Professional Documents
Culture Documents
WALC 10 Memory
WALC 10 Memory
by Kathryn J. Tomlin
Skills Ages
use of visual-auditory-kinesthetic (VAK) 16 and up
coding strategies
associations
Grades
following directions
recalling information high school and up
Evidence-Based Practice
According to the Preferred Practice Patterns for the Profession of Speech-Language Pathology
(http://www.asha.org/members/deskrefer-journals/deskref/default, 2004), the Clinical Guidelines
of The Royal College of Speech & Language Therapists (www.rcslt.org/resources, 2005) and the
National Stroke Association (2006), the following therapy principles are supported:
Intervention should address processing of varied types of information in various activities and
settings (e.g., ability to attend to, perceive, organize, and remember verbal and nonverbal
information including social cues, reasoning, and problem solving).
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.
Therapy should include tasks that focus on semantic processing, including semantic cueing
of spoken output, semantic judgments, categorization, and word-to-picture matching.
Therapy may target the comprehension and production of complex, as well as simple,
sentence forms.
Therapy should be conducted within natural communication environments.
Rehabilitation is an important part of recovering from a stroke, and the goal is to regain
as much independence as possible.
This book incorporates the above principles and is also based on expert professional practice.
East Moline, IL 61244 The enclosed CD is for your personal use and convenience.
It is unlawful to copy this CD or store its contents on a
FAX: 800-577-4555 multi-user network.
Phone: 800-776-4332
E-mail: [email protected] Printed in the U.S.A.
Web: linguisystems.com ISBN 978-0-7606-0751-0
About the Author
Kathryn J. Tomlin, M.S., CCC-SLP, has been working with clients
who have memory loss for over 25 years, and the techniques
in this book have evolved through her experiences. She has
authored many materials with LinguiSystems over the last 20
years. Some of her works include:
Acknowledgments
My special thanks to all those clients and professionals I have had the pleasure to work with
and learn from over the years. I especially acknowledge Lana Liberto, Pam McAbee-Nesbit,
and Cliff Nesbit who have taught me more than I will ever know.
My appreciation also toward all those who have worked with me at LinguiSystems. I thank
you for your patience, encouragement, and humor. But most of all, I humbly thank God for
all the gifts He has given me. May you and your clients benefit from those gifts.
There are two main factors underlying all the exercises in WALC 10.
1. To initially make all of the processes involved with memory highly intentional.
The most common erroneous belief a client frequently expresses is that she has
never used memory strategies. It is imperative to help her understand that although
she is unaware of it, all memory skills are tied to some kind of strategy. It’s just that
the strategies functioned more on an automatic (habit) basis prior to the injury or
illness. As your client improves with intentional use of strategies, the emergence of
spontaneous, automatic use frequently occurs. The ultimate goal is for the client’s
memory skills to return to a functional, automatic level once again.
Working with emphasis on the process requires active and constant therapeutic
intervention initially but as your client’s awareness and abilities increase, she will take on
more of the training responsibilities herself. As skills increase, your client will frequently
begin telling you of times she has found success using her memory skills outside the
therapeutic situation.
I devised the exercises in WALC 10 for use primarily with individuals who have suffered
from a head injury, a non-dominant hemispheric stroke (usually a right CVA), and other
neurological deficits resulting from various causes (e.g., Lyme’s Disease, anoxia, Moya
Moya Disease). In addition, the exercises have also had a positive effect with clients with
aphasia and with students who have been referred for therapeutic intervention for learning
disabilities and ADD. Success becomes apparent as the client’s functional interaction with
life situations increases (e.g., social interaction, employment, schooling).
Although WALC 10 only touches upon the intricacies involved in memory, I hope it
becomes a catalyst for growth for each person who uses it.
Kathy
The first step in retraining memory processes is to determine the primary strategies a client
uses most successfully. There are three main systems we use to code and learn information.
The systems are visual, auditory, and kinesthetics/feelings. Even though we have the ability
to use all three systems, each person has one system that is strongest. Determining which
system is your client’s strongest will greatly aid you in being able to help her retrain her
memory.
A person who learns visually codes things in her memory with pictures (either “snapshots”
or entire “movies”!), graphs, colors, and so on. A person who learns auditorily uses words,
stories, and dialogues to code information. A person whose kinesthetic system is strongest
learns and codes with movement and feelings. Kinesthetic learners watch and imitate with
their hands by actually doing the activity. Since it is difficult to simulate that kind of learning
with pen and paper exercises, this book will focus primarily on visual and auditory systems.
But, as stated earlier, people have a capacity to use all three systems, so even if a client’s
primary system is kinesthetic, doing the tasks in this book will help retrain all her systems.
The chart on the next page will help you determine which system appears to be your client’s
strength. Hopefully it will also help you learn about your own preferred system. By identifying
your own system, you will have a greater awareness of how to help those who have a pattern
similar to your own and help you to shift to a different system in order to assist someone who
learns and codes information differently from yourself.
Key phrases Words reflect visual Words reflect auditory Words reflect
used system, as in “I see system, as in “I hear movement or feeling,
the picture,” “That’s what you’re saying” as in “That feels okay,”
clear,” and “Look and “That rings a bell” “I can handle it,” and
at this” “Let me touch base
with you”
Environmental Notices what is going Hears things going Very aware of mood
interaction on around her (“Did on around her and and tone; generalized
you see that?”) not all that aware coding; not greatly
of visual things aware of visual or
auditory activity
around her
2. Within a therapy session, focus on several different tasks. For example, begin with a
visual task of associating figures to shapes, progress to working with ten associated
words, and then do some of the functional memory tasks or memory and mental
manipulation tasks.
3. Be aware that initially, this retraining will feel very strange to your client and he
will frequently state that using strategies is not necessary because he never used
strategies before his illness or injury. As he sees that the strategies really work, he will
become more interested in using them.
4. Due to the nature of memory loss, those with a more serious impairment will have little
carryover from session to session until skills improve. Your client will forget that he
forgets, and he will forget the successes he had in therapy. Just continue to build the
foundations and watch for spontaneous use of memory strategies (e.g., learning his
way around the facility, remembering something he did at home the previous day) and
reinforce those milestones.
5. There will occasionally be clients for whom these processes do not appear to help.
Most frequently it has been with clients who have had profound memory loss from
anoxia or encephalitis.
6. Whenever possible, aid your client with developing strategies for things directly
associated with his life. For example, if you know he has a 2:00 appointment with
his neurologist on Wednesday, October 22, assist him with coding the information or
devising compensatory strategies.
The exercises in this section are designed to provide you and your client with tasks that
will reveal which learning system she predominantly uses. Knowing your client’s system
preference will aid you in assisting her in developing the best-suited coding strategies and
will insure that you are both speaking the same language.
If your client has a predominant visual system, assist her in developing visual coding
strategies. If, on the other hand, her predominant system is auditory, act as a guide for
using auditory strategies. As your client becomes more aware of her own systems, she will
become more effective in developing appropriate strategies. Be aware that although one
system is predominant, your client will use both visual and auditory systems. You only need
to “step in” and steer her toward her predominant system when she is being unsuccessful.
Process
Initially, have your client complete the exercise without your assistance. Listen to and watch
how she processes and codes the information. Ask her to verbalize how she did it. It is
common for a client to initially say, “I don’t know how I did it.” With encouragement, though,
she will be able to recall pieces of strategies that will key her into recalling more of the
components. At this point, be careful not to provide too many possible suggestions because
they can interfere with the processes she used. If your client is unable to create any strategy,
provide two visual and two auditory strategies for her to choose from. After providing the
choices, it’s helpful to ask, “Will one of these work for you?” This will either aid your client in
picking one that “feels” right, or it will provide enough choices for an independent strategy to
be triggered.
Build a list of possible memory strategies to suggest to your client by listening to other
clients talk about their strategies. Code these strategies and share them with other clients.
For example, the task may be coding the figure with the figure .
Other clients might have stated they coded the figures as:
• I see a glass and a frying pan.
• It’s a lounge chair and a sofa.
• When the cup fell over, it became flat.
• I had a glass of juice when I got out of bed.
Closely watch your client’s face as you present possible strategies to choose from. A client
usually gives very clear signs of when she feels a strategy will not work and when one
“clicks.” Then have her intentionally rehearse the strategy that she feels will work, as this
greatly improves coding skills.
