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Answer transcribed from Brightway's interview with Dr. Thomas Franz:
I don't have a particular online therapy that I endorse or that I have worked with extensively enough to say that oh you ought to go to this website or use this app. Although I'm working with some people to develop some that may be useful in the future, I don't have a particular site that I endorse right now.
There have been a lot of these that have been developed over the years and what I would say is look at the ones that are out there. If they have you practicing real-world tasks like recalling a grocery list or taking you through some sort of simulation of a shopping trip, things you might do in your actual life, those are going to be more useful than just memorizing lists of words or playing video games. This is because what we do know is that you get better at what you practice, so if you practice memorizing and reciting lists of words that's the skill you develop. If you practice playing a video game, and unless that video game has some grounding in a real-world task, you're just getting better at playing the video game. You want something that has a connection to what you want to do in your day-to-day activities to make it translate to what we call generalized. You want to pick a task that will help you with the cognitive things you want to do in your day. Similarly, you wouldn't try to strengthen a weakened leg by working your thumb because that would be very little benefit. It might strengthen your thumb but it's not going to help you with the task at hand.
Answer transcribed from the Brightway Answers interview with speech-language pathologist Amber Kloess:
I'm going to focus on the speech and language side of this question, but check out my answer about cognitive symptoms to learn more about how to improve memory.
I’ll start with the language side first. To work on receptive language (that's the understanding of language), speech-language pathologists can target simple directions all the way to multi-step, complex directions depending on the level of where you are at the time.
For expressive language, we use lots of visual supports and supported conversation when strategies can then be established. I’ll also pick apart things that are motivating and functional in your environment - we're not going to be working on basketball terms when you might have no knowledge of basketball.
Some of the more descriptive areas - for word finding in particular - is through semantic feature analysis. This is the ability to use semantic features or meanings of words to assist in accessing the actual word. For instance, if you're having difficulty finding the word “dog”, you may able to get to it by saying “it has four legs, it barks, it's a man's best friend” - “oh, that's a dog”.
Another area in word finding is VNST, which is verb network strengthening treatment. This focuses on verbs or action words to help formulate full sentences, and there's a wide protocol to help train individuals and their caregivers in in these areas.
Speech pathology has a role in training caregivers to be supportive communication partners and I feel this is really important, especially in those early stages of recovery. A speech-language pathologist will strategize and come up with a lot of things to implement in any setting. And all of these skills can be carried over into the home environment. A tip that I usually tell families of those I work with is to keep conversation going. It can be socially isolating following a brain injury, so being able to practice speech language or cognitive skills in a functional setting - whether it's at home, at a doctor's office, at a restaurant - can be so helpful and meaningful.
Apps like Tactus Therapy, Lumosity, Brain HQ and Constant Therapy are definitely something to try.
We also have something called the WALC series - this is a series of cognitive rehabilitation books - there's WALC 1 through 10. They specialize in different speech and language areas and different cognitive areas. I would recommend WALC 2, 3, 9, and 7. The PDFs are free to download - you can just google “WALC books”.