Download How to Use this Workbook - Pro-Ed

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This treatment manual, like Aphasia Therapy Workbook: Volume One,
is intended to assist the therapist in providing not only materials to work
with in therapy sessions, but also a comprehensive home program for their
patients. We all face the challenge of helping persons with brain injury
recover from the unplanned and devastating changes in their lives. When I
began working in the area of brain injury, I was enormously helped in pro­
viding treatment for patients by the workbooks that were available to me,
especially those of Susan Brubaker and Kathryn Kilpatrick. I can only hope
that my own contributions of therapy materials may help other clinicians
in their treatment programs.
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We are finding more persons on our caseload who have had relatively
mild or moderate brain injuries with good potential to return to at least
part-time employment. In working with these patients, I have found one
area of difficulty is helping them regain spelling skills. As was true with
Volume One, I find myself writing exercises that I need to help my own
patients regain skills. Therefore, the focu~QLthis-w(}:rkbookjsJQhelp_.
patients to (egain spelling ability, though it is not limited to that skill
alone-:'While completing these lessons, patients also exercise word-finding
and cognitive skills such as attention to detail and problem solving. In
addition, I have found that working on this material also improves reading
skills. Again, as in Volume One, the exercises can be completed by patients
with limited graphic skills.
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The fact that this book is focused on spelling may cause people who
know me well some amusement. I openly discuss my own difficulty in this
area with my patients. I use many compensatory techniques, and my little
spell checker dictionary is well marked and falling apart. Actually, I feel
that my own difficulty in spelling gives me a unique viewpoint from which
to write this book. I am pleased to report that in writing this material my
own spelling skills have improved significantly.
I think of these exercises as word games. I use this phrase in intro­
ducing these tasks to patients. Many of these exercises are tasks, albeit in
simpler forms, that are in game books found on racks at the supermarket
or drugstore. Hopefully, when patients become proficient at working these
exercises, they can transfer this skill to word games published for general
consumption. I encourage patients to continue working on the "search for
words" or "fill-it-ins" available at newsstands as part of their home mainte­
nance program after the cessation of their regular therapy program.
There is an answer section at the end of this workbook. I would
encourage the therapist who is using these materials as a home program to
also provide the client with a copy of the answers. The client should be
encouraged to check his or her responses with the answer section.
Section by Section
Letter Subtraction
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These are simple exercises designed to help the patient think about
how words are structured and about letter sequences in words. The patient
is asked to subtract only one letter from the original word to form a new
word, for example, exist - s = exit. There is often more than one correct
answer for each word, Le., flume - I = fume and flume - m = flue. Again,
not only spelling skills are involved in these exercises; deductive reasoning
and word-finding skills are also important.
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Letter Addition
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Letter addition is another group of these exercises designed not only
to improve spelling skills but also word-finding skills. The patient is asked
to add one letter only to the beginning, middle or end of the word to com­
plete the word. In letter subtraction (above) there was often more than one
possibility, but the patient was asked only to provide one answer. In this
exercise the patient is always asked to provide more than one answer, and
at times up to eight. Parts of this exercise may help the patient who is hav­
ing difficulty with word rhyming.
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Anagrams
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This is a difficult exercise designed for use with high-level patients.
An anagram is a word in which the letters can be rearranged to form
another word. The most simple example of this would be the word "no"
which can be rearranged to spell the word "on." The most common com­
mercial form of anagrams is a game called "Jumble" which can be found in
newspapers, puzzle books and even in electronic game form. Any patients
who are able to complete this section of the book should be encouraged to
work on "Jumble" puzzles. Note: You can make this exercise easier by pro­
viding clues such as the first letter or first few letters of the answer.
Word Matching
These exercises are good for patients with real difficulty in spelling.
The patient must match the ending of each word with the beginning
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letter(s}. Most of this exercise limits itself to a choice of five possibilities.
The exception to this is in the last section of this exercise which matches
ten words with ten others to form compound words. Again, word-finding
skills as well as deductive reasoning and spelling skills may be improved
using this exercise.
Letter Shuffle
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As a child I remember my mother teaching me to do this word game
one evening when a windstorm had caused a power outage. I can only
imagine that I must have been complaining about the lack of television as
she wrote down a word and challenged me to find as many words of vari­
ous lengths as I could using the letters found in the word Washington. I
have played this game ever since when bored and finding myself with only
a pen and some paper. This is a more difficult word game than the others
in this workbook as it is the exercise with the least amount of structure.
Again, not only spelling but word-finding skills are involved in completing
this exercise.
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Each stimulUS word is a name of a city. An answer section is provid­
ed with possible word lists. The answer section is not meant to list all pos­
sible words that can be formed but only a sample. If you wish to provide a
score for this exercise, you can give each letter used one point. Therefore, a
two-letter word is worth two points, a five-letter word worth five points, etc.
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Search for Words
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I have included more "search for words" in this volume for several
reasons. The theme of the "search for words" in the first volume was cate­
gories. The theme for the words in this book is words that are confusing or
difficult to spell. My patients seem to like to do "search for words" and usu­
ally ask for more. This is a very good task for visual tracking as well as
forcing the patient to concentrate on the sequence of the letters of a word.
The skills developed in this section can also be transferred to puzzle
books which are found in newsstands. However, the "search for words"
which are commercially available are more difficult in that the words are
often written backwards or diagonally. In helping patients work with the
commercially available puzzles, I teach them how to "cheat" by using the
edge of an index card to isolate the rows. I also encourage them to look at
the answers in the back of the book if needed.
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Fill-it-Ins
"Fill-it-Ins" is a common word game form and can be easily found in
game books for sale at newsstands or supermarkets. The "fill-it-ins" written
for this book range from very easy to a moderate degree of difficulty. In
completing this task, patients must not only focus on the order of letters in
words, but also use deductive reasoning, scanning, and attention to detail
skills. There is only one correct space for each word, and letter cues are
given. If you have a patient who is having difficulty with this task, you may
want to add more letters which lessens the difficulty level.
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When my patients have completed this section and wish to do more,
I provide them with samples of commercially available puzzles or ask them
to purchase an easy level or large print "fill-it-in" puzzlebook to bring to
therapy. I then fill in some of the letters on several puzzles. I strongly
encourage the patient to look to the answer section whenever needed. Most
patients are reluctant to do this. I ask the patient to think of these puzzles
as therapy and not some kind of test which they win or lose. If the task is
too hard for them, they can become frustrated and stop working with the
puzzles. I try to avoid having that happen.
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