I’ve found some great free multimedia resources for language and cognitive therapy. As speech-language pathologists (SLPs), we are very comfortable using print in therapy. But since we’re surrounded by audio and video in our lives, using multimedia in therapy is a natural step. After all, the average American spends 11 hours a day consuming audio or video!
SLPs can use audio or video to work on a wide variety of language and cognitive-communication skills. It’s relatively easy, interesting, and taps into how most of our patients spend their time. It’s likely that most of our patients listen to some form of audio or watch some form of video as a part of their daily routine.
Not only can you use these resources in therapy, but your patients can continue to use them after discharge for maintenance, cognitive stimulation, enrichment, and life participation.
Outline:
- Why we should incorporate multimedia into therapy.
- Free narrated text pairs auditory comprehension with reading comprehension.
- Podcasts are more conversational and many are transcribed.
- Video adds visual context to language or may be wordless.
- Audio books and magazines (with free equipment).
- Related Eat, Speak, & Think posts.
- Please share your tips for using multimedia in therapy.
Why we should incorporate multimedia into therapy
Follow your patient’s lead
While we, as SLPs, determine which language or cognitive-communication skills are impaired, our patients determine our specific goals and how we address them in therapy. Our goals should be focused on the desired outcomes of our patients and their families. And those goals should be directly targeting real-life activities and participation.
I always ask my patients what they want to get out of therapy. I let them take the lead, because as we know, improving language or cognitive skills takes a lot of work. If people don’t have an intrinsic desire to use those regained skills, then they’re not likely to put in the required work.
Certainly, if my patient’s goal is to improve reading or writing skills (such as writing checks), then that’s what we target.
But often, my patient’s don’t really care if they return to reading for pleasure. And most are happy to allow a family member to continue handling the mail and finances.
What my patients do care about is social engagement. My patients or their families often complain that they can’t remember the conversation they just had, or what they just watched, or that they don’t quite grasp what they’re hearing.
Some of my patients are spending hours a day looking at the TV without really taking in what’s being said. They’re not mentally engaging in the activity, and they’re not socially engaging with their family.
Skill areas we can target with audio and video
We can choose audio or video media on subjects that interest our patient to work on a wide variety of language and cognitive-communication skills, including:
- Auditory comprehension.
- Verbal expression.
- Attention.
- Visual and auditory short-term memory.
- Long-term memory.
- Reasoning and problem solving.
- Executive function skills.
- Pragmatic skills.
- Even reading and writing skills.
Functional outcomes may include improving the following:
- Participating in conversation.
- Learning new information or procedures.
- Noticing and remembering details in the environment.
- Predicting possible outcomes and making safer choices.
- Actively engaging in preferred leisure activities.
- Regaining enjoyment of preferred leisure activities.
- Staying oriented and keeping up with current events.
Tips for writing cognitive-communication goals
I wrote a post on how to write SMART cognitive-communication goals, and you can download a cheat sheet which includes a full page of suggested wording for why the goal is “relevant”
The following are useful resources for therapy and cognitive stimulation. I’ve used these resources in therapy and maintenance programs, as well as for cognitive enrichment at all levels.
Free narrated text pairs auditory comprehension with reading comprehension
CommonLit.org
CommonLit.org is a free, web-based reading program designed for schools. However, all SLPs and their patients can sign up for free accounts with CommonLit.
CommonLit provides fiction and non-fiction texts in a wide variety of genres. Just remember that the average adult in the US reads at a 7th or 8th grade level, so don’t automatically jump to 12th grade reading material!
If you or your patient don’t want to sign up for an account, you can still access the reading material online and download free PDFs. You also have access to parent guides, which may be helpful in therapy.
Creating an account provides the following additional features:
- Narration.
- Comprehension questions.
- Media related to the text.
- Teacher guides.
You can browse their online library by clicking on the “Library” tab in the upper left corner and choose among:
- 3rd grade – 12th grade reading levels.
- 34 genres.
- 32 literary devices.
- 35 sets of related texts.
- Dozens of short passages related to famous books.
- 28 themes.
- Texts in Spanish.
TalkPath News by Lingraphica
TalkPath News offers short news articles with accompanying narration. Anyone can sign up for a free account.
You can access the program via the web, iPad app, or Android app. As each sentence is read aloud, it’s highlighted in yellow. There are audio controls, and you can repeat a sentence or jump around in the text simply by touching or clicking the desired sentence.
