MORE Memory Therapy Task Ideas

 Memory troubles are just the worst!

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!).  I know I have posted about memory task ideas here and here in the past.  This post just has more!  These are ideas gathered from several SLPs and students.  Comment and let us know what you do for memory!

(The cat realizes she left something in the oven.)

• Functional Strategies
• Associations
• Chunking
• Calendars
• Visual Memory/Mental Imagery
• Use of Alarms
• Writing things down in a planner or notebook
• Daily log
• Daily checklist
• Mnemonics
• Visual reminders
• Post-its
• Written instructions to-self
• Rehearsal
• Tasks
• 3 Facts
• Prospective memory: ask them to initiate telling them to you at a specified time.
• Have them make up a memory strategy to remember each
• Word list retention
• The Simon Game app (there are several variations/apps like this)
• Recalling 4 categories as they go through a 4x4 categorization matrix
• The “Help for Memory” book is great
• Study a picture 1-2 minutes, then recall all they can.  THEN think of a strategy to remember them better and practice again or change pictures
• Flick Flag app (First we study the flags under the instructions.  I have them come up with a good association strategy for remembering each flag- the more creative the better.  Great for learning to make memory tricks and associations.)
• Hide 3-4 objects around the room (good for non-verbal patients)
• Have them remember a hand shake combo (also good for non-verbal patients)
• Apps with “concentration” game
• Practice strategies for remembering faces or photo cards
• Practice strategies for memorizing state abbreviations
• Chunking word lists (Help for Memory p. 52)
• Using visualization to remember information (Help for Memory p. 101)
• Taking notes from material presented out loud (Help for Memory p. 103)
• Associate visual objects (The Source for Memory Exercises p. 81, 83)
• Mental Manipulation - read patient 3 words, have pt. say them back in alphabetical/chronological/reverse order (ie. “October, April, February” → “February, April, October”)
• Visual Memory: Have the patient use a chunking strategy to recall 12 pictures (The Source for Memory Exercises p. 152, 153)
• Identifying “key” information: Read sentence to patient, have patient identify key words to simplify encoding. (Help for Memory p. 21)
• Repeat list of 3-6 words, then ask pt. to identify which items have certain attributes (e.g., which are animals, which are the softest, etc.)
• Cog-log worksheet (more difficult than it's famous sister worksheet- the O-log)
• WALC 10 workbook is great.
• Practice using day planner or electronic day planner (calendar app)
• Alternating card task: I show them one word or picture card (e.g., fork) and then another (e.g., ball) and have them say the previous card (fork).  We continue until they get lost.  I have found that ~11 is typical for my non-impaired co-workers.  Some people can go an even longer time!
• Mental math with no writing things down
• Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson - See more at: http://pathologicallyspeaking.blogspot.com/2013/05/email-slp-q.html#sthash.0EaYqvrC.dpuf
   Book: "Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson.
  "Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson - See more at: http://pathologicallyspeaking.blogspot.com/2013/05/email-slp-q.html#sthash.Ec7dO5e9.dpuf

Hope you got some new fodder for your sessions tomorrow.  :)   

Don't forget to comment- 

I need some fresh ideas!  

What do you use for working on memory deficits?

-Kristin

Review of Sanapsis app for People with Aphasia and Cognitive Deficits

I was recently given the opportunity to try out the Sanapsis app.  The app has picture naming cards, verb photo cards, cards to prompt questions and descriptions, sentence-building/unscrambling tasks, etc.  I want to tell you some of the exercises I think will be helpful to use with my aphasic patients.

Sanapsis App

My favorites:
Giving Instructions-- This is a unique task I haven't found in many other language apps.  It gives prompts such as, "Give instructions on how to give a dog a bath."  I get tired of picture and object description tasks for sentence and conversation elicitation.  This is new, and having it on a tablet device or smart phone seems to spice things up a bit in therapy as well.

Retell a Story-- I thought this was great, because every story contains humor in the punchline, and would allow for me to assess humor, abstract language skills, inferencing abilities in patients with higher-level cognitive deficits.  I will definitely be using this with some of my R CVA patients who need practice understanding subtleties.  Not to mention, it's a great memory exercise!

Organize a sentence-- This one (pictured above) requires the patient to put the sentence back in the correct order.  Some would be pretty tough for my aphasic patients, but could work really well for some of the cognitively-impaired patients who need to work on sequencing, or cognitive organization. 

It was obvious that some of the naming and description pictures and word choices were more European/UK, but it could make for interesting responses from the patients and provide an opportunity for them to take initiative (e.g., "I don't really know what that is!  Is it some sort of tool?") 

The app is about to come out with a new update including edits and many more pictures (they tell me it will have over 200 more words, and over 5000 more pictures).  They were also really great about wanting my feedback and suggestions.  Check it out at the app store!  (Not yet available at the Google Play Store.)