You will frequently need to guide your client in using strategies that are directly associated.
If the strategy is not associated, the client will be ineffective in retrieval. Intentionally make
the client aware of how the association wasn’t actually present. Then help her determine
one that is related.
Once you’ve identified a client’s predominant system, make her very aware of it. Discuss
your client’s system and compare it to your own. Remember, you want your client’s skills
to be at a highly intentional level. Once you and your client are aware of the client’s system,
you can guide her to use that system in the various tasks throughout this book.
Ask your client to tell you how she remembered which objects went together. What system did
she use? Did she code in pictures? For example, did she visualize a tree out of the first set, a
person out of the second set, a bowl and spoon out of the third set, and star with a cloud out of
the fourth set? On the other hand, did she code in words, phrases, and sentences? She might
have said to herself, “There is a sun setting by the volcano” for the first set. Did she describe
what she saw and associated together? If she is having difficulty determining how to code, help
her devise strategies that will work for her.
Bush
Tree
Grass
Path
Garden
Flowers
Bird
1. _______________________________________
2. _______________________________________
3. _______________________________________
4. _______________________________________
5. _______________________________________
6. _______________________________________
7. _______________________________________
Once again, analyze how the client coded the words. What system(s) did she use? What are
you finding out about how she learns and remembers?
One of the first steps in retraining memory is to make the information coding very intentional.
If the client is aware of how she learns and recalls, it will be much easier for her to intentionally
code new information. As the client becomes more accurate and faster at recalling information,
the goal will be to make those recall skills automatic again.
Tamara Yuet
Margo
Cheryl Kaitlin
How did the client code the names? Bring it to your client’s conscious awareness. If he didn’t
get them all, go back and help him code. Encourage your client to code out loud.
Remember, your client has the capacity to use all three systems—visual, auditory, and
kinesthetic. Don’t be surprised if you find that although he uses one system the most, there
are times when he will use one of the other systems to code things.
By now, your client should be becoming aware that memories work best when we use
some kind of strategy. Instruct your client not to assume he’ll just remember information
because our minds don’t work that way. Everything we learn is coded in some way. There
is always an association with something already in our minds. If your client is finding that
he is not remembering things, then his associations aren’t strong enough. Sometimes it is
helpful to exaggerate the associations so they really stand out in the mind. For example,
an association for remembering to buy soap could be a mental picture of a gorilla sitting in
the bathtub washing with a large bar of soap.
The focus of word and mental picture associations is to establish coding patterns.
The associations on the following pages are initially broken down into specific patterns
to provide practice. This progresses to mixed groups of words so your client can use the
patterns in an integrated manner. The final word groups lead your client into developing
associations between words that have no clear association. This encourages them to use
the coding patterns they have practiced as they link the unrelated words together.
Process
Present the pairs in a slow manner—one, two, or three pairs at a time. Watch your client
for signs of coding. Review the list of pairs periodically as you go through it. After your
client codes all ten pairs, slowly provide the first item in each pair, allowing your client to
provide the second item in the pair. If your client misses any, go back and help him code
the pair in his visual or auditory system. If your client codes something incorrectly, aid him
in changing the strategy to replace the wrongly coded item with the correct item.
The example on the next page will help you get started.
Therapist: These words are going to be related to each other by associating a color with
an item. When I say “yellow,” you will say “canary.’’ When I say “blue,” you will
say “ocean.”
Therapist: yellow
Client: canary
Therapist: blue
Client: ocean
Therapist: Great! Now, when I say “green,” you will say “grass.” When I say “white,” you
will say “salt.” (pause) “yellow”
Client: canary
Therapist: blue
Client: ocean
Therapist: green
Client: grass
(Continue until you have finished the list.)
If your client has been successful in creating strong associations, then he will be able to
retain the list after a delay. The pattern that usually appears to be most successful is to
review the list:
Tell your client that you will be following this sequence (or whatever sequence you devise) as
it will help strengthen his motivation for efficient coding.
There will be times, particularly with impulsive clients, that the client will either silently
associate or state aloud a different word from the one you present. For example, you might
say, “When I say yellow, you will say canary.” But instead of coding canary, your client
independently codes banana. This can sometimes be counteracted by explaining to your
client before the training event begins that he will have to try to keep his mind open to your
paired words and to actively inhibit any other words from “popping” into his head. If this
pretraining shaping doesn’t work, you can attempt to erase his code and establish a new
code with the appropriate paired word. If this is not successful, accept your client’s coded
version and expect that paired word to be the one provided after the delays. Although this is
not the best result because it reflects decreased new learning abilities, it still reflects that your
client used an association strategy.
Word Lists
Word Lists
Word Lists
Word Lists
These pairs have no obvious association, but they can be linked together creatively.
Go slowly and insure that a code has been devised before moving to the next pair.
Word Lists
Word Lists
__________________________ __________________________
1. __________________________ 1. __________________________
2. __________________________ 2. __________________________
3. __________________________ 3. __________________________
4. __________________________ 4. __________________________
5. __________________________ 5. __________________________
6. __________________________ 6. __________________________
7. __________________________ 7. __________________________
8. __________________________ 8. __________________________
9. __________________________ 9. __________________________
10. __________________________ 10. __________________________
_________________________ _________________________
1. __________________________ 1. __________________________
2. __________________________ 2. __________________________
3. __________________________ 3. __________________________
4. __________________________ 4. __________________________
5. __________________________ 5. __________________________
6. __________________________ 6. __________________________
7. __________________________ 7. __________________________
8. __________________________ 8. __________________________
9. __________________________ 9. __________________________
10. __________________________ 10. __________________________
This area builds on the paired association strategies used in the previous section but
takes the skill one step further. Instead of just coding pairs of words, your client will
be able to code entire lists of words or ideas. These tasks help to reestablish the need
for making associations between items and linking them to information already stored in
the brain. As we frequently need to retain more than two items, these tasks also aid in
retraining the brain’s ability to code lists of information.
Process
Basically, the strategy the client will use in this section is the same as the last section
but each word gets chained to the next through an association. As before, have your
client attempt each exercise independently at first. Offer assistance if needed.
Example
milk
cleaned up spilled milk with tissues
tissues
dried out the tissues on the grill while cooking hot dogs
hot dogs
dentist
dentist bill came in the mail with some letters
letters
child scribbled all over the letters with a crayon
crayon
If the codes are successful, the chain can go on almost indefinitely, although testing that
with clients is not suggested. Also, the list should remain in the client’s mind after a delay
or a distractor if the codes are strongly associated. Listening to each of your client’s
codes will help you cue her if she gets stuck and will provide you with possible strategies
to recommend to other clients when they have difficulty devising an association.
Since it will be possible for a client to make a mental picture (visual system) or story
(auditory system) that incorporates all the components, make sure the client is coding
the words in order. Once the client has mastered the chain, challenge her to recall the
list in reverse order. She will be surprised how easy it is by using her associations.
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
3 3 3
beach trees teacher
sand trails computer
shells hills lesson
3 4 4
film hands cold
lens date glass
pose wrist milk
time ice
4 4 4
cake quiet sofa
surprise books relax
card table TV
balloons read nap
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
5 5 5
parking lunch meat door
theater rolls seat belt
ticket mustard key
popcorn knife gear
seat plastic bags drive
6 6 6
alarm garage coffee
rise mower spoons
wash gasoline cups
dress start sugar
eat cut cream
leave rake cake
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
7 7 7
newspaper home match
memo dinner flame
note relax wood
letter TV logs
pamphlet read burn
magazine phone cook
postcard bed marshmallow
8 8 8
bush drive lettuce
dirt enter carrots
tree sit noodles
shovel order popcorn
grass wait crackers
hoe talk soda
weeds eat napkins
flowers pay cereal
Have your client use a strategy to memorize each phrase in each list in order. After
you feel your client has coded each list, have her cover the list and recall each item
on the list in order.
List 1
Check the oil.
Add oil, if needed.
Check the radiator.
Add antifreeze, if needed.
Wash the car.
Wax the car.
Admire your work.
List 2
Put the “soaps” on TV.
Listen while you work.
Dust the downstairs.
Put in a load of laundry.
