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Just for Adults Following Directions
Ages: 16-Adult   Grades: 11-Adult

Improve direction-following by targeting the underlying processes of language comprehension and reasoning.  Clients follow simple to complex directions with varied content and formats. 

Outcomes

  • Follow multi-unit commands
  • Understand written directions
  • Improve language comprehension and reasoning

 

Book
#31114
$13.95
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** This is a Cloud E-Book that is accessible from any device with Internet access. .

The lesson content is pertinent to adults and carefully designed to accommodate limited language abilities of clients with neurological impairments.  Skills trained in the beginning activities are reinforced and built upon in subsequent lessons.  Clients respond to the tasks by marking the correct answer, physically following commands, and completing simple drawings.  A screening tool helps you identify the client's use of strategies and reasoning patterns prior to designing therapy sessions.

The activities include:

  • one-, two-, and three-step movement commands
  • concrete and abstract two- and four-component directions
  • conditional directions
  • directions with pictures and numbers
  • written directions

You may purchase Just for Adults Following Directions individually or as part of the 6-book Just for Adults set.  The 6-book set consists of:

Just for Adults Abstract Categories

Just for Adults Concrete Categories

Just for Adults Deductions

Just for Adults Following Directions

Just for Adults Word Relationships

Just for Adults Yes/No Questions

 

Copyright © 2007

Components
40-page book, screening tool, answer key
  • Communication, both verbal and nonverbal, is a fundamental human need.  Meeting this need by facilitating and enhancing communication in any form can be vital to a patient's well-being (NSA, 2005).
  • Rehabilitation is an important part of recovering from a stroke, and the goal is to regain as much independence as possible (NSA, 2005).
  • In an extensive review of the literature, Holland, Fromm, DeRuyter, and Stein (1996) found aphasia treatment to be efficacious and benefited the majority of individuals with aphasia in comparison to no treatment groups.
  • Therapy should include tasks that focus on semantic processing, including semantic cueing of spoken output, semantic judgments, categorization, and word-to-picture matching (Taylor-Goh, 2005).
  • Therapy may target the comprehension and production of complex, as well as simple, sentence forms (Taylor-Goh, 2005).

Just for Adults Following Directions incorporates these principles and is also based on expert professional practice.

References

Holland, A.L., Fromm, D.S., DeRuyter, F., & Stein, M. (1996). Treatment efficacy: Aphasia. Journal of Speech and Hearing Research, 39, S27-S36.

National Stroke Association (NSA). (2005). Clinical guidelines for stroke rehabilitation and recovery. Retrieved August 13, 2009, from www.nhmrc.gov.au/publications/synopses/_files/cp105.pdf

Taylor-Goh, S. (2005). Royal college of speech & language therapists: Clinical guidelines. United Kingdom: Speechmark.

Author(s)

Kathryn J. Tomlin

Biography

Kathryn J. Tomlin, M.S., CCC-SLP, has been a speech-language clinician in hospitals, rehabilitation centers, and in long-term care facilities for over 25 years.  She has authored many materials with LinguiSystems over the last 20 years.  Some of her works include:

  • WALC 1 (Workbook of Activities for Language and Cognition) Aphasia Rehab
  • WALC 2 Cognitive Rehab
  • WALC 8 Word Finding
  • WALC 9 Verbal and Visual Reasoning
  • WALC 10 Memory
  • WALC 11 Language for Home Activities
  • The Source for Apraxia Therapy

Zanmi, Kathy's Samoyed, goes to work with her to encourage the clients.  Her clients enjoy feeding and spending time with Zanmi, and Zanmi enjoys their company.  Everybody wins!

Introduction

Following directions is an integral part of our daily communication and functioning.  We have to follow directions in various ways for a multitude of activities every day.  We follow directions when we use a recipe, carry out the responsibilities of a job, build something, pay our bills, drive to a new location, and so on.  The ability to follow directions is frequently impaired in someone who has language or thinking difficulties.  Life and communication can become very confusing and frustrating when the ability to follow directions is impaired.

Many factors can hinder one's ability to follow directions, such as:

  • difficulty understanding language or concepts due to aphasia
  • difficulty with mentally manipulating information and then acting upon it
  • impulsivity, causing action before receiving and analyzing all pertinent information
  • difficulty following a multimodality task
  • perseveration, causing an inability to shift from how one task is done to a different method
  • difficulty attending to and completing multi-step activities

The exercises in Just for Adults Following Directions have been developed to address different forms and processes involved in following directions.  In some of the sets of activities, the items get progressively harder.  The later exercises use the underlying processes targeted in the initial exercises.

The exercises can be done in multiple ways.

  • Have clients read items silently and complete them independently.
  • Have clients read task items aloud and perform the action or write the response.  In general, performance improves when a person has multi-modality input (i.e., hearing it while reading it.)
  • Read the items to the client and have the client respond appropriately.

The screening tool is not to be used as a test but rather as a way to observe a client's use of strategies and reasoning patterns.  Some questions to think about while observing how the client completes the screening include:

  1. Does the client need to use verbal rehearsal to aid comprehension?
  2. Is the client impulsive, and does his impulsivity lead to errors?
  3. Does the client read too much into the task and become confused?
  4. Is the client aware of his error responses?
  5. Does the client ask for clarification when having difficulty or does he just keep going, whether the item is understood or not?
  6. Does the client miss salient information?
  7. Is the client able to think convergently and divergently?
  8. Does the client have trouble shifting from one task to the next?

These guidelines will help you present the activities in this book.

  • The exercises are not for testing purposes.  Try to make them as enjoyable as possible.  Talking about the specific task items, particularly when correcting error responses, will help to improve the client's ability for achieving the goals.  Do not get into debates if the client is unable to see another viewpoint for a response.  Just move on to the next item.
  • Review common direction words and practice the appropriate motor response before beginning a section of activities.  For example, ask the client to draw a circle, a box, or underline.  Write examples on index cards for future reference if necessary.
  • Help the client associate directions to appropriate body parts before asking him to follow the direction.  For example, when he hears the word wink, which body part does he associate with it?
  • Be flexible with presentation and accept answers that differ from your viewpoint if the person can give a logical explanation.  The answers in the Answer Key are provided as a reference and are not intended to be all inclusive.

I hope you and your clients find these exercises enjoyable and beneficial.

Kathy