This Speechinar will include a review of common cognitive impairments seen in various adult populations, examples of activities of daily living that are impacted by cognitive changes and how we can address them in cognitive speech therapy sessions, and strategies you can use at home to manage these challenges in your daily life.
Slides used during the Speechinar:
Speechinar Transcript
00:00
Taylor Groth: So I've worked with. I've worked an inpatient rehab, outpatient rehab skill, nursing facilities, assisted living facilities, home health, and now virtual therapy with better speech. So yes, lots of experience working with adults, with cognitive impairments. I am going to share my screen. So you guys can see that my presentation. So let's do that really quick.
00:37
Taylor Groth: okay. So to day we will discuss common cognitive communication impairments in adults, daily activities that are impacted by these changes. What therapy might look like for you?
00:51
Taylor Groth: And some strategies to tackle these challenges at home.
00:56.
Taylor Groth: So our definition of cognitive impairment, cognitive communication disorders are problems with communication that have an underlying cause and cognitive deficit rather than a primary language or speech deficit. Okay, so cognitive deficit.
01:18
Taylor Groth: these are a bunch of different types, or like areas of cognition. So a cognitive communication disorder results from impaired functioning in one or more of these cognitive processes. So we'll go through these quickly. Attention is one area that can be affected. That's our concentration or switching attention between tasks. Our memory is often impacted.
01:43
Taylor Groth: That is our recall of facts, procedures in past and future events.
01:49
Taylor Groth: Our insight and judgment. It can be impacted. So that's understanding one's own limitations and what they mean. Organization. That's either a thought organization
02:01
Taylor Groth: or our ability to organize one's environment.
02:04
Orientation is knowing where, when and who you are as well as why you're there.
02:11
Taylor Groth: Language.
02:13
Taylor Groth: which is our words for communication, processing speed, which is quick thinking and understanding problem, solving, just finding solutions to obstacles, our reasoning skills, which are logically thinking through different situations.
02:27
Taylor Groth: executive functioning, which is making a plan, acting it out.
02:32
Taylor Groth: evaluating your success, and then adjusting your plan. And then metacognition, which is thinking about thinking, thinking how you think.
02:42
Taylor Groth: Okay? So some diagnoses that can lead to cognitive def difficulties. We? We have stroke, brain injury, concussion, dementia, mild, cognitive impairment, Parkinson's disease, brain tumor, chemobrain, and long covid.
03:03
Taylor Groth: So what are some common complaints that we hear on a regular basis as speech therapists. I just can't remember where I can't remember things the way that I used to.
03:14
Taylor Groth: I keep forgetting which day is trash day. That was never hard for me before my stroke.
03:19
Taylor Groth: I get so distracted when I'm trying to get something done. It seems like I can't get anything done.
03:25
Taylor Groth: I lose track of time so easily.
03:28
Taylor Groth: My wife has to manage my medication now, if it's too confusing, and I forget to take them. I keep missing my appointments or forgetting that I have plans right. I walk into a room, and I can't remember what I went in there, for. I keep losing my keys.
03:44
Taylor Groth: The words seem to be on the tip of my tongue. I feel like I can't make decisions like I used to. I can't accomplish everything at work like I used to. It's so hard to think clearly all the time. Right? So this is just a brief list we we hear a lot more. But these are very common ones.
04:03
Taylor Groth: Okay, so activities of daily living, what does that even mean? So our basic Adl's activities of daily living, our toileting, bathing, eating, grooming, and dressing. Those are usually tackled by our occupational therapists. Speech therapists tend to focus more on
04:23
Taylor Groth: ideals which is instrumental activities of daily living and then higher level, cognitive, the activities that go along with that so that could be cooking, shopping, laundry, household tasks, finances, medication management driving
04:39
Taylor Groth: or specific higher level things like time management skills as a big one, planning skills, remembering names.
04:48
remembering new information, how to do something or your appointments.
04:52
Taylor Groth: remembering things in the future, which is our prospective memory. Managing your home.
04:58
Taylor Groth: focusing at work, accomplishing everything on your to do list, saying organized using your smartphone or your computer successfully and paying attention during conversations.