Take something out of the freezer for dinner.
Check the wash.
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
3 3 3
work school dollar
five rock brass
chair wall lamp
3 4 4
foot corn hat
green today picture
house ring time
talk music
4 4 4
lid jump train
back fountain slow
tree pen park
nail stairs blanket
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
5 5 5
blue ring table
week beard weekend
home twist glasses
word hour robe
nose punch book
6 6 6
license camera bird
carrot tooth think
three peanut spend
piano night month
china crack bench
mayor beach towel
Have your client use a strategy to memorize the words in each list in order. Have her
associate each word directly to the one below it. After you feel your client has coded
the whole list, have her cover it and say the list out loud.
7 7 7
park step cheese
million feather hair
microphone soda state
pan drum test
stick vacation left
knee gold summer
clock raisins train
8 8 8
calendar star holiday
confidential cotton soft
spread vase instrument
shiny position double
freezer hungry shelf
tube moose easy
day key promise
shirt field number
Help your client create several lists of things she might have to recall in daily life.
Some topics you might use are a shopping list, a weekend schedule, or a gift list.
List 1 List 3
Topic: __________________________ Topic: __________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
List 2 List 4
Topic: __________________________ Topic: __________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
_______________________________ _______________________________
The exercises in this section pair following written or spoken directions with motor
execution on visual figures, letters, words, and numbers. This is a skill your clients will
use every day. Many things we do require us to listen to or read directions and carry
them out in some manner. For example, we need direction-following skills to write an
appointment in an appointment book, put toys or furniture together from printed directions,
or remember to pick up a specific newspaper at the convenience store while you’re on
your way to watch your child play soccer on Field B at 6:30 against the blue team.
Process
These exercises can be presented in one of two ways. You can either read each
direction aloud to the client and he then carries it out, or you can have your client
read each direction, code the information, and then carry it out.
Either method should incorporate a specific focus on coding. As your client hears or
reads each step within a direction, watch his eyes to insure he is scanning for the specific
item he will be targeting. It is important that each step is presented at a rate that allows
sufficient time for coding.
The first group of exercises includes two components in each step. One component
leads the client to determine which items are to be targeted or acted upon in that
direction. Examples of these components include a shape, a letter, a number, or a
word. The execution component is the method the client will use to act on the other
component. Examples of the execution component include circle, underline, and cross
out. Frequently, the client will recall the item but not the method. If necessary, help the
client in his mental visualization or word coding of the method to be used.
“I will be giving you a two-step direction. Listen carefully to remember what you are going
to do and which figures you are going to do something to. Try to picture in your mind how
the page will look when you’ve carried out the directions. Feel free to ask me to repeat
the direction before you start. Any questions?”
Although it is not encouraged because mental manipulation is faster, your client might
benefit from talking specifically about what he plans to do in order to follow the direction.
Move this toward mental manipulation of the information as soon as possible.
The second group of exercises requires your client to make a word picture or mental
visual picture of what the directions request and then to carry it out in its entirety. Have
him verbally describe what he will be drawing before actually doing it. If it appears he has
not coded it correctly, aid him with coding the information.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the box will look like after he has followed the directions. Then have
him carry out each direction.
1. Draw a line from the square to the triangle. Shade in the circle.
5. Put a dot under the circle. Write your name above the rectangle.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the items will look like after he has followed the directions. Then have
him carry out each direction.
Box 1
Box 2
A B C 1 2 3
1. Underline the B. Divide the triangle in half.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the items will look like after he has followed the directions. Then have
him carry out each direction.
Box 1
Box 2
A B C D E 1 2 3 4 5
Box 3
1. In Box 2, cross out the letter that comes before D and put a dot in the diamond
in Box 1.
2. Circle the item that is clear in Box 3 and shade the square in Box 1.
3. In Box 2, put lines above the two numbers that equal 9 when added together,
and in Box 3, put a box around the word that means the same as fall.
4. Draw a line to divide the circle in Box 1 in half and underline the vowels in Box 2.
5. Cross out the vehicle in Box 3 and put a star in the triangle in Box 1.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the items will look like after he has followed the directions. Then have
him carry out each direction.
Box A
Box B
1. Put a line through every A in Box C and shade in the four-sided figures in Box A.
2. Draw a line from the third letter to the number that equals 13 – 1 in Box B and
circle the metal in Box C.
3. Underline the even numbers in Box B and put a line over the star in Box A.
4. Put a box around the clothing in Box C and draw a small circle inside the oval
in Box A.
5. Put a line over each letter that is in the word RUST in Box B, and put a check in
front of the 11 in Box B.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the items will look like after he has followed the directions. Then have
him carry out each direction.
Box 1
Box 2
Box 3
1. In Box 3, put a box around each thing with legs. In Box 1, draw a circle in the
square. Underline the two numbers in Box 2 that equal 22 when added together.
2. Draw a line from the middle letter to the last letter in Box 2. In Box 3, cross out the
thing that opens a lock. Write the word STOP in the eight-sided figure in Box 1.
3. In Box 3, put a line through the opposite of black. Shade in the triangle in Box 1.
Put a line over the first three letters of the alphabet in Box 2.
4. Circle the even number in Box 2. In Box 1, put a dot in the circle. Cross out the
numbers containing 5 in Box 2.
Read one direction at a time to your client or have him read it. Have him code what
he is to do to the items in the box. Encourage your client to make a word or visual
picture of what the items will look like after he has followed the directions. Then have
him carry out each direction.
Box A
Box B
1. Put a box around the shortest word in Box C. Draw a line over the two letters
following W in Box B. Divide the square into four equal parts in Box A.
2. Put an X inside the twelve-sided figure in Box A. In Box B, cross out the largest
number. Circle the word that means the opposite of over in Box C.
3. In Box B, underline the last two letters of the alphabet. Draw a line from the
triangle to the diamond in Box A. In Box C, cross out every E in the word
CEREAL.
4. Put a check mark after the place of business in Box C. In Box B, circle the letter
after X. Shade in the three-sided figure in Box A.
Read one direction at a time to your client or have him read it. Have him make a
visual or word picture in his mind of what the directions are telling him to draw. When
your client has coded the directions, go to the next page and have him draw in the
space provided.
(When you’re ready, go to the next page and draw the figures.)
2. Draw a rectangle that is about four inches long and two inches high.
(When you’re ready, go to the next page and draw the figures.)
Have your client use the spaces below to draw the shapes described on page 46.
1.
2.
Read the directions to your client or have him read them. Have him make a visual or
word picture in his mind of what the directions are telling him to draw. When your client
has coded the directions, go to the next page and have him draw in the space provided.
(When you’re ready, go to the next page and draw the figures.)
2. Use a horizontal and a vertical line to divide the space into four equal
sections.
Put three small circles in the bottom right section and draw a triangle
in the top left section.
Draw two squares, one inside the other, in the bottom left section.
(When you’re ready, go to the next page and draw the figures.)
Have your client use the spaces below to draw the shapes described on page 48.
1.
2.
The exercises in this section are designed to improve coding of visual content coupled
with placement. Throughout the day we automatically use this skill for daily functioning
(e.g., when placing things in the refrigerator, when putting keys on a table next to a
purse, when filling out a Daytimer, when reading a prescription) but the skill is frequently
impaired in someone with a memory impairment. The tasks begin with shapes and
progress to coding entire designs, numbers, and words.
Process
For these exercises, have your client study the shapes, figures, numbers, and words and
devise a strategy to code them and their placement within the boxes or on the page. Then
have your client cover the shape(s) and draw them in the provided boxes or in the space
provided.
Initially, do not assist your client. Only aid her if she is having difficulty devising an
effective strategy. Encourage the client who uses a visual system to create mental
pictures and the client who uses an auditory system to use her word strategies.
Performance can be negatively affected by visual perception difficulties (e.g., visual field
neglect or cut). Be prepared to help her compensate (e.g., verbally direct the client to
look at the left [or right]). If she is impulsive, insure she takes enough time to code the
content.
Example
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the shapes in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the shapes and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and draw the shapes in their correct positions
in the box on the right.
Have your client study the figure. When she has it memorized, have her cover it and
draw it in the space below.
Have your client study the figure. When she has it memorized, have her cover it and
draw it in the space below.
