Quick, Easy and Cheap Addition to an Aphasia Therapy Toolbox


Do you incorporate Anagram, Copy and Recall (ACT) into your aphasia sessions?  I’ve been meaning to get around to making this box of letters for ACT for weeks.  Organized, laminated letters just seems more sensible than cutting out letters for each session (my old habit!). If you already own a LARK kit (for the line drawings or photos) then this project takes 15 minutes.  If you don’t own a LARK kit then you will need pictures of line drawings or photos. I suppose that you could use Scrabble or Bananagrams letter tiles but I wanted the letters organized and faster to select. You’ll also need something to organize the letters in – I used a cheap tackle box.  Interested in the protocol for Anagram, Copy and Recall Therapy?  Refer to your aphasia diagnosis and treatment textbook, stroke and aphasia-related journals online or review some of the links below for brief but useful information/demonstrations.

Visual Demonstration of the Method

Quick Overview and Rationale

New Concepts in the Management of Aphasia: Practical Application – pages 14-16

photo 1-1 photo 2

Free Photo Cards Adult Speech Therapy


I created this bank of photo cards over the weekend for a patient with aphasia.  Family members often ask me for hands-on materials to take home for extra practice.  We spend a lot of time discussing ways to use functional objects in the home environment but an easy-to-grab stash of photo cards is always a useful and versatile tool.  Print these in color and laminate for durability and infection control.  Make 2+ copies to use in a group setting (Go Fish, etc.).  Happy printing!


Possible Uses:

– Constraint Induced Language Therapy Tasks

– Verbal Expression & Word Finding: Semantic Feature Analysis

– Reading Comprehension: Word Level

– Verbal Expression: Increase MLU

– Verbal Expression: Word Level Intelligibility

– Verbal Expression: Confrontational Naming

– Verbal Expression: Associations and Word Fluency

– Comprehension: Picture Identification in growing field choice based on name, description, function, etc.

– Problem Solving: Simple visual categorization

Activities Calendar Task

wheelpicWe are all aware that social isolation can negatively impact communication and cognition. Back when I worked in a SNF referrals for increased confusion often correlated to residents with the lowest amount of daily and quality social participation. I often completed a 2-week therapy trial to explore patient response to environmental and staff communication modifications and to encourage social interaction.

Additionally, direct therapy goals often focused around maintaining simple to complex attention for group activities (depended on the level of the resident), following simple commands for group activities, critical listening for instructions/conversation (generally correlated to attention skills) and basic social communication for a group setting.

If this approach was effective then I discharged the resident with a functional maintenance program. Once discharged, the restorative nursing program and activities department would continue weekly for 2 months.


Orientation Worksheet

Depending on the cognitive level of the resident you may need to orient them to you facilities calendar. Be sure to have copy for them. Please it in their memory book or on the wall. If you work in a facility with a large calendar in the main lobby then ask the activities department to make weekly/monthly copies for you.

Weekly Activities Schedule Worksheet

Read through the instructions. Place in memory book or on the wall. Consider spending a portion of your therapy session in the activity with the resident (if appropriate) to provide skilled feedback on attention, command follow, communication, etc. and assess functional carryover in a group environment.


orientation1 orientation2

Session Planning And Data Collection

planninganddataIn graduate school one of my favorite professors always emphasized,  “A thorough assessment leads to strong goal writing. No task is more important than the goal. Write a strong goal and the activity will fall into place”.

I try my best to keep this in mind each day.

Unless I come in early or stay late to work off of the clock, I rarely have the amount of time I’d like to for planning therapy sessions.

Here are some quick considerations I try to make when pressed for time, both before and after a session, to help with data collection and review of performance.


Short Term Goal (STG):______________________________

Proposed Therapy Task to Meet STG: ______________________________

Goal of Proposed Therapy Task: ______________________________


Short Term Goal (STG):

Utilize trained memory strategies to improve recall of novel information (visual/verbal) after a short delay (2-5 mins).