05:11
Taylor Groth: Okay, so as a client struggling with these things, what? What should I work on my biggest pieces of advice is to keep it functional.
05:20
Taylor Groth: You need to work on what is hard for you. Communicate these day to day, struggles with your speech therapist to come up with a plan of action that's tailored to you. That's where we're gonna see the most success. Okay? So if managing medication is hard. Let's find some strategies that work for you and practice that
05:40
Taylor Groth: if organizing your thoughts to write an email for work is hard.
05:43
Taylor Groth: let's practice that if keeping up with your calendar, your appointments, your events is hard. Let's practice that I get asked about brain games, brain teasers, doing brain games and brain teasers. Word searches. Sudoku.
05:59
Taylor Groth: Learn. That's not gonna necessarily help. You get better at remembering your appointments, for example.
06:05
Taylor Groth: doing brain games will help you to get better at doing brain and games right? So we need to be practicing the skill that we want to improve. If by all means, if before your stroke, brain injury, whatever happens. You were really good at word searches, and now you're struggling with that, and you want to get better at it.
06:23
Taylor Groth: We'll work on that for sure. But as long as it has to be functional, okay? So we can expect that
06:31
Taylor Groth: doing Tetris every day for an hour is gonna help us manage our medication better? Right? Things like that. Okay, so let's start with the most kind of significant cognitive impairment that we see so severe cognitive impairments. Maybe in the setting of dementia.
06:51
Taylor Groth: so a problem could be. She isn't remembering her grandkids names, or where she's living now
06:58
Taylor Groth: right? So some possible solutions for this that we can talk about our external memory supports, we call them, are visual reminders, signs in her room or around her home that provide personalized reminders.
07:14
We always want to use first person language.
07:17
Taylor Groth: Otherwise she might think that the signs are for someone else. That's very common. Okay, so an example could be assigned. That says my name is Susan.
07:26
Taylor Groth: I'm living in an apartment in Madison, Wisconsin. I am safe and happy here.
07:31
Taylor Groth: If I need help, I can press the button that's around my neck. Dinner is at 5 Pm. Someone will come and get me right. These types of external supports are very comforting to our clients who have significant confusion issues with memory orientation. Okay? Another one could be, you know, hanging this above her phone or next to her calendar
07:54
Taylor Groth: says, my address is 2, 7, 5 oak drive, and so on. Prairie Wisconsin. My phone number is this, Sarah's phone number. Maybe her daughter. Is this right?
08:05
Taylor Groth: another one that I love to do with people is memory books? So this could be anything you want it to be right. Pictures with, you know, Label who they are. You know the names of who's in the pictures, the kids, the grandkids, important details from that person's life.
08:23
Taylor Groth: maybe their daily routines, or anything that she needs help remembering. Keep this open, and in a spot where she looks at frequently throughout the day.
08:33
Taylor Groth: Daily journaling, we'll talk more about that. That's a a great strategy as well. So with some other visual supports could be for how to complete a daily task. Right? So in the bathroom steps for brushing your teeth, steps for getting dressed.
08:51
Taylor Groth: maybe we need a visual of the steps of how to use your phone, or how to make coffee right? Right above the coffee maker. steps for how to use the TV remote. maybe a simplified TV directory of her favorite channels. Right? All of these things, you know, a caregiver can just do these things for them. But
09:11
Taylor Groth: we, our goal is always independence. Right? So if we have someone who
09:16
Taylor Groth: has to rely on their husband to make them coffee every morning, and that was never a the case for them. That isn't. That is, that's not great. Right? So the goal is independence. So let's
09:27
Taylor Groth: hang up a sign that explains the steps of how to make coffee so she can go back to doing that
09:32
Taylor Groth: for her husband, you know, every day. So independence is is always our goal or modified independence right? So calendar use and daily journaling for memory.
09:43
Taylor Groth: So putting in the effort to write things down can actually help you remember these things better without looking back at the notes. Okay, this goes across the board. Not just for these lower level clients.
09:57
Taylor Groth: Okay, so in therapy for this specific type of client. We would always, if we can do a family interview, ask, what is the client struggling with?