Have your client study the figure. When she has it memorized, have her cover it and
draw it in the space below.
1
1
A
2
B
Have your client study the figure. When she has it memorized, have her cover it and
draw it in the space below.
Have your client study the numbers in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the numbers and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and write the numbers in their correct
positions in the box on the right.
1 8 0 5
7 2
4
3 8
9 1
3
6 0
8 0
5
4 9
WALC 10: Memory 62 Copyright © 2007 LinguiSystems, Inc.
Recalling Boxed Information Exercise 13
Numbers
Have your client study the numbers in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the numbers and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and write the numbers in their correct
positions in the box on the right.
0
9
2
7
4
6
2
5
8
0
5
2 7
6 1
7
9 0 3
4
WALC 10: Memory 63 Copyright © 2007 LinguiSystems, Inc.
Recalling Boxed Information Exercise 14
Words
Have your client study the words in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the words and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and write the words in their correct positions
in the box on the right.
PAID
OVER LIVE
HAIR
FREE
WOOL STOP
WHAT
FIRE CHIN
WANT LAST
TALL DOES
TURN
HILL
Have your client study the words in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the words and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and write the words in their correct positions
in the box on the right.
WALK
NEAR
CALM
SHORE
DUST COOL
HOME
BACK
TREE JOKE
SALT
FOOT
FIVE
HERE MOST
MAIL
Have your client study the words in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the words and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and write the words in their correct positions
in the box on the right.
LEG
COLOR SNOW
PAPER ON
NIGHT TEAM
TWO
MAY HERE
THERE
WATER
LOVE ANT TO
LESS
THE RED SOUND
FORM
Use this page and the sample directions to create your own practice items.
Have your client study the _______ in the box on the left. Do only one box at a time.
Ask your client to take her time and create a strategy to remember the _______ and
where they are located in the box. When your client feels she has accurately coded
the information, have her cover the box and reproduce the _______ in their correct
positions in the box on the right.
In this section, your client will create a mnemonic using the first letters of words in a word
list. This is another method for assisting the brain in reestablishing the use of strategies
for associating words and information in a manner that can be linked to pre-existing
concepts and content. This will provide your client with another method to use for coding
and recalling information. Using mnemonics can help you remember items in grocery
lists, To-Do lists, and other lists of multiple items.
Process
Instruct your client to take the first letter of each word in a list of words that need to be
memorized and create a new word from those letters. For example, your client may need
to memorize grocery items: eggs, milk, tortillas, and sausage. Using the first letters of the
items (E, M, T, and S), have your client make the word stem to help him remember the
items. Then your client can create a new sentence using words that begin with the first
letters of the items in the list. For example, using the letters from the grocery list above
(E, M, T, and S), your client might create this sentence as a mnemonic: Every Morning
Tigers Sleep.
Example
York
Limerick
Flourtown
From their first letters (YLF), you can make the word fly. Now make sure you coded the
town name to each letter. Cover the town names and see if you can say them aloud.”
To prepare for the exercise on the next page using first letter mnemonics, have
your client practice making words using the first letters of the words in each of
these groups. Your client may want to underline the first letter of each word.
Example
Yellow
Table = the letters Y T A S = the word stay
Arm
Sugar
Group 1
Turnips
Apples = the letters ____ ____ ____ = the word ___________________
Carrots
Group 2
March
February = the letters ____ ____ ____ ____ = the word ___________________
October
August
Group 3
Eagle
Robin = the letters ____ ____ ____ ____ = the word ___________________
Sparrow
Ostrich
Have your client use the first letters of the items in each list to make a word. Then
have your client recall the items in the list using the word he made as a reminder.
Instruct your client to find the first letter of the words in each list and write them on
the blanks. Then have him create a sentence that uses the letters as the first letter of
each word in the sentence. When your client is finished, have him cover the list and
recall the words using the sentence as a reminder.
List 2 List 5
lease _____ __________________ tickets _____ __________________
deposit _____ __________________ hotel _____ __________________
rent _____ __________________ pack _____ __________________
fly _____ __________________
List 3 List 6
floor _____ __________________ supermarket _____ __________________
carpet _____ __________________ pharmacy _____ __________________
vacuum _____ __________________ shoe store _____ __________________
linoleum _____ __________________ gas station _____ __________________
Instruct your client to find the first letter of the words in each list and write them on the
blanks. Then have him create a sentence that uses the letters as the first letter of
each word in the sentence. When your client is finished, have him cover the list and
recall the words using the sentence as a reminder.
At this point, many different strategies have been practiced that require coding and
retrieving information. The focus has been on intentional use of the strategies with very
little flexibility in how the information was coded and retrieved. The tasks in this section
will continue to use those previously learned strategies but will also include a mental
manipulation factor involving inclusion and exclusion. This will give practice utilizing
the strategies and becoming more flexible with their usage. Memory skills like this are
needed for planning daily and weekly schedules, determining what to cook for dinner
based on family members’ likes and dislikes, and for any activity requiring the comparison
of information.
Process
Read the words in each list to your client and pause while she rehearses them. If you
observe that your client is having trouble recalling all the words, ask her if she’d like to
have the list repeated. When your client has successfully coded all the words, ask the
question. If she is still unsuccessful, repeat the stimulus items for her to reattempt coding.
Do not ask her to repeat the stimulus items as she codes them because that encourages
rehearsal and coding of incorrect information. If presenting the words auditorily isn’t
successful, switch to a visual mode and have your client read the items. Keep the
stimulus question covered as your client codes the words. After she feels the words are
coded, cover them and have her read and answer the question.
Read the four words in each list to your client or have her read them. Then pause
while your client rehearses the words. If she can’t recall all the words, say them
again or have her read them. Then have your client cover the words and answer
the question.
Read the five words in each list to your client or have her read them. Then pause
while your client rehearses the words. If she can’t recall all the words, say them
again or have her read them. Then have your client cover the words and answer
the question.
Have your client code the words in each list as you read them aloud. Pause to allow
your client to rehearse the words. If your client can’t recall the words, repeat them.
Then ask the question.
Have your client code the words in each list as you read them aloud. Pause to allow
your client to rehearse the words. If your client can’t recall the words, repeat them.
Then ask the question.
Read the four words in each list aloud. Then pause while your client rehearses the
words. If your client can’t recall all the words, say them again. Then ask the question.
Read the five words in each list aloud. Then pause while your client rehearses the
words. If your client can’t recall all the words, say them again. Then ask the question.
These tasks have your client associate two visual items and then recall one of the items
by using her coding strategies. This skill aids in coding people’s names to their faces,
recalling information provided by someone, or when reading and recalling information
(e.g., where you park your car).
Process
Instruct your client to study each pair of figures and to devise a strategy to associate the
items together. Explain to your client that he will be required to recall the geometric shape
on the left when shown the line drawing. Once he has coded one pair, have him move to
the next one until all five pairs have been coded. When your client is finished, have him
review all five pairs before going to the next page and drawing (or stating the name of)
each shape.
The order of recall of the paired shapes will change on the response page. This is done
to prevent fixation and to stimulate flexible mental manipulation skills. If a client has been
successful with devising effective strategies, the order change will have little effect on
recall. It will also help to encourage a client as he will feel a greater sense of success.
Aid your client in creating his own strategies only when necessary. Once he has
completed the response page, it will be beneficial for him to verbalize the strategies he
used for each pair. This will make him more consciously aware of the strategies he is
using. It will also help you understand how your client develops the strategies and will add
to your list of possible strategies to provide for other clients when they need assistance.
As with all tasks in this book, the level of difficulty can be increased by including a delay
or distractor between the coding and retrieval of the information. Distractors could include
conversation, another task (not a memory task), or simply a delay.
In this section, your client will practice coding people’s names to their faces. This is
obviously a skill your client can use immediately as she meets new people and recalls
the names of people she sees on a daily basis.
Process
Have your client code each person’s name to his or her face. When your client thinks she
has accurately coded all five people’s names and faces, have her go to the next page and
write each person’s name in the appropriate place. The pictures on the second page will
be arranged differently than the first page.
Encourage your client to use not only facial features to code the names but also other
factors, including clothing, body position, occupation (where applicable), or age. If your
client is having trouble accurately coding, aid her with devising a strategy to help her
remember. For example, she might make up a short story that links the person’s name
and appearance, such as “Carl is very proud that he graduated today” for a picture of
a man named Carl in a graduation cap and gown.
