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WALC 6 Functional Language
Workbook of Activities for Language and Cognition
Ages: 16-Adult   Grades: 11-Adult

Keep client interest high with fresh content and functional activities.  These 300 pages of exercises cover a broad scope of skills including orientation, auditory comprehension, verbal expression, and reading comprehension. 

Outcomes

  • Improve orientation to time and space
  • Improve verbal and nonverbal communication
  • Develop auditory comprehension
  • Advance speech intelligibility
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Convenient, ready-to-use activities feature illustrations and formats designed especially for persons with neurological injury.  Many of the tasks can be used to address co-existing deficits in concentration, memory, reasoning, and problem solving.

The activities target these skills: 

Temporal and Spatial Orientation
Recognize, understand and use time concepts in everyday activities like using a calendar and work schedule.  Understand concepts of location and direction and use maps.

Nonverbal Communication
Communicate by using gestures and pantomime.    

Oral Motor /Speech Production
Practice phoneme-specific exercises ranging from the single word level to sentence level. 

Verbal Expression
Target a wide range of skills from the single word level through the structured and unstructured conversation levels.  Activities include automatic phrase completion, naming from descriptions, asking questions, giving explanations, and conversing about world events.

Auditory Comprehension
Exercises progress from single word comprehension and discrimination to comprehending and recalling multiple paragraph information.  Clients answer yes/no questions, follow directions, listening for details, detect and understand humor, and answer questions about stories. 

Reading Comprehension
Exercises progress from recognition of individual letters all the way through the paragraph and functional reading level.  Reading tasks are done with and without picture supports. 

Written Expression
Clients practice writing information about themselves and writing checks.

 

Copyright © 2004

Components
313 pages, answer key
  • There is evidence that individuals with aphasia who receive speech and language treatment have significantly better outcomes than those individuals with aphasia who do not receive treatment (Hickin, Best, Herbert, Howard, & Osborn, 2003).
  • Aphasia rehabilitation should focus on underlying cognitive and language skills that will transfer to everyday life skills.  Aphasia therapy should assist individuals with aphasia in becoming effective communicators in a variety of settings, including home, community, and work (Brookshire, 2003).
  • The hallmarks of traumatic brain injury include impairments in memory, organization, speed of thinking, attention and concentration, affective control and irritability, motivation, judgment, and socialization (Hutchison & Lebby, 2005).
  • Evidence exists for the effectiveness of several forms of cognitive rehabilitation for people with stroke (remediation of language and perception after left and right hemisphere stroke, respectively) and traumatic brain injury (remediation of attention, memory, functional communication, and executive functioning) (Cicerone et al., 2000).
  • A stroke may impair an individual's verbal expression, auditory comprehension, and reading comprehension (Brookshire, 2003).  The tasks addressing these language areas in this book are systematically arranged to allow for varying difficulty levels as the patient shows improvement.
  • ASHA's National Outcome Measurement Systems (NOMS) shows that outpatient speech therapy services for dysarthria are associated with improved intelligibility and communication functioning (ASHA, 2008).

WALC 6 Functional Language incorporates these principles and is also based on expert professional practice.

References

American Speech-Language-Hearing Association (ASHA). (2008). Treatment efficacy summaries: Dysarthria. Retrieved August 27, 2009, from http://www.asha.org/NR/rdonlyres/986EF2DF-56C4-4FFA-BD9F-A254BD950901/0/TESDysarthria.pdf

Brookshire, R.H. (2003). Introduction to neurogenic communication disorders (6th ed.). St. Louis: Mosby.

Cicerone, K., Dahlberg, C., Kalmar, K., Langenbahn, D., Malec, J., Bergquist, T., . . . Morse, P.A. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine & Rehabilitation, 81(12), 1596-1615.

Hickin, J., Best, W., Herbert, R., Howard, D., & Osborn, F. (2003). Therapy for word finding difficulties in aphasia: Measuring the impact on real-life communication. Proceedings of the Fifth European Congress of CPLOL.

Hutchison, H.T., & Lebby, P.C. (2005). Traumatic encephalopathies. In R.B. David (Ed.), Child and adolescent neurology (2nd ed.). Malden, MA: Blackwell Publishing, Ltd.

Author(s)

Leslie Bilik-Thompson

Biography

Leslie Bilik-Thompson, M. A., CCC-SLP, earned her master of arts degree in speech language pathology at Indiana University in Bloomington, Indiana.  She has worked as a speech-language pathologist in a wide variety of clinical settings, including intensive and acute care, rehabilitation, extended care hospitals, private practice, and home health care.