10:06
Taylor Groth: What are their repetitive questions? Right? What do they keep asking over and over and over, what do you want to remember? What do you want them to remember on their own, or do on their own like the coffee example? Then together we would set up and create these external supports and visual queues and talk through it right?
10:26
Taylor Groth: We would also practice, directing the client to these supports to answer their own questions rather than the caregiver, continuing to provide them with the verbal responses and or answer to their question each time. So this retrains the clients brain to look for the answer themselves rather than rely on their caregiver and their auditory memory.
10:50
Taylor Groth: Okay, another example problem that we hear. I need to remind him to take out the trash every Wednesday, and if it's trash day or recycling day or not for us. That's every other every other week, right? So it can get kind of confusing.
11:06
so a possible strategy to try
11:08
Taylor Groth: that we would talk about in therapy as keeping a large family calendar in a central location in the home.
11:14
Taylor Groth: making a note on the calendar of the trash days and large bright letters trash day and add recycling to the recycling days right cross off the days of the week each day to keep track right of the day. That's very important. We don't know what day it is. We can't really use a calendar very well. We have to get into the routine of checking what day. It is every morning throughout the day, if needed.
11:39
Taylor Groth: Another strategy that I love to use with people. If you're tech, savvy, and interested in using your smartphone as a therapeutic tool set in alarm to go off every Wednesday morning.
11:51
Taylor Groth: label it as trash day.
11:53
Taylor Groth: So in therapy we will actually get out your smartphone train you on how to set that alarm. If that's something you don't know how to do. and train you on how to label the alarm, which is very important. If an alarm just goes off on Tuesday night or Wednesday morning, and it's not labelled as trash.
12:10
Taylor Groth: You could easily just ignore it right, and not only like I don't remember what I set that alarm for, so making sure every time you set an alarm, you know how to label it right sweet practice practice to ensure your independence. With that.
12:26
Taylor Groth: we also can create a central hub together. We'll talk about in that in the next slide.and a calendar
12:34
Taylor Groth: confirm the trash and recycling days. Write that in your calendar. Virtual therapy is great for this, because it's like we're right there with you. We're literally in your home. You can walk around with the computer and we can help you set things like this up and then each week, you know, we would check on this with you. Talk to your spouse or your family if needed. Tweak the plan adjust as needed. Right?
12:56
Taylor Groth: So a big point. Remember that forgetting to do things is a very common memory problem. Okay? Prospective memory is our ability to remember to do things in the future. So that's for getting to go to an appointment.
13:10
Taylor Groth: forgetting about a meeting that's coming up at work.
13:13
Taylor Groth: forgetting to send a birthday card or forgetting to return something that you borrowed from your neighbour. Right?
13:19
Taylor Groth: So using a calendar system is truly the best way to avoid these problems altogether. Okay. Some benefits. For this you will need to rely less on your memory.
13:32
Taylor Groth: You cannot only see what's coming up on your schedule, but you'll also have a record of what happened in the past to look back on. Your calendar will help you get into a routine. Our brains love routine.
13:44
Taylor Groth: You can use your calendar to schedule events or things that you need to do. But remember, this is not just for appointments. This is not just, doctor appointments, therapy appointments.
13:54
Taylor Groth: That's it. Put on your calendar to remind you to return that tool to your neighbor, or to take the trash out, or to call your sister back right. And as long as we're in a routine of looking at these, this calendar or daily planner, whatever it is. Frequently we're gonna remember to do these things because we're writing it down right? So that's an you know, fail proof method. Okay?
14:18
Taylor Groth: Alright. So that central hub that I mentioned. So what this is this is an area in your home where you can keep important items ideally close to the entrance of your home. This could be, you know, a table right? A bowl for your keys and other important items. You just drop right when you walk in the door. You always know where they are that wallet, headphones, keys, things like that? A hook for your purse or your bag
14:44
Taylor Groth: backpack, whatever a charging station for your phone, maybe, or ipad something like that.