Earl Jack
Calvin
Pete Carl
Tam Randy
Marcus
Matt Greg
Simon Alex
William
Chuck Doug
Sherrie Ellen
Ruth
Marla Gina
Erik Peppar
David Martinez
Henry Sved
Marie Morgan
In this section, your client will learn and practice strategies for remembering numbers and
sentences. The everyday importance of being able to remember telephone numbers and
social security numbers is self-evident but your client will also find himself in situations
when he needs to remember sentences as well. For example, your client might need to
remember sentences any time he’s asked to relay a message or when given directions by
his doctor.
Process
In Exercise 1, your client will learn and practice a strategy for remembering telephone
numbers. This strategy involves converting numbers into words using the letters that
correspond to each number on a telephone keypad. Use the top half of the page to
introduce the strategy to your client. Then have him practice the strategy by completing
the bottom section.
In Exercise 2, present the chunking strategy to the client and then have him work
through the rest of the exercise. Provide alternative strategies only if the client is
unable to recall the numbers when you request him to do so.
In Exercises 3 and 4, explain the chunking strategy to your client and then have him
memorize the sentences by reading them independently or by having you read them
aloud. Encourage the client to use the chunking strategy and to pair it with the memory
system that works best for him. For example, if his primary system is visual, encourage
him to visualize one chunk of a sentence and then another to help him code the
information.
7 7 6 – 4 3 3 2
GHI JKL MNO PRO – IDEA
4 5 6
The Internal Revenue Service uses this system
PRS TUV WXY for some of its telephone numbers. For example,
the national line for ordering tax forms is:
7 8 9
1-800-829-3676
8 2 9 – 3 6 7 6
T A W C M P M
U B X E N R N
V C Y F O S O
Have your client write his phone number and others that he calls on a regular basis.
Have your client use the system explained above to remember these phone numbers.
Instruct your client to cover the page as you ask him to recall the individual numbers.
(Remember, there are no letters that correspond to the numbers 1 or 0 so your client
will need to come up with a different strategy for remembering those numbers.)
One good way to remember information is by chunking it into manageable parts. The
most commonly used chunking strategy is for remembering telephone numbers. To
remember a telephone number, chunk it into groups of three and four digits. Here’s an
example of a “chunked” telephone number.
776 – 4332
You can remember this telephone number by learning its two parts first, then putting
them together when you need to recall the number. List five telephone numbers you
call often. Then practice the chunking strategy to remember them.
The chunking method can also be used for remembering your social security number.
Write it in the boxes and see how it can be chunked into three, two, and four digits.
Now make up a social security number and use the chunking method to remember it.
What other groups of numbers could the chunking method help you remember?
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
7. When the child became sick, they almost cancelled the trip.
12. Joel put the bags of groceries in the trunk of the car.
2. He waited in the front of the clothing store while his wife picked out school
clothes, new shoes, and warm jackets for their three children.
3. A cold front will be coming through the area this afternoon bringing cooler
temperatures, driving rains, and strong winds.
4. The Grand Canyon in Arizona is said to be extremely breathtaking, and its size
brings everything into perspective.
5. For dinner they had chili and onion hamburgers, carrot sticks, several kinds of
fruit juices, and apple pie with ice cream for dessert.
6. In the United States, high school often starts in mid-August and lasts until the
beginning of June.
7. There was a major traffic problem on the expressway because the cars and
trucks were backed up for two and a quarter miles.
8. If you’re looking for convenience without a lot of expense, try staying at one of
the cheaper hotels along the parkway downtown.
9. In countries other than your own, most foods are very good, although the taste
of them can be quite different from what you are used to eating.
10. We were disappointed because the baseball team lost to Atlanta last night after
having a ten-game winning streak.
In this section, your client will practice coding associations between different types of
pictures. This kind of skill is needed when we choose to remember what to buy at the
grocery store by walking up and down the aisles until we see what we need to buy or
when we need to remember what we want to take when we go somewhere. The paired
pictures address associations between people and objects, people and places, and
between two different objects. The different formats are given to provide practice with
coding varied relationships.
Process
As your client codes each pair of pictures, encourage her to use any kind of association
she can imagine. It might help to use exaggeration. For example, to auditorily code the
association between a person fishing and a pocketknife, your client might say to herself,
“The person fishing used the pocketknife to cut her line just before she was dragged
into the water by a 300-pound catfish.” A client with a predominantly visual system might
associate the two pictures by combining them into one picture. When your client closes
her eyes, she might see the person fishing with the pocketknife sticking out of her back
pocket.
Have your client study each person and the object he or she is associated with so that
if your client is shown or told one, she will be able to recall the other. Tell your client
that the object may not be commonly associated to the person so she will need to use
a strategy to remember the association.
Person Object
Have your client study each person and the object he or she is associated with so that
if your client is shown or told one, she will be able to recall the other. Tell your client
that the object may not be commonly associated to the person so she will need to use
a strategy to remember the association.
Person Object
Have your client study each person and the object he or she is associated with so that
if your client is shown or told one, she will be able to recall the other. Tell your client
that the object may not be commonly associated to the person so she will need to use
a strategy to remember the association.
Person Object
Have your client study each pair of objects so that if she is shown or told one, she
will be able to recall the other. Tell your client that the objects may not be commonly
associated so she will need to use a strategy to remember the association.
Object 1 Object 2
Have your client study each pair of objects so that if she is shown or told one, she
will be able to recall the other. Tell your client that the objects may not be commonly
associated so she will need to use a strategy to remember the association.
Object 1 Object 2
Have your client study each pair of objects so that if she is shown or told one, she
will be able to recall the other. Tell your client that the objects may not be commonly
associated so she will need to use a strategy to remember the association.
Object 1 Object 2
Have your client study each pair of objects so that if she is shown or told one, she
will be able to recall the other. Tell your client that the objects may not be commonly
associated so she will need to use a strategy to remember the association.
Object 1 Object 2
Have your client study each person and the place he or she is associated with so that
if your client is shown or told one, she will be able to recall the other. Tell your client
that the people and places may not be commonly associated so she will need to use
a strategy to remember the association.
Person Place
Have your client study each person and the place he or she is associated with so that
if your client is shown or told one, she will be able to recall the other. Tell your client
that the people and places may not be commonly associated so she will need to use
a strategy to remember the association.
Person Place
26 5
G as
A DA M S S C HO OL
This section provides stimulus items for coding the names of shapes and pictures. The
shapes are used to give practice coding without content distractions. This is done to
establish the association coding pattern into the client’s cognitive processes. The pictures
then give practice coding with content. The pictures will naturally stimulate associating
content between items, even if the items are unrelated. This set up provides another
format for client to practice the strategies they have learned for coding lists of information.
Process
Instruct your client to use his strategies to code or memorize the stimulus items.
Encourage him to use various memory strategies, such as associations, chaining, and
chunking to recall the shapes and pictures. Aid with the strategies as necessary and help
your client in determining which strategy appears to be the most effective.
Following the shapes are exercises that provide stimulus items for coding the names of
pictures. Attempt to use various strategies with your client. Associations, chaining, and
creating a sentence or short story that involves the picture names are frequently the most
effective strategies.
The shape section is introduced by a page which insures that your client knows the
names of the shapes used in the exercises. If necessary, make a copy of the page for
your client if he has difficulty naming the shapes while he is trying to code them.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study each line of shapes and use a strategy to code it. When your
client feels he has the line memorized, have him cover the shapes and name them
or draw them on another sheet of paper.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
To:
:
From
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the pictures and use a strategy to code them. When your client
feels he has them memorized, have him cover them and name them.
Have your client study the picture and use a strategy to code its details. Then have
him answer the questions on the next page.
Have your client answer these questions about the picture he just studied.
________________________________________________________________
Have your client study the picture and use a strategy to code its details. Then have
him answer the questions on the next page.
Have your client answer these questions about the picture he just studied.
Have your client study the picture and use a strategy to code its details. Then have
him answer the questions on the next page.
BAKERY BA
Doughnuts
Have your client answer these questions about the picture he just studied.
