How can I improve my Expressive Aphasia?
Tips for Understanding word-retrieval when it affects writing, plus worksheets & resources for home treatment.
Written language refers to the ability to communicate in text. It does not mean being able to use a pen or pencil. My focus here is the language, not manipulating a pencil. To make it clearer, we'll refer to Writing as Spelling because they could type, choose a letter from a list, slide scrabble tiles around, etc. Some common diagnoses are Agraphia or Dysgraphia.
MoreSpeech.com for Writing Treatment
Writing Exercise with Spelling Hint
- Before you try to evaluate their Writing ability, you should first confirm they can read at the word-level. (View How to Evaluate Reading)
- Figure out easiest way for them to spell. You might do this with Writing Letters, below.
- Writing the letters. (This is the hardest because they have to manipulate the pencil/pen and remember what the letters look like.
- Choosing letters from a list.
- Sliding alphabet tiles around. Scrabble tiles are great for this. This gives them the most independence, especially if they are slow.
- "Copying" a word (by moving/choosing from a list of letters)
- Give them a word.
- Give them some alphabet tiles (scrabble times work great for this).
- At the easiest level, you give them just the letters for that word, but scrambled.
- At harder levels, you give them more letters, up to the full alphabet.
- Write letters
- Show them a, b, e, f, g and have them write : A, B, E, F
- Spelling word for picture
Show them a photo and have them spell the word for the photo. You can use the printable Worksheets below for this or you can use the Writing exercises in MoreSpeech.com
- Give them the correct letters, but scrambled. ( for apple: elpap, etc.), if they can do that, then for the next one try:
- Give them the letters for the word plus some extra unnecessary letters (what therapists call Foils). If they do OK with that, keep adding more foil letters. Eventually, just give them all the scrabble tiles.
- When done, ask (very neutrally) if they are confident of the word (almost as if you are not certain. You don't want them to think they got it right or wrong. You want them to decide.)
- Sentence
Same as Spelling the word, but use complex photos (a man throwing a ball, instead of just a photo of a ball or a man)
- Written Picture Naming
- Written Sentence Completion
- A few photos for Written Sentence Construction. These are from Sights'n Sounds 2 (part of our Monthly Subscription).
Have them write a complete sentence describing each of these.
The more effective alternative to Worksheets
Worksheets are a fine place to
start, unfortunately, there is no research that worksheets alone are effective (that was confirmed for me by researcher (Dept head of a Speech Pathology University program). They are better if the caregiver (or therapist)
works with the survivor while they are using them, so that the survivor can work at a challenging level without frustration. When the survivor is frustrated, the helper provides cueing.
Specific Problems:
- Many survivors are embarrassed by failing in front of someone, especially a family member. But they must to work at a challenging level for it to be effective.
- Survivors often don't work well with family members (partially due to the failure issue above, and because of relationship dynamics. (You keep telling me what to do).
- Helping is hard to master. It takes enormous patience to provide only the hints/cues that the survivor needs. Provide too much and they'll get angry (you robbed them of the chance to be correct). Provide too little, and they get frustrated... and angry. Speech Pathologists get spend years on these skills. It's difficult to pickup in just a few hours, weeks, or even months
However, the research shows that treatment software is effective when it's specially designed speech & language software.
Survivors often prefer working independently with treatment software because:
- They work at their speed and on their schedule.
- They can work in private, where no one can see them fail.
- They get cueing (hints) automatically, so it's frustration-free.
- They gain control over the very thing that has robbed them of freedom: their speech & language.
Once upon a time there was a speech therapist who realized her patients
needed more therapy than insurance was providing. So she asked her
husband, a software engineer if he could help. So he created
interactive treatment software for her to use at work.
And her patients loved it. So did other therapists. So they made it
available to everyone and he worked full time creating even more programs.
I am that software engineer. And I continue to
work on that software today. It's used in the top Rehab Hospitals and all
around the world.
A few years ago we collaborated with Dr. Richard Katz and produced a web-based program for speech therapy: MoreSpeech.com which provides unlimited practice for all areas of speech & language, including writing. You can create a free account and try the Writing Skills.
Independent Writing Treatment
MoreSpeech.com provides unlimited practice for all areas of speech & language, including writing. You can create a free account and try it out.
Try MoreSpeech.com (claim your free account)