14:50
Taylor Groth: Your family calendar, a whiteboard for reminders. I love a whiteboard. A notebook could be there for your daily journaling, or to do lists, list of important addresses or phone numbers, whatever you you need in that space. Okay? So that way, you're not searching around for your keys. You're not searching around for that notebook you're supposed to write in every day, and everything is right in that central hub.
15:16
Taylor Groth: So getting into a routine of stopping at the central hub right when you walk in, the door is key, and then frequently checking it throughout the day.
15:26
Taylor Groth: Alright. Another problem that we hear all the time. When I walk into a room I forget what I went in there for. Right? What's going on here. It could be a lot of different things. But typically our attention short term, memory difficulties. Our brain might just be wandering right, which is very typical.
15:44
Taylor Groth: so strategies for this, we're going to go through with some attention strategies. So self-talk is one of my favorites.
15:51
Taylor Groth: It's basically just talking to yourself. This brings your focus and your attention back to the task at hand and reduces the chance that your mind is gonna wander during the time that it takes to get to the other room right. So if you need charger Q-tips, toilet paper, I literally want you to be walking up the stairs saying, Charge or Q-tips, toilet paper, charger, Q-tips, toilet paper, because then guess what? When you get there, you're still saying it out loud. So you're gonna remember what you went up there for, right?
16:19
Taylor Groth: Some people say, you know, I don't wanna be talking out loud. I have family. My wife thinks I'm you know, whatever. So we'll we'll work. And slowly transitioning that to a whisper or using your inner voice. But at first, if this is a serious problem, I want you to be talking out loud.
16:35
Taylor Groth: it really brings your focus back to what you're supposed to be focusing on. Instead of letting your mind wander. Okay?
16:45
Taylor Groth: All right. So some more attention strategies, active effort. What active effort is is just paying attention to paying attention. Ok.
16:55
Taylor Groth: slow down, focus consciously, attend to details closely analyze when reading, for example, allow time to reread sections, summarize things in your own words, check for errors.
17:08
Taylor Groth: Talk out loud again when going through a recipe, for example, marking off as you go as needed. I lose track of time. I get distracted. That's another
17:20
Taylor Groth: problem that we hear kind of in this area. So a strategy besides active effort and self talk would be to set timers and alarms which we talked about briefly before. These can go off when you need to be done with the task. So let's say, you think that doing this task really should only take you 30 min, or you only have 30 min.
17:40
Taylor Groth: Set a timer. So when it goes off in 30 min to remind you to be done.
17:45
Taylor Groth: it can go off 5 min before you need to leave your house. I do that personally, I have for years and again, at the time you need to be in the car.
17:54
Taylor Groth: Can be used for cooking really anything. It can be used as a reminder during your work day to take bringing breaks very important, or to remind you to attend a meeting or make a phone call if you're at work, and some you know, your boss says, Hey, can you hop on this call at 20'clock, and it's noon.
18:13
Taylor Groth: If it's not on your calendar, let's either put it on the calendar and set an alarm because it's something that that just got added right. So let's set an alarm for 10 min to 2 to remind you to get on that call.
18:26
Taylor Groth: Okay, energy conservation is a really big thing. That helps all of our cognitive skills. So step back every letter of this. I don't know where I learned this from, but every letter of step back stands for a different energy conservation tip. So sleep.
18:45
Taylor Groth: sleep enough. Take care of yourself, eat well, stay hydrated big things right? We have to take. We have to take care of our brain. The T is take breaks when you need to refocus. Even 30 s can help. These are true. Brain breaks. So if you're struggling to focus at work.
19:04
Taylor Groth: I don't want your 30 s break to be taking your phone out, scrolling through emails, scrolling through Facebook, whatever. That's not a brain break right. Our brain is still processing so much information. When we do those tasks
19:18
Taylor Groth: a true brain break is literally leaning back.
19:22
Taylor Groth: closing your eyes.
19:24
Taylor Groth: deep breathing for 30 s. Okay. so really rest your brain for 30 s.
19:30
Taylor Groth: for as long as you can. The ears exercise regularly for better relaxation. Sleep and blood flow to the brain. Very important. Pace yourself.