Kristin

More Short-Term Memory Therapy Ideas

Thanks for your comments and requests.  Sounds like a couple of you would like another post about memory task ideas.

Memory is one of my favorite things to work on with patients. I love teaching compensatory strategies. Maybe it's because I need them so badly for myself?

Image courtesy of: http://mainepi.org/ALZ/Cafes.html

I usually start out each session with a quick memory quiz (What did you have for breakfast?  What was you first therapy session this morning?  Who is your nurse?  What was for dinner last night?  What time did your wife leave/arrive?)  We also use the O-log and the Cog-Log protocols around here quite a bit.

Here are a couple of books I use a lot:

• WALC 10
• HELP for Memory
• The Source for Memory Exercises
• One of my blog commentators recommended: "Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson

Apps I like for short-term memory:

• Calendar App
• Flick Flag (I have the patient come up with a memory "trick" (association, elaboration, visualization, etc.) for each flag as we study them, then we play the game to see what they can remember.  It's great for learning how to come up with effective "tricks."
• Simon (remember this memory game from the 80's??  Love it.
• Brain Baseline has a couple of tasks for memory (and a lot of great tasks for improving processing speed!)

Much of the therapy focuses on compensatory strategy training.   
We practice using the tools they will use in their home: calendars, calendar apps, day planner, notebook, post-its, alarms, association "tricks"/mnemonics, elaboration, chinking, rehearsal, visualization...


Other fun tasks:

• Index cards with faces on one side and names on the back.  Again, we focus on associations to help remember the names (e.g., Nyla never likes to smile-a).  I make sure they are effective (e.g., she looks like another Allison I know) vs ineffective (Tyler starts with T, tooth starts with T-- Tyler has big teeth!  There are too many names that start with T.)  I also like to try it the first time with no strategies so that they can see what a difference the strategies make.

• Objects - I'll show a photo or drawing of several objects (or anything!  A magazine picture with a bunch of foods...).  I'll have them study it for 1-2 minutes and remember all they can.  Then we'll list them out.  Then I have them do it again with some strategies and associations (e.g., make up a story using the objects, or group them into meaningful categories).  THEN, I'll do yes no questions to see what they can remember (e.g., Was there a hammer?  Was there a beach ball?  Was there a shoe?).     

• Sometimes I'll read a story/article/bit of information and have them answer questions afterward.

• Prospective memory tasks:  Prospective memory involves remembering to do something at a certain time or in a certain situation.  Such as remembering to take a pill or feed your dog.  I will give the patient tasks to remember at a certain time.  This could be anything from remembering to hand my a paperclip every 5 minutes on the clock, to remembering to tell me the 3 facts I taught them about their favorite hobby (I pick facts they don't already know) at the beginning of our next therapy session.  Etc., etc.  There are a million ways to do this one.  I could go on and on but you get the idea.  They key here is that they try to initiate the task without my help.  If needed, we add compensatory strategies or reminders.

Image courtesy of http://cognitivepsyc.tripod.com/id10.html

Well, I could say more.  But I would LOVE to hear your ideas!  Do you have any to add?  Post them, por favor, in the comments below.

Until next time,

Kristin 

SLP Q&A's (from my email) Memory Therapy Task Ideas

Hi guys!

I get a lot of email questions from young SLPs.  I thought it might be fun to start posting their questions and my responses.  Feel free to add your own comments!

-Kristin

Hi Kristin,

I just graduated with my Masters in speech in May from the University of (withheld).  I'm now working for a hospital there where I was previously a student.  I mainly see inpatients, however my outpatient caseload is growing.  Ive been seeing one of my outpatients since I was a student and I was wondering if you had any tips for functional working memory therapy tasks that might spice up my therapy sessions.  Thank you for your time!  I am looking forward to any ideas/tips you may have!

Sincerely,

Haley S.

----------------------------------------
 Hi Haley,

Do you mind if I post your question on the blog?
Ummm, how about the following:

1)  I'll ask them to imagine a 4x4 matrix and I  name 4 letters and 4 categories.  (this is a high level task).
I'll have them mentally fill in the chart.  They have to remember the letters and categories on their own.  (E.g., for slot 1, they'd name an animal that starts with B)

2)  I'll ask them to listen to 3-5 words, and then repeat them back in alphabetical order

3)  Same task as #2, but repeat them back in reverse order

4)  Mental math problems where they have to remember the problem's elements as they work it out.

That's just a quick list.  I'm trying to be working memory-specific here.  I can think of a lot of other short term memory tasks I like (most of which focus on some aspect of compensatory strategy retraining).  Does this help?

Thanks for reading!

Kristin

***note:  Haley did agree to let me post her question.  :)
Can you add some more memory task ideas?  Also see my 2 other memory task posts!