The highlight of my week was spending time with the clinic's speech therapist. I was finally able to observe the speech therapy process with a few of her patients. This was actually incredibly helpful since I had no knowledge about the treatment beforehand. The first patient (Patient 1) returned for a follow-up visit, while the second (Patient 2) was evaluated for the first time. Both were tested on word association and attention. I'll start with Patient 1. For her first test, she was given a letter and 1 minute to come up with as many words as possible that started with this letter. The test was repeated two more times with different letters. Overall, there was improvement since her last visit. The next test involved filling in the blanks with letter combinations that complete each word. Each row had the same letter combination somewhere in the word (i.e. skirt, mask, risky). The last word association test was also a worksheet which involved filling in the blanks. Patient 1 would choose several words that related to a given word and correct her work after every row. The alternating/selective attention tasks were a bit more interactive. One was an app which required Patient 1 to choose the correct shape or color based on a command. For example, the app would display "Color: triangle" and Patient 1 would have to choose a green star rather than a triangle. In the final test, Patient 1 was asked to sort through a deck of cards by flipping any cards that were odd and red or even and black face-up. In most of the tests, Patient 1 realized that she improved her scores by talking herself through the task or writing reminders on a Post-it note. This is what is so effective about speech therapy; it trains patients to develop skills that are applicable to their own lives. Patient 2 was tested more holistically since it was his first evaluation. In addition to the other word association tests, he was required to associate words with images. For the first task, he was shown a series of images and was required to name them as fast as possible. In the next test, he was shown a symbol key, which stated the names for each individual symbol. He was then shown a phrase created with these symbols, which he would decipher and read aloud. For example, if ☼= "sun", ↑= "above", and ⚘⚘= "trees", then ☼↑⚘⚘= "sun above the trees".
Example of Visual-Auditory Learning Test
In the next test, the speech therapist read several short stories to Patient 2, and he was required to recount the stories using as many of the same words as possible. He was also asked to recall a series of numbers backwards. The last test was confusing even for me. The speech therapist would read a phrase with objects and numbers. Patient 2 would have to repeat the objects first and the numbers second, but in the same order as the original phrase. For example, "frog two hat five" would become "frog hat two five". These are just a few of many tests commonly used in speech therapy programs. The point is that consistent practice is required for these cognitive tasks to have any impact on patient recovery. For obvious reasons, patients who never return after their evaluation don't benefit from the skills that are practiced in therapy. Perhaps the most interesting fact that I learned by observing these sessions is that the door is intentionally left open for each patient visit. This may seem counterintuitive (and in direct violation of HIPAA), but the speech therapist claims that "the real world isn't quiet" so her practice sessions shouldn't be either. I think this focus on real-world application is what leaves a lasting impact on patients.