19:40
Taylor Groth: Do your most difficult work when you're most alert. Okay. B is for be open to help
19:48
Taylor Groth: avoid interruptions. That's a big one. Turn off your phone, do not disturb, put up, or do not disturb, sign whatever you need to do to avoid any interruptions cut out distractions which can use up cognitive energy that could be directed somewhere else. If our brain is distracted by a million distractions.
20:06
we're not gonna be able to focus on what we need to focus on right?
20:09
Taylor Groth: Keep it simple, avoid multitasking, do things one at a time. I people say, all the time I used to multitask.
20:17
Taylor Groth: I don't love multitasking. I want you to focus on things one at a time, and you're more likely to be more productive and get things done. If we focus on one thing, finish it, move to the next versus jumping between a bunch of different things. Okay.
20:34
Taylor Groth: alright. Another problem that we hear is, I can't find the right word when I'm talking. It's like it's on the tip of my tongue right? I hear that phrase all the time. So in speech therapy, we'll talk about word finding strategies. Which I have listed here. So I'll go through those. Basically don't sit in silence, hoping the word comes to you.
20:50
Taylor Groth: because then you're the listener. The person who you're talking to has no idea what you're trying to say, and they can't even try to help you. Right? So that's the first tip. Second would be so delay. So just give yourself some time. Hold on 1 s, let me think.
21:10
Taylor Groth: Oh, yeah, here it is. Right. Describe the word describe, describe, describe. That's my biggest strategy for word finding think about. So let's say the word is scissors that you can't come up with. Describe category, its location function, what it looks like. So you could say, you know, it's office supplies. It's in my office drawer. It cuts paper scissors. That's it. Right.
21:35
Taylor Groth: Association. Think of something similar. You can find a synonym or an antonym, so you could say.
21:44
Taylor Groth: you know, it's kind of like
21:47
Taylor Groth: I don't know. It's it's not knives. It's not a knife.
21:50
Taylor Groth: right? So kind of saying what it's similar to or what it's not. Gesture. That's an easy one for scissors. First thing of the first letter, the sound, if you can draw it. I actually a lot of people draw what they're trying to think of, or the word that they're stuck on, and that works
22:08
Taylor Groth: narrow it down. Think of the category. This gives the listener context to possibly help you. Okay, so don't just sit there. Start talking about it as best as you can. The goal is successful communication. Right? So let's start talking about it. If you can't come up with the word yourself, who you're talking to hopefully will be able to help you if you're giving them these descriptions right, and then come back later. It is kind of a last resort, right? You just can't
22:36
Taylor Groth: think of it. If you can't think of how to describe it, whatever it is, come back later, right? It'll it will come back to you.
22:44
Taylor Groth: So in therapy. I kind of already said, this will talk through these strategies in depth, decide what works for you and what situations, and then practice them together, will role, play different communication situations that are important to you. And practice different word, finding strategies and conversation, and during more structured tasks.
23:06
Taylor Groth: Oh, I threw this in here. This is what we call semantic feature analysis. So this is back to our word finding strategy of describing it. So basically, we pull this out. And we practice describing. Okay, so let's say the word. Let's go back to scissors. Scissors is in the middle, and then there's 6 different ways to describe it. So we think about what group it belongs to, what you use it for. What does it do?
23:32
Taylor Groth: It's properties. So describe it. Location and association, right. Not all these are gonna work for every single word, but it's kind of a good visual in a good map for how to accurately describe something. Okay. So either your brain can come up with the right word yourself. That's typically what happens.
23:51
Taylor Groth: As soon as you kind of kick start your brain, you're you're you're stuck on a word and you kick. Start it by describing it. Your brain typically will actually find the word yours word itself. If not, your communication partner will be will definitely be able to figure it out if you've described it in this this step. Okay?
24:11
Taylor Groth: All right. So another problem is, I can't get things done like I used to completing all the steps involved is much harder. Can't get started on my to do list right. You have this long list can't get started on it.
