Therapy post

February 10, 2014

8:30-9:20 am

We started with the objective of working memory. The client was given 6 words to read and recall after another task later. The words were planning, working, thinking, writing, reading, and resting. I wonder how they were chosen or if there was a reason they were chosen. He had a difficult time remembering any of them on his own, and with cuing recalled the words planning, reading, and writing. I wondered if he knew the meaning of some of the words, which would affect his working memory because we remember information based on meaning. He kept saying “planting” for “planning” and that affected the rest of his memory because he also said “garden” and “tomato.” It might be a good idea to ask what the words mean as he is reading them for the first time. I am not sure what the purpose of the activity is though, and that would affect the way we do it.

We continued with inferences and assumptions, word retrieval, article practice, and pragmatics practice. During inferences and assumptions, the client was presented with a picture card and told to look at it for a minute. The card was taken away and the clinician asked questions that were already prepared about that picture. There were also inference cards (words and pictures) where the client would have to read a short paragraph and infer things about where they were, what they were doing, and how they felt while doing it. The questions were informal and conversational, and the client appeared to have no problem doing such

Compound words and spontaneous recall prove to be more difficult. After the client was asked to tell the clinician as many compound words as he could remember, he struggled with the task, pausing initially and saying words like “cedar,” “barbeque,” and “apple pie.” He was cued and given the example “mailbox” and then came up with words like “snowball,” “snowman,” “snow bear,” and “ice cream” before admitting that he was thinking of winter words. It’s funny how the brain works and I wonder if he knows what a compound word is or if he was counting syllables.

The article worksheet proved to be too difficult a task when read orally. It wasn’t until the clinician gave the worksheet to the client that he was able to successfully complete the task of identifying the article and replacing it with the correct one if it is wrong. He seemed to do well with identifying, and fairly well with replacing except on the tricky ones like “the airport” and “a security line.”

Pragmatics proved as well to be a difficult task. The client was given scenarios where he had to choose the best response out of four. “You are meeting a friend for coffee and he is two minutes late. What do you do?” A. Tell him to fix his watch, B. Tell him that he is late, C. Don’t worry about it, and D. Greet him and ask how he is doing. Immediately he wanted to tell him he was late. It took quite a bit of convincing from the clinician to convince him otherwise if he was even convinced. Pragmatics seems to be an area to work with.