8. What was sticking out of the top of the person’s bag? _____________________
Have your client study the picture and use a strategy to code its details. Then have
him answer the questions on the next page.
Have your client answer these questions about the picture he just studied.
1. Which end of the pool was the deep end, the right or left? _________________
________________________________________________________________
Have your client study the picture and use a strategy to code its details. Then have
him answer the questions on the next page.
FLOUR SUGAR
COFFEE
Have your client answer these questions about the picture he just studied.
_______________________________________________________________
________________________________________________________________
10. What was in the open cupboard under the counter? ____________________
In this section, your client will practice sorting words and pictures into categories, coding
them, and then recalling them. Acquiring memory skills in the area of categorization
will help your client in her everyday life. For example, remembering a grocery list will be
easier if your client is able to break the items into categories like meat, vegetables, and
cleaning products.
Process
Show your client each page and have her sort the words or pictures into four categories.
Then cover the page and have her write the words or names of the pictures on a separate
sheet of paper. If your client is having trouble recalling the words, help her code them by
using a chaining strategy for each category. For example, if the words in a category are
oven, refrigerator, microwave, and vacuum cleaner, have her create a chaining strategy
that includes all four.
After I took the turkey out of the refrigerator, I defrosted it in the microwave and
cooked it in the oven. When I took it out of the oven, I dropped it on the floor and
cleaned it up with the vacuum cleaner.
Have your client sort the words in the box into four categories. Then have her
study them and code them. When your client thinks she can remember all of the
words, have her cover the page and write all 16 words on a separate sheet of paper.
Have your client sort the words in the box into four categories. Then have her
study them and code them. When your client thinks she can remember all of the
words, have her cover the page and write all 16 words on a separate sheet of paper.
Have your client sort the pictures into three categories. Then have her study them
and code them. When your client thinks she can remember all of the pictures, have
her cover the page and write the names of all 12 items on a separate sheet of paper.
Have your client sort the pictures into three categories. Then have her study them
and code them. When your client thinks she can remember all of the pictures, have
her cover the page and write the names of all 12 items on a separate sheet of paper.
The exercises in this section focus on coding functional information in tasks that are
similar to items we encounter in life on a daily basis. They begin with simple messages,
and progress to short paragraphs and narrative length materials. Your client will use
various strategies to code the information based on what he has successfully learned
during previous activities.
Process
Encourage your client to take his time with these exercises. Provide information as much
as needed for coding to be successful but guard against some clients’ tendencies to want
to review the content over and over.
Instruct your client to use the strategies he feels he has always used. For example, if he
highlights important information, give him a highlight marker. If he tends to write things
down, give him a pencil and paper. Encourage him to study his cues and then let you
know when he is ready for the review questions.
If your client claims he will just recall the information by reading it or listening to it, test his
theory. If he is successful—that’s great. However, if he is unsuccessful, help him develop
one of the strategies mentioned above or work together to devise a system that will be
effective for him.
Read the memo to your client or have him read it. If he reads it, encourage him to
study it and code it. If you read it aloud, ask your client if he would like it repeated.
Be prepared to repeat it as many times as necessary until your client is comfortable
that he coded the content. Then cover the memo and have your client answer the
questions, either by listening to them or reading them.
MEMO
TO: All Office Staff
To: ____________________________________________________________
In: _______________________________________________________
Explain to the client that John has appointments with two doctors next week. Have
the client read or listen to the information about the appointments and encourage
him to code the information. Tell him to reread the information as many times as he
needs, or repeat it for him until he feels comfortable that he has learned the details.
Then present the questions verbally or have him read and answer them.
Read one set of directions at a time to your client or have him read them. Cue him
to code the information. Then ask your client to tell you what he read or heard from
memory. Encourage him to reread the directions as many times as necessary, or
repeat them for him until he says he has coded the content.
1. Go straight ahead. Halfway down the hallway, the door to the lobby will be on
your right.
2. Take I-95 South until you get off at the Annapolis exit. I’ll meet you at the gas
station at the end of the exit.
3. The office is on the second floor. It’s the second door on your left when you get
off the elevator.
4. The guest room is upstairs at the end of the hallway on your right.
5. The library is two buildings further down from the police station on Main Street.
6. Go left after you leave the store. Walk two blocks and you will see the car parked
in the lot on your left.
7. Take State Street south. At the first light, go right. The mini-market will be on
your left in about a half mile.
8. We will walk down East Drive, go left on Chestnut Street, and meet them in front
of the bank.
9. Take the escalator down to the ground floor. Walk through the Appliance
Department and you’ll see the Lawn and Garden Department by the back wall.
10. After getting off the bus at 17th Street, walk toward the river for four blocks. Then
go south on Avenue B for six more blocks.
Read one set of directions at a time to your client or have him read them. Cue him
to code the information. Then ask your client to tell you what he read or heard from
memory. Encourage him to reread the directions as many times as necessary, or
repeat them for him until he says he has coded the content.
1. Take 309 North. After you come to Mac’s Diner, take the next left onto Orville
Street. Go about two miles along Orville, and at the next light you’ll see the pizza
place on your right.
2. Walk up Market Street for three blocks to Third Avenue. At Third Avenue, go
right and walk four blocks until you reach Maple Avenue. Go right on Maple,
and in about two and a half blocks you’ll see the drugstore across the street.
3. After leaving this room, go right. When you get to the end of the hall, go left.
Pass the elevators on your right and enter the lobby. On your right, you’ll see
a door that leads to a short hallway. Go through that door, and physical
therapy will be the second door on your left.
4. Get on the Turnpike at Valley Forge. Go east on the Turnpike for about 16
miles to the Fort Washington exit. After you pay the toll, stay to the right and
get on 202 North. From there you will see the hotel on the left.
5. At 3:00, get on Bus 313 at the Mill Street stop. Transfer to the 454 at Archer
Avenue and take that bus to the mall. Use the south entrance and meet me
at Barnes Shoes, which is three stores down on the left-hand side.
Have the client read or listen to each paragraph. Then have him answer the question
from memory.
1. After washing and drying his clothes, he put away the detergent and dryer sheets.
He hung his shirts and pants in the closet and put his T-shirts in the drawer.
What clothing did he put away? ________________________________________
2. Marietta is an animal lover. She has two cats and a German Shepherd. She
keeps a fish in a large tank in her living room. It’s a good thing she has a large
apartment.
What animals does Marietta have? _____________________________________
3. Henri reads anything he can get his hands on. He reads any books and
magazines he can find. He loves to go to the grocery store and read the labels
on the containers. He even reads all the junk mail he receives every day.
What does Henri read? ______________________________________________
_______________________________________________________________
4. On Saturday mornings, Jacquette gets up early and goes to any yard sale she
can find. This past Saturday she bought two games, a vacuum cleaner that was
missing its cord, and three chipped plates that she thought might be collectors’
pieces.
What did Jacquette buy last Saturday? __________________________________
_______________________________________________________________
5. Tanya really enjoys living in the city. Yesterday when she went to Central Park, she
saw a mime performing for a small crowd, bought a hot dog from a vendor, and sat
on a bench to watch the children playing. She thought it was a perfect day.
What did Tanya do and see in the park? _________________________________
___________________________________________________________________
Have the client read or listen to each paragraph. Then have him answer the question
from memory.
2. Craig likes to watch the home shopping channel. Within the last month, he
ordered an embroidered blazer for his daughter, a cooking set to give as a
wedding present, and some Super-Duper Car Wax for himself. He likes being
able to order things by phone because he doesn’t like shopping in stores.
What did Craig order? _______________________________________________
___________________________________________________________________
3. Bette’s daughter called her from school. Her daughter said she had forgotten
some things and asked Bette to bring her lunch that was packed and in the
refrigerator, her math homework that was on her desk, and her gym clothes that
were somewhere on her bedroom floor. Bette said, “Okay,” hung up, and went to
look for the items.
What did Bette’s daughter forget to take to school? ________________________
________________________________________________________________
4. They had decided to get a pet dog so they looked at several breeds of puppies
before narrowing the choice to three breeds. The Shetland sheepdog was
friendly but seemed very high-strung. The chow chow looked like a little teddy
bear but the owner said that the breed was usually a “one-person” dog. The
golden retriever, however, seemed perfect in every way. After a short discussion,
they decided to get the retriever.