Your patient will be prompted to answer three multiple-choice questions at the end of the article. You can change settings for whether the text is narrated and whether questions are presented in the TalkPath Therapy web-based program.
Examples of how to use narrated text
SLPs are pretty comfortable using print in therapy and can extrapolate different ways to incorporate audio. But here are some ideas to choose from, depending on your patient’s current abilities and goals:
- Listen and read simultaneously (silently or aloud).
- Read first, then read and listen simultaneously.
- Read first, then listen, then read again.
- Only listen.
- Listen first, then read.
- After listening, read and listen simultaneously.
- Listen first, then read, then listen again.
However you choose to present the audio and text, you have many choices for the accompanying activity. For example:
- Answer “yes-no” or “wh” questions.
- Answer multiple choice questions (both programs above provide these).
- Recall the main points or specific details (immediate or delayed recall).
- Retell the passage in own words.
- Teach the information to a family member who is unfamiliar with the passage.
- Take notes.
Podcasts are more conversational and many are transcribed
More and more people are carrying smart phones or have an internet-enabled device that will allow them to play podcasts. Podcast episodes can run from a few minutes to two hours or longer. Podcasts cover a huge range of topics and interests. You can search for podcast episodes on ListenNotes.com.
Where to find very short podcast episodes
- Search ListenNotes.com by entering “1 minute” or 2 minute” etc and scrolling the horizontal results bar just underneath the search box.
- PlayerFM’s list of 5 minute podcasts in 2019.
- DiscoverPods’ list of 10 podcasts you can listen to in 10 minutes or less.
- Bello Collective’s list of short podcasts, starting at 5 minutes or less.
Take care in choosing the type of podcast
Choose the format to suit your patient and their goals. For instance, a monologue is easier to understand than a two-person conversation. Many people have difficulty following group conversations in real life, so you may have a goal to work on this.
Some podcasts have very lively conversations, such as the Stroke Comeback Center’s podcast The Slow Road to Better. Other podcasts have more structured conversations, such as the Australian Stroke Center’s podcast EnableMe.
Some podcasts are completely clean, some have swears, and some are NSFW! So I’d suggest listening first!
Some ways to use transcribed podcasts in therapy
Many podcasts include word-for-word transcripts, which can be used in therapy in many ways. For example:
- Listen to a short section. Read the transcript. Listen again.
- Listen to the podcast and read the transcript simultaneously (silently or aloud).
- Read the transcript first, and then listen to the podcast.
- Listen to the podcast. Recall the main ideas. Read the transcript and check accuracy.
Example of how to use a podcast episode in therapy
The Memory Loss After Stroke episode on the EnableMe Podcast has a nice two-minute segment on fatigue after stroke and how to deal with it. You can play the podcast from your own phone via the internet or a podcast player such as iTunes or SoundCloud. The segment runs from [00:10:45] to [00:13:00].
This podcast includes a downloadable PDF word-for-word transcript marked with the time at 30-second intervals.
You can use this two-minute segment to work on auditory comprehension, reading comprehension, memory, problem solving, or verbal expression. A few ideas:
- Listen and answer your “yes-no” or “wh” questions.
- Have the questions up-front and listen for the answers.
- Listen and read the transcript simultaneously (silently or out loud).
- Read the transcript first, answer questions or recall details, and then listen. (Or vice versa)
- Listen to the segment and recall the main points.
- Listen to the segment and the retell in own words.
- Discuss fatigue before listening. What’s it like for your patient? How are they handling it now? After listening, discuss whether fatigue is common after stroke and tips for handling it.
Video adds visual context to language or may be wordless
YouTube.com, of course, is a huge repository of video. Depending on your patient’s interests and goals, you may find yourself using anything from cat videos to TED Talks.
Many non-profit and patient/caregiver support organizations have YouTube channels, as well as free video on their own webpages. For instance, I’ve pulled together a large list of dementia-related videos.
You can find many types of video on YouTube, including:
- Commercials.
- News.
- Weather.
- Sports.
- Historical videos.
- Fail videos or bloopers.
- Speeches.
- Comedy.
- Music.
- Movies or TV shows.
- Documentaries.
- How-to instructional videos for hobbies and recreational activities.
- Educational videos on diseases, injuries, and medical procedures.
- Educational videos on tips and strategies for patients and caregivers.