24:25
Taylor Groth: exist. These are all about executive functioning, which is making a plan, initiating it, acting it out, evaluating your success and adjusting. My biggest strategy for these types of difficulties are is
24:40
Taylor Groth: goal plan. Do review. Okay, that's what we call it. So excuse me, basically, you're gonna write this out of ahead of time. Think through every step that's involved, instead of just jumping into a task blindly. Because that's typically when we kind of fail at a task, as if we just jump in and try to do it right.
25:00
Taylor Groth: So an example for this, your goal could be cleaning out the garage.
25:06
Taylor Groth: What's our plan?
25:08
Taylor Groth: Maybe divide the garage into sections? Do one section per day create bins for donation bins to organize and a trash right? Adding items in as I go.
25:19
Taylor Groth: So then you actually do the task complete the task, using attention and energy conservation strategies that we've talked about and then review it. How did it go? What could I have done differently?
25:31
Taylor Groth: This can be done, you know, at the end of the task, or throughout the task, if needed.
25:36.
Taylor Groth: So we can use this template goal plan. Do review for any task that you're trying to accomplish. Okay.
25:44
Taylor Groth: okay, another common problem. I always get home from shopping and realize I forgot a few things. Obviously the, you know, most obvious strategies and make a list before you go. This is great, but sometimes it's hard to think of everything you need during that 5 min period of writing a list before you go right. You sit down to write that list, and your mind kind of goes blank. Right? So instead.
26:09
Taylor Groth: have a running list in your phone
26:12
Taylor Groth: or in a notepad. If you keep that with you all the time. That's key, and add items onto the list as you think of them throughout the day or the week.
26:22
Taylor Groth: Write the item down. As soon as you run out. You take the last tissue out of the box.
26:28
Taylor Groth: right tissues on your list immediately. That way you have everything written down when you go to the store I do this. Consider a few lists. So in your phone, wherever you're keeping this, maybe a list for target, the grocery store in Costco. So that way, if you just stop at a store, let's say, every time you go in there, you open your phone up. Look at the running list, and it's like, Oh, I forgot I needed tissues. I'm at Costco. I can get that here right.
26:57
Taylor Groth: Adding items to your Amazon cart, save for later section. Every time you think of something you need. That's a big one. If you're an Amazon shopper. So that way you you know you go on, Amazon, to check out for something else. Quick! Look in your save for later section, and say, Oh, that's right. I did need that. Let's add that to my cart. Right?
27:18
Taylor Groth: Okay? Another problem is, I struggle to pay attention during conversations. Now that's a big one.
27:24
Taylor Groth: Some strategies for that. Listen actively, turn toward the speakers and face them. Open your posture, lean toward the speaker, maintain appropriate eye contact, relaxed posture right? Just by changing your body language
27:39
Taylor Groth: to list to look like you're listening actively, actually can help you listen. Better
27:43
Taylor Groth: eliminate distractions. Go into a quiet place to have a conversation. If you're at a restaurant. Choose a table away from the chaos, get away from the front door, away from the kitchen right? Turn off the TV. Silence. The phone, close the door. Whatever you need to do to eliminate distractions. So you can focus on the conversation asking questions for clarification. So asking the speaker to slow down or explain something in a different ways is really important.
28:11
Taylor Groth: Paraphrasing. Repeat information back in your own words, our brain loves that, and more and more likely to remember it if it's in your own words. Okay? And it helps ensure that you've actually heard correctly and and understand what the speaker's saying.
28:32
Taylor Groth: okay, so I just kinda added in some other random, like activities that we might do in therapy.
28:39
Taylor Groth: So these are all based on the cooking and meals. Okay? So if someone has a problem solving problem, solving difficulties or difficulty with reasoning, and we're talking about cooking and meals, I may have you come up with different recipes
28:54
Taylor Groth: that use both ground beef and diced tomatoes, or find 2 meal planning or meal delivery websites, and compare and contrast them right. Find a new recipe to try this week and think of all the steps involved. Plan it out. Talk about what could go wrong.
29:09
Taylor Groth: Right?