Which breeds did they consider? _______________________________________
___________________________________________________________________
5. The Saturday schedule for the Shelbys was going to be busy. They planned to go
to the nursery and buy some bushes for their front yard. Then they would have to
plant the bushes by 1:00 because they were expected at a picnic by 2:00. After
the picnic, they planned to go home and watch TV.
What were the Shelby’s Saturday plans? ________________________________
___________________________________________________________________
WALC 10: Memory 158 Copyright © 2007 LinguiSystems, Inc.
Functional Memory Tasks Exercise 7
Paragraphs with 3-4 Elements – Exclusion
Have the client read or listen to each paragraph. Then have him answer the question
from memory.
1. Mindy received many gifts for her birthday. Grandma gave her some clothing.
Uncle Bill gave her a doll and a book bag. Aunt Sheryl gave her tickets to the
zoo and a basketball.
Which gifts did Mindy get that were not toys? _____________________________
_________________________________________________________________
2. Geraldo liked to collect many things. He had a book of rare stamps and a book
of foreign coins. He added to his butterfly collection every summer. He wondered
what else he could collect.
What did Geraldo collect that was not an insect? __________________________
___________________________________________________________________
3. Beverly welcomed her out-of-town guests warmly. She took them to the park and
then to the museum downtown. They bought lunch from a street vendor before
going to the fishing pier.
Where did Beverly and her guests go that were not buildings? ______________
____________________________________________________________________
Have the client read or listen to each paragraph. Then have him answer the question
from memory.
1. Christine reviewed her telephone bill carefully. She had made an overseas call to
France to talk to an old college friend. She had a collect call from her brother in
Georgia and two calls that she had made to friends in Texas and Arkansas.
Where did Christine call that was not in the United States? __________________
________________________________________________________________
2. She decided to cook a special meal. She baked fresh bread and made a Caesar
salad. She prepared broiled flounder stuffed with crab meat and had strawberry
cake for dessert.
3. It was a Saturday night and they were trying to decide what to do. They could go
visit friends or treat themselves to a movie. They talked about taking a walk in
the park but finally decided to rent a movie and stay home.
Where did they consider going that was not indoors? ______________________
_________________________________________________________________
4. Before Oscar began his Saturday chores of mowing the lawn and washing the
car, he ran some errands. First he went to the library and then to the hardware
store to buy some wood screws. On the way home, he remembered to stop at
the grocery store for milk and bread.
What did Oscar do that did not cost him money? __________________________
________________________________________________________________
Have the client read or listen to each paragraph. Then have him answer the questions
from memory.
1. Maria went to the grocery store and searched up and down the aisles. She
selected cereal for the kids to eat for breakfast, some lightbulbs to replace those
that had burned out, and she stocked up on meat to store in the freezer and use
as needed.
2. Robert was getting more and more butterflies in his stomach as the time for
his presentation approached. He knew he was well-prepared, though. He had
researched the topic thoroughly, organized the information carefully, and had
even made handouts to give to each person in the audience.
What three things had Robert done to prepare for his presentation? ___________
____________________________________________________________________
_____________________________________________________________________
How did Robert feel? (Give two answers.) _______________________________
_______________________________________________________________
3. Paula always had difficulty deciding what to get her mother for her birthday. Her
mother had more than enough clothing, didn’t like to read books or write letters,
and complained about having more things to dust if you bought her a knickknack.
Paula decided to give her mother a gift certificate to her favorite restaurant.
Have the client read or listen to each paragraph. Then have him answer the questions
from memory.
1. Your meeting time has changed. It will be on Tuesday instead of Wednesday, and
it will start at 1:30. Please remember to bring your minutes from the last meeting.
It is anticipated that the meeting will last an hour and a half.
What day was your meeting originally scheduled for? ______________________
What day is it scheduled for now? _____________________________________
What time will the meeting start? ______________________________________
How long will the meeting last? _________________________________________
What should you remember to bring to the meeting? ________________________
2. Before leaving on vacation, Syndie went to the post office to put in a notice to get
her mail held for the one week she’d be away. She also arranged for her parents
to watch her dog, and she took her cat to an animal boarding center. Lastly, she
called the newspaper office and asked them not to deliver the newspaper while
she was away.
Why did Syndie go to the post office? ____________________________________
What did she arrange for her dog while she was away? ______________________
What did she arrange for her cat while she was away? ______________________
What was the last thing she arranged? ___________________________________
How long was she going away? ________________________________________
3. Before going to Haiti with a group to build a boys’ orphanage, Kathy had to
prepare. First she got her passport. Then she arranged to get shots for typhoid,
tetanus, and hepatitis. She also had to start taking tablets to prevent malaria. She
went to classes to learn about the country and to learn some basic Creole and
French. The group leader helped to get the airline tickets and hotel reservations.
What country was Kathy going to? _____________________________________
What did she get first? _______________________________________________
What was one disease she had to get shots for? ___________________________
What were the tablets for? ____________________________________________
What did she learn in the class? ________________________________________
What did the group leader help to get? __________________________________
Have your client listen to or read the paragraph. If he is reading, encourage him to
underline or highlight the key information. If he is listening, encourage him to take
notes. Then have him answer the questions from memory.
1. What was the home of the President of the United States originally called?
______________________________________________________________
Have your client listen to or read the paragraph. If he is reading, encourage him to
underline or highlight the key information. lf he is listening, encourage him to take
notes. Then have him answer the questions from memory.
2. How does your brain find out how something tastes? ____________________
______________________________________________________________
______________________________________
______________________________________
______________________________________
______________________________________
Have your client listen to or read the paragraph. If he is reading, encourage him to
underline or highlight the key information. If he is listening, encourage him to take
notes. Then have him answer the questions from memory.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
6. What is the last thing done to the sheet of bills so they can be put into
circulation?
_________________________________________________________________
Have your client listen to or read the passage. If he is reading, encourage him to
underline or highlight the key information. If he is listening, encourage him to take
notes. Then have him answer the questions on the next page from memory.
Selecting a Puppy
1. How will everyone in your household feel about and deal with a puppy?
2. Which breed will you choose? Choose the breed carefully, considering
the size the puppy will grow to be, the temperament of the breed, and
any limitations in your environment.
3. Is the person who is providing you with the puppy reliable?
4. Do you want a male or a female puppy?
5. Who will be the main caretaker of the puppy?
Although it’s recommended that you don’t get a puppy that is younger than six
weeks old, waiting until the puppy is eight weeks old will help insure that the
puppy is fully weaned from its mother and is strong enough to be on its own.
Look at the puppy carefully and make sure that it’s healthy and active. If the
puppy has a runny nose or watery eyes, it may be a sign that it is ill, and you
should consider selecting a different puppy. Watch the puppy’s behavior.
Stay away from an overly shy or easily frightened puppy, one that snaps, or
one that is overly aggressive.
Have your client answer these questions about the narrative on the previous page.
Ask him to first go through the questions and answer as many as he can from
memory. For those he can’t recall, have him go back and scan the narrative or have
him use his notes to locate the answers.
2. What are three of the five considerations that one should take into account
when selecting a puppy?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
3. Why is it advised to wait until a puppy is eight weeks old before bringing it home?
___________________________________________________________________
Have your client listen to or read the passage. If he is reading, encourage him to
underline or highlight the key information. If he is listening, encourage him to take
notes. Then have him answer the questions on the next page from memory.
Flashlight Tips
A flashlight is one of the most useful appliances you could own. To insure
that it keeps in the best working order, here are some dos and don’ts:
1. When you insert the batteries, make sure the positive (+) end points
forward toward the lightbulb. If you insert the batteries in the wrong
direction, there won’t be an electrical current flowing to the lightbulb
and the flashlight won’t work.
2. Cold weather can be very hard on batteries. Don’t expect the flashlight
to work if you’ve left it out in the cold all winter. However, heat will
frequently bring a battery back to life, so try bringing the flashlight
indoors. Don’t discard the batteries until you are sure they are
unusable.