WALC 6 is Leslie's first publication with LinguiSystems.

Introduction

The Workbook of Activities for Language and Cognition 6 (WALC 6) was developed to provide a comprehensive series of tasks and functional carryover activities allowing for integration of language and cognitive skills for neurologically-impaired adolescents and adults with diverse levels of functioning.

The activities in the following sections can be adapted for clients with a variety of functioning skill levels.

  • Temporal Orientation
    Clients with neurological impairments often exhibit difficulty planning their days, understanding how long it takes to do something, using a calendar, and planning a schedule.  The tasks in this section focus on recognizing, understanding, and using time concepts for everyday activities.
  • Spatial Orientation
    Clients with damage to the non-dominant hemisphere can demonstrate decreased ability to localize objects in space and show diminished capacity to determine spatial orientation.  This section includes tasks structured to target spatial awareness and visual awareness.  These tasks can also be used to integrate memory, problem solving, verbal naming, and following written and oral directions.
  • Nonverbal Communication
    The tasks in this section focus on developing strategies to facilitate nonverbal expressive communication for those clients who have lost the ability to produce speech or verbalize in a meaningful and effective manner.  Specific gesture and pantomime exercises are included as well as activities for functional carryover and expansion of these skills.
  • Oral Motor
    This section is designed for those clients who demonstrate dysarthria (a weakness or incoordination of the speech muscles) or verbal apraxia (an impairment in the sequencing of speech sounds).  Specific oral-motor exercises are included, along with sound specific exercises, ranging from the single word level through the sentence level.
  • Verbal Expression
    Verbal expression encompasses content (vocabulary concepts), form (how words are formed and linked into phrases/sentences), and use (what the speaker wants to get from using language).  Many of the tasks in this section can be used two ways: you can either focus on one target area at a time (e.g., speech intelligibility or word finding) or you can integrate skills to focus on a number of target areas within the same task (e.g., speech intelligibility and word finding or speech intelligibility, word finding, and expressing emotions).  The tasks are broken down to target a wide range of skill levels, ranging from the single word level through the structured and unstructured conversation levels.
  • Auditory Comprehension
    Following neurological trauma, clients will often show deficits in understanding spoken language.  The tasks in this section cover a wide and diverse range of receptive abilities, and provide for flexibility by using a continuum of skill levels.  Exercises progress from single word comprehension and discrimination to comprehending and recalling multiple paragraph information.  Attention and concentration, memory, reasoning, problem solving, and deduction can also be integrated in many of these exercises.
  • Reading Comprehension
    Clients may have problems reading due to comprehension impairments, visual deficits, or both.  It is important to determine which deficit is affecting a client's ability to read, and to target tasks accordingly.  Tasks cover the isolated letter level all the way through the paragraph and functional reading level, with an incremented progression of reading comprehension and visual field awareness skills.  These tasks can also be used to integrate cognitive skills, including attention, concentration, and memory.
  • Written Expression
    When evaluating a client's ability to use written language, think about the underlying causes of the deficit.  Impairments in vision, motor control, auditory and reading comprehension, and cognition can each play a role in a client's ability to write.  Tasks may be broken down to more simplified levels in order to meet each client's individual needs and to allow for individual impairments.

For Auditory Comprehension and Reading Comprehension, you can vary the method of response based on the client's level of functioning (e.g., client points to or circles the target letter; client verbalizes, uses eye blinks, or makes another physical signal to indicate identification of the target letter as you point to it).

I recommend that you take a close look at the "Suggested target areas" within each section, and to always consider which target areas might be integrated to maximize the functionality of each task.  In addition, I strongly encourage you to look at the "Functional Carryover Activity" sections throughout WALC 6, as I feel that making therapy individualized, functional, motivating, and meaningful is paramount to each client's potential and success.

It is my hope that you find the tasks in this book to be practical and effective.  I also hope that the tasks stimulate the development of your own ideas for functional carryover activities to meet each of your client's individual needs.

Although many clients are diagnosed with the same "textbook" communication deficit, I urge you to remember that each client is unique and speech-language therapy should be adapted to meet each one's individuality.  It was the unique qualities of my clients that prompted me to write WALC 6, and to them I am thankful and honored to have experienced speech, language, and cognitive rehabilitation with them.

Leslie