29:11
Taylor Groth: if you're having difficulty with difficulties with your memory in this area, we could try to recall the steps for a family recipe. Put a post note on the stove, reminding you to turn off the stove. If this is a problem, practice setting timers and alarms for cooking practice, creating a meal, prep calendar together. Right? If you're having issues with that organization or word finding we can
29:36
Taylor Groth: talk about anything related to cooking and meals. But
29:39
Taylor Groth: specifically, maybe practice instructing someone on how to work your dishwasher. It's very specific, so harder to find the right words. Tell me how to make one of your go to fast dinners describe what you need to take into consideration before making a grocery list. Right? So talking through some of those things
29:59
Taylor Groth: in the area of parenting and child care and therapy. We might, you know, use your school, lunch, menu and plan which days your child needs a cold lunch pact, create a calendar and make plan for this. Calculate the total amount of money your child will need for hot lunches this month. If you're struggling with memory in this area we can practice recalling and memorizing bus pickup times. Rules drop off times. Come up with a daily or weekly
30:28
Taylor Groth: chores that need to be completed. Write these down
30:32
Taylor Groth: memorize important dates, teachers, names, etc. Things like that. If you're struggling with problem, solving and reasoning come up with 2 different actions you could take for different scenarios. Right? We'll talk about either real situations that you're struggling with, or I'll come up with some right, and we can talk through those. So maybe your child isn't staying in as bad. Your child wants a new friend over, but you don't have the family's contact. Info. What do we do?
30:59
Taylor Groth: Your teenager snuck out of the house and took your car? Your middle schooler keeps forgetting to return his library, books, etc., etc. Okay, other ways to practice cognitive skills. Together, we can practice planning a detailed road trip, create a house, maintenance calendar, binder plan, a birthday party or a holiday
31:19
Taylor Groth: create family a family weekly schedule. Talk about what external supports can help you get through specific challenges. Right? Okay?
31:32
Taylor Groth: So oftentimes
31:34
Taylor Groth: I pull up this type of to do list for people ask people to print it out and use it at home. Sometimes a simple to do list, just jotting down everything you could possibly need to do today, is it? It's not good enough, or it can be too overwhelming. And you look at your list, and you're like, well, I'm not gonna get any of that done. That's too much. So instead, let's prioritize high priority. Okay on column
31:58
Taylor Groth: things that need to get done today or tomorrow. Right? So obviously, you would start with that
32:03
Taylor Groth: medium priority. So things that need to get done within a week or so within a week or so low priority things that need to be done within a month or so. I like this cause. It's a good visual. You know you can see the things that you need to get done within the month that if you have time today, great and then you can really focus on
32:26
the things that need to be done today. Right?
32:29
Taylor Groth: Okay?
32:32
Taylor Groth: Alright. Some basic memory strategies. So we have internal and external memory strategies that I really talk about with clients. We talked a lot about the external strategies. Internal strategies are things we do in our brain to help us remember things a lot of us do these automatically without really thinking about it.
32:52
Taylor Groth: External strategies are things that we do in our environment to help support our memory.
32:57
Taylor Groth: So some internal strategies, rehearsal or repetition. This is basically just repeating the information that you wanna remember over and over and over in your head. It helps retain the information in your short term memory. So that's like, if you meet someone in their name is Betty.
33:14
Taylor Groth: Hi, Betty! Nice to meet you, Betty, Betty, Betty, Betty, Betty, Betty, Betty, Betty! Right you to repeat it over and over. Instead of never saying their name again. Right? It's going to go in one ear and out the other.
33:27
Taylor Groth: So let's repeat that information, get it in our head and ideally, ideally, maybe go write it down somewhere. The next internal strategy would be grouping or categorizing. So grouping information into smaller pieces to help you remember it. This is really good for like phone numbers, we do that automatically, social security numbers, or maybe like items in the store. Okay.
33:51
Taylor Groth: visualizing something. A lot of times. Our brain can remember something better if we have a visual of it. So attempt to picture the item person word, whatever it is you're trying to remember in your mind. Be intentional about observing details. The weirder the better. Our brain likes.
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Taylor Groth: really different, unique, weird things. We're more likely to remember it. So make some sort of visual in your head
34:18
Taylor Groth: to try to remember it. Okay, association. So that's building a connection between the new information and something you already know to strengthen your recall of that new item.