If the light keeps flickering when you turn on the flashlight, it probably has
a poor connection. Try opening the flashlight and gently stretching the
coiled spring in the cap to improve the connection of the battery with the
contacts. If the light becomes faint, it’s probably due to weak batteries and
it’s time to replace them with new ones. There is the possibility that if you
leave batteries in a flashlight for too long, they’ll begin leaking a brownish,
sticky liquid. If this happens, throw away the batteries (be careful not to
touch any of the liquid) and clean the inside of the flashlight before installing
new batteries.
Have your client answer these questions about the narrative on the previous page.
Ask him to first go through the questions and answer as many as he can from
memory. For those he can’t recall, have him go back and scan the narrative or have
him use his notes to locate the answers.
4. What does a flickering light indicate, and what is a possible solution for this
problem?
_________________________________________________________________
_________________________________________________________________
5. What should you do if the light from a flashlight becomes faint? ______________
_________________________________________________________________
Have your client listen to or read the passage. If he is reading, encourage him to
underline or highlight the key information. If he is listening, encourage him to take
notes. Then have him answer the questions on the next page from memory.
During World War II, lumber was a precious resource, and one that needed
to be protected for use in the war effort. As a result, the U.S. Forest Service
worked with the Wartime Advertising Council to design an ad campaign to
educate people about the dangers of forest fires that would damage the
lumber supply. Their creation was the now famous cartoon figure Smokey
the Bear. In 1950, firefighters found a real-life Smokey the Bear—a four-
pound bear cub that was found clinging to a fire-blackened tree in New
Mexico’s Lincoln National Forest. Firefighters named him Smokey the Bear,
and he was sent to the Smithsonian Institution’s National Zoo where he lived
until his death in 1975.
In the 50 years following the creation of the symbol of Smokey the Bear,
he has been featured in advertisements, cartoons, billboards, and was
even on a postage stamp. Representations of Smokey have participated in
Macy’s Thanksgiving Day Parade and in the New Year’s Day Tournament of
Roses Parade. In 1994, the Forest Service planned a year of special events
commemorating Smokey’s golden anniversary. At that time, the Fernbank
Museum of Natural History in Atlanta, Georgia, opened a traveling show
focusing on Smokey the Bear’s history and on the characteristics of forest
fires and fire prevention.
Have your client answer these questions about the narrative on the previous page.
Ask him to first go through the questions and answer as many as he can from
memory. For those he can’t recall, have him go back and scan the narrative or
have him use his notes to locate the answers.
2. Which U.S. service was involved in developing the symbolic Smokey the Bear?
________________________________________________________________
9. What did the Forest Service plan in 1994, and why? ______________________
________________________________________________________________
11. What kind of traveling show did the museum open? _______________________
________________________________________________________________
A higher level of memory coding involves the element of being able to mentally
manipulate the information without losing any salient content. In many instances, we
need to have this mental flexibility for integrating new information and for making effective
decisions based on all the facts. The following tasks present several formats for coding
and manipulating information before responding with a specific answer.
Process
Reassure your client that you’ll repeat the items as necessary but that you’ll always
present the stimulus items in their entirety. Many clients will unintentionally attempt
to get you to create a chunking system for them by providing the information in chunks
as shown in the following exchange.
Clinician: Rearrange these items from smallest to largest: hat, desk, button, suitcase.
Client: Please repeat.
Clinician: hat, desk, button, suitcase
Client: Okay, let’s see . . . button . . . uh . . . hat . . . what were the other two?
Clinician: I’ll give all of them to you again. The four words are hat, desk, button,
suitcase.
Client: button, hat . . . uh . . . hat and desk . . . suitcase
If your client is unable to do the task auditorily, provide her with the written list.
Let her study it and mentally rehearse the answer. Then cover the items and have her
provide the answer.
Read the three words to your client. Have her repeat them to you in reverse order.
Read the four words to your client. Have her repeat them to you in reverse order.
Read the words to your client. Have her rearrange the words into a sentence and
say the sentence aloud.
Read the words to your client. Have her rearrange the words into a sentence and
say the sentence aloud.
Read the three words to your client. Have her repeat them back to you in the order
they would occur.
2. 16, 19, 17
Read the four words to your client. Have her repeat them back to you in the order
they would occur.
Read the four words to your client. Ask her to mentally rehearse the words and to
let you know if she coded all of them. If not, repeat the words. Then give her the
instruction for each set of words.
Read the three words to your client. Have her repeat them back to you in alphabetical
order. Repeat the words as needed.
Read the four words to your client. Have her repeat them back to you in alphabetical
order. Repeat the words as needed.
Read the words to your client. Have her identify the smallest item on the list.
Carney, N., Chestnut, R., Maynard, H., Mann, N.C., Patterson, P., & Helfand, M. (1999). Effect of
cognitive rehabilitation on outcomes for persons with traumatic brain injury: A systematic review.
Journal of Head Trauma Research, 14(3), 277-307.
Cicerone, K.D., Dahlberg, C., Kalmar,K., Langenbahn, D.M., Malec, J.F., Bergquist, T.F., et al. (2000).
Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of
Physical Medicine and Rehabilitation, 81(12), 1596-1615.
Cicerone, K.D., Dahlberg, C., Malec, J., Langenbahn, D.M., Felicetti, T., Kneipp, S., et al. (2005).
Evidence-based cognitive rehabilitation: Updated review of the literature from 1998 through 2002.
Archives of Physical Medicine and Rehabilitation, 86(8), 1681-1692.
Coelho, C.A., DeRuyter, F., & Stein, M. (1996). Treatment efficacy: Cognitive-communication
disorders resulting from traumatic brain injury in adults. Journal of Speech and Hearing
Research, 39(5), S5-S17.
Craik, F.I.M., Winocur, G., Palmer, H., Binns, M.A., Edwards, M., Bridges, K., et al. (2007). Cognitive
rehabilitation in the elderly: Effects on memory. Journal of the International Neuropsychological
Society, 13, 132-142.
Cuesta, G.M (2003). Cognitive rehabilitation of memory following stroke. Theory, practice, and
outcome. Advances in Neurology, 92, 415-421.
Winocur, G., Craik, F.I.M., Levine, B., Robertson, I.H., Binns, M.A., Alexander, M., et al. (2007).
Cognitive rehabilitation in the elderly: Overview and future directions. Journal of the International
Neuropsychological Society, 13, 166-171.
Elbaum, J., Kramer, P., Benson, D., & Dulaski, C. (2002). Functional memory manual. Austin, TX:
Pro-Ed, Inc.
Helms-Estabrooks, N., & Albert, M.L. (2005). Manual of aphasia and aphasia therapy. Austin, TX:
Pro-Ed, Inc.
Hillis, A. (2002). The handbook of adult language disorders. NY: Psychology Press, an imprint of the
Taylor & Francis Group.
Higbee, K. (2001). Your memory: How it works and how to improve it. NYC: Marlowe & Company.
Keith, R.L., & Schumacher, J.G. (2001). Speech and language rehabilitation. Fourth edition. Austin,
TX: Pro-Ed, Inc.
LaPointe, L.L. (2005). Aphasia and related neurogenic language disorders. Third edition. NYC:
Thieme Publishers.
Sarno, M.T., & Peters, J.F. (Eds). (2004). The aphasia handbook: A guide for stroke and brain injury
survivors and their families. NYC: National Aphasia Association.
Organizations
Websites
www.memory-key.com
About Memory is devoted to “learning about memory for permanent memory improvement;” offers
two free newsletters about memory
American Kennel Club. (2006). The Complete Dog Book. (20th ed.) NYC: Ballantine Books, a Random
House Publishing Group.
Bandler, R., & Grinder, J. (1979). Frogs Into Princes--Neurolinguistic Programming. Moab, UT: Real
People Press.
Buhr, K. (1997). An experiment testing the eye movement hypothesis of NLP by presenting visual
stimuli and measuring reaction times. Unpublished master’s thesis, University of Bielefeld,
Department of Psychology, Bielefeld, Germany.
Liles, M.D., & Liles, R.M. (1974). Good Housekeeping Guide to Fixing Things Around the House.
NY: Good Housekeeping Books.
McAbee, P., & Nesbit, C. (October 1988-June 1989). NLP with Ethics. Workshop for Practioner
Training. Philadelphia Training Institute for Neuro-Linguistic Programming.
Ravenal, R. (1994). Where There’s Smokey, There’s Never Any Fire. Smithsonian Magazine, 59-61.
23-07-987654321