coming appointments or to-do's (e.g., Write a birthday note to Julie before Friday.)
• I like to use a small post-it sticky on "today's date" if the patient is struggling each day to find it.  Each morning we practice moving the sticky and crossing off the previous day.
• Discuss different ways to find orientation info (environmental cues, calendars, newspapers, etc.)
• Have the patient go on a walk and find ways to answer orientation questions (Where are we?  Where could you go to find the answer?)
• Have a daily log book
• Have them write down what the patient did each session, who was there, any other significant events, visitors, the patient's thoughts and feelings.
• Have the patient review past entries each day to remind them of what's going on and who has been around.  
• Practice day planner use, including to-dos, etc. 
• Or for tech-savvy patients and teens, we work on electronic planners, calendar apps, etc.
• Practice using alarms (cell phone alarm to remind them to take pills, etc.)
• I'll put an enormous poster-sized calendar or orientation poster at bedside if needed.  Sometimes I'll have the patient put it together with me as part of therapy.

What other comments do you have?  Leave me some fresh ideas in your comments!