34:29
Taylor Groth: Our external strategies. We talked about writing it down. Fail, proof method. Daily calendar and planner.
34:38
Taylor Groth: right alarms and reminders, and a dedicated space. So ha! Making sure everything you have, you own
34:45
Taylor Groth: has a spot in your house. So you know where to find it when you're in a crunch.
34:51
Taylor Groth: Okay, so I'm gonna end with the talking briefly about brain health. So
34:57
Taylor Groth: making sure you're taking your medication and supplements. That's really important. Okay, if we're behind on our medication that can really it can mess up your your cognitive skills,
35:09
Taylor Groth: and nutrition and hydration. So talking to your doctor about food that promotes a healthy brain.
35:15
Taylor Groth: This is big protein, rich foods, omega, threes, fruits and vegetables, leafy greens and berries stay hydrated. Our brain does not function as well when it's dehydrated. Okay, we have. We gotta keep drinking water if we can. Physical activity. That's very important to keep our brain healthy. Even daily walks can be enough.
35:34
Taylor Groth: cognitive stimulation, so doing something every day that works your brain in some way, right reading, even learning something new, playing a card game with friends and family. Anything that makes you think right. We gotta just keep your brain active.
35:50
Taylor Groth: Social activity. Staying social is very important. We don't want to isolate ourselves.
35:57
Taylor Groth: We want to make sure we're staying social, even if that's calling someone. Okay, rest and relaxation, practicing mindfulness and deep breathing.
36:06
Taylor Groth: Prioritizing your sleep. Poor sleep can directly relate to cog to cognitive difficulties.
36:14
Taylor Groth: so prioritize that sleep. relaxation, strategies.
36:20
Taylor Groth: so anxiety, tension, cognitive difficulties. They're all related, and can cause one another. Okay, we gotta break that cycle. One way to do that is progressive muscle relaxation.
36:34
Taylor Groth: This reminds your body what relaxation feels like and trains your body to remain relaxed, which can help prevent fatigue, decrease, irritability, promote sleep, all good things for our brain, right to keep our brain healthy, and to, you know, keep our cognitive skills strong. So how we do this is, you first tighten mu a muscle, then relax. So you find a comfortable place without distractions. Tense, then release muscle groups one at a time.
37:02
Taylor Groth: When tensing for 5 to 7 s, focus on the feeling of tightness.
37:07
Taylor Groth: and then, when releasing for 15 to 20 s, focus on the feeling of limpness
37:13
Taylor Groth: and progress through the muscle groups right? There's no necess, no
37:17
Taylor Groth: exact way to do this, I would kind of recommend going top to bottom or bottom to tap, you know, turning with your your forehead, your cheeks, your jaw, your shoulders. your arms, your hands, and go all the way down. Okay.
37:32
Taylor Groth: abdominal breathing is the next one. This one's really big. So this is just deep breathing. Right inhale through your nose.
37:41
Taylor Groth: your lungs filled with air, your stomach should be protruding out and then release
37:46
Taylor Groth: exhaling through your mouth, blowing through slightly pursed lips. Okay? We really want to make sure shoulders are down to be unclench, our jaw, loosing your face. Mo face muscles. Okay.
37:59
Taylor Groth: Try to remind yourself of this frequently, frequently throughout the day. Where are my shoulders? What's my jaw doing right? Am I like this right? This is very common. You need to release all of that
38:14
Taylor Groth: while you're breathing you can put your hand on your stomach. If doing this correctly, your hand will rise and fall with each breath. Do this several times per day. Even a couple of breaths can promote relaxation and improved cognitive functioning.
38:30
Taylor Groth: Okay, that is the end of my presentation. Thank you guys for listening. If anyone has any questions lingering, feel free to chat or chime in.
About the Presenter
Taylor Groth
I am an ASHA board certified Speech-Language Pathologist certified to treat children and adults. Throughout my 10-year career as a speech therapist, I have enjoyed working with clients experiencing a variety of speech, language, and cognitive issues. I am passionate about keeping therapy person-centered and functional, and love helping clients reach their goals.