Proposed Therapy Task to Meet STG:

Read patient a personally relevant 7 digit phone number (favorite take-out restaurant, sister’s home phone, etc.). Utilize trained memory strategies. Alternate attention to silent reading of a newspaper article during forced delay. When timer goes off – patient is to recall phone number.

Have patient then perform self-evaluation

-Was information recalled? Why or why not?

– How can he/she be more successful in the future?

– Were strategies effective or not? What can we change?

– Is this task functional? How can we make it more personally relevant?

 Goal of Proposed Therapy Task:

Use memory strategies of (1) writing new down new information and (2) auditory rehearsal 3x per stimulus to improve attention to and recall of of verbally presented stimuli after a 3 min delay and with visual distraction


Memory Book Writing Prompts

IMG_2957Looking for ideas of questions to ask when developing memory books?

An OT passed this helpful document to me about a year ago- it contains over a dozen pages of memory book writing prompts. In the past, I’ve generally roped it into an alternating attention task when a patient is expected to alternate between verbal/written/motor-based activities at timed intervals OR during visual/verbal short term memory tasks where I need a delay between memory trials and strategy training. It’s also provided a nice break between swallowing exercises, when patients also had a goal related to creating/utilizing a memory book. If needed, you could also ask close family members to complete the document.

You don’t need to complete the whole thing. You just need relevant personal information to add to their memory book. Afterwards, your goals, such as to target spaced retrieval with functional use of memory book reference, could be be addressed. Don’t forget to include information important to daily life, such as hip or aspiration precautions, phone numbers, orientation, daily schedules, important staff names.



Written Expression Strategies


I found this list, along with others that I will be sharing in the near future, online some years ago.  It contains written expression strategies for patient education and training.  In my setting there is rarely time to fully address written expression goals but often patients are motivated to pursue them in outpatient.

1. Observe the margins on the page or the different lines and boxes on the form.

2. Try to stay on the lines or within the given space.

3. Use proper spacing or letter words.

4. Check grammar, spelling, and punctuation. Make sure you did not omit or repeat letters or strokes.

5. Pay attention to details. Cross and dot appropriate letters, close loops, and complete letters.

6. Use a dictionary for spelling and a thesaurus for word finding.

7. If you are having trouble expressing a thought in writing, try talking to yourself through it while writing. You may need to stop for a few minutes to think about it, and then try to write it again.

8. Read what you wrote aloud to double check organization of sentences, word usage, spelling, grammar, and punctuation. For important letters or forms, you may want to have someone else proofread the information.

9. Always remember to proofread your writing. If you have the time, it may be helpful to put the information aside and check for mistakes later.

Free Dementia and Dysphagia Resource


Some of you may be familiar with this packet.  I found the techniques and strategies listed inside to be very helpful during my first year in a SNF with limited resources and only 1 dysphagia textbook from graduate school.  Many of the ideas were used to train non-clinical staff during in-services or to help develop functional maintenance plans for staff.

Although the first 1/2 of the packet is a very basic run-down of normal swallowing, dysphagia symptoms and diet modifications, the second 1/2 contains hundreds of tips for managing feeding issues related to cognitive decline.

What may be most useful to you are pages 22-50 ‘Troubleshooting Issues During Mealtimes’.




Griffin, A., Hollingworth, L., Tyberek, M., Vourgaslis, J. Czapnik, D. and McNeill-Brown (2009). Dining with dementia. LaTrobe University. http://www.latrobe.edu.au/hcs/attachments/pdf/dw /dining_with_dementia.pdf

Can You Unite the States? Therapy Activity


I came across these fabulous printable maps from Mr.Printables and wanted to incorporate them into a therapy task somehow.  This task targets thought organization and word retrieval (specifically divergent naming) skills but can be modified for so many others!  It’s most fun as a group activity but can easily be completed with just the clinician and 1 patient.  I hope you like it!