Example of how to use a wordless video in therapy
You can search for “inference” and find videos such as Pixar’s Birds on a Wire. I forgot about this 3-minute wordless video, but I love it! I haven’t shown it to anyone yet, but I have someone in mind who is working on expressive language and cognitive-communication skills following a stroke.
For expressive language, I can ask my patient to narrate the video (pausing the video if necessary). I can ask him to retell it to his wife, who always joins us at the end of our sessions.
For pragmatics, I can pause the video along the way and ask how the characters are feeling.
For cognitive-communication, I can pause the video before the final event and ask him to predict what will happen. I can ask him what the characters could have done differently to avoid trouble. Or I could simply ask what the cause of the outcome was after watching the video
Audio books and magazines (with free equipment)
If your patient is more comfortable with older technology, they may be able to borrow equipment and audio books or audio magazines from the National Library Service and Choice Magazine Listening. Both organizations offer digital access as well.
National Library Service from the Library of Congress
The National Library Service (NLS) offers free braille and audio books to anyone with a temporary or permanent visual or physical disability that interferes with their ability to read printed materials. Printed materials are mailed, and digital downloads are available for both audio and ebraille.
The NLS also offers services to hospitals, nursing homes, assisted-living facilities, schools, and other organizations
There’s a brief form for a qualified medical professional to sign. Each state has at least one designated library that provides services. You can check with your state library to see if you can sign as a qualified medical professional. The application would be faxed or mailed to your state library.
The NLS also offers music materials through the Library of Congress in Washington D.C., including musical scores, instructional books, and recorded information about music and musicians. The materials are available in braille or large-print which are mailed, or digital downloads in audio or ebraille.
Choice Magazine Listening
Choice Magazine Listening (CML) is a non-profit organization that offers a free lending service to people in the US who have difficulty reading printed materials. CML publishes a 12-hour issue once every 3 months. Each issue includes one or two dozen complete articles and a few fiction and poetry selections chosen from 100 magazines.
You’ll need to have the free digital talking book player provided by the National Library Service. You have two choices for the format: physical cartridges or digital downloads. If you choose the physical cartridge, you’ll have almost two months to listen before you’d have to mail it back.
Alternatively, you can download current and back issues and listen to them on the digital talking-book player. You can store the files on any USB memory stick, or purchase blank cartridges.
Check with your local library
Your local library may have a delivery service for people who have difficulty navigating the community. In addition to books on tape or CDs, your library may have books loaded onto a player. The listener just needs to supply their own headphones.
In addition, libraries offer free digital books and magazines, as well as audio books.
Related Eat, Speak, & Think posts
- Attentive Reading and Constrained Summarization tutorial.
- 24 podcasts for adult medical speech-language pathologists.
- Treating cognition in the real world.
Please share your tips for using multimedia in therapy
Are you already using multimedia in therapy? I’d love to hear how you’re using multimedia in therapy. Do you have a favorite go-to?
Featured image by John Schnobrich on Unsplash.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
Natural Readers is a free online text reader that reads from many different document types. With the Chrome extension, it will read webpages and GoogleDocs.
The sentence being read is shown in large font, with the word highlighted as it’s spoken.
You can also download an MP3 to listen to later.
https://www.naturalreaders.com/online/
Honeycomb Speech Therapy has a master list of 8 great TED talks to use in therapy. Sarah includes therapy ideas and materials for each one!
https://honeycombspeechtherapy.com/ted-talks-master-list/
The Week publishes daily “10 things you need to know today”. Each topic is a paragraph of information, which could be useful in therapy. https://theweek.com/10things
At this time, according to AllSides Media Bias Ratings, The Week is Centrist. https://www.allsides.com/news-source/the-week-bias
Free photos for aphasia therapy! Check out Name and Tag on Instagram (nameandtag1 through nameandtag4, as well as nameandtagv for verbs).
https://www.instagram.com/nameandtag1/
[…] offers a wealth of short videos that can be used in therapy in many ways. I wrote about using video in therapy, and an example of how to use a wordless video in […]
Wonderful compilation of resources and ideas Lisa!
Great work! Thank you!
You’re welcome, and thanks so much!
Another site! This one offers English articles at different difficulty levels. Pick an article, then scroll down to see a variety of activities, comprehension questions, etc.
https://breakingnewsenglish.com/
News in Levels offers articles in 3 levels of difficulty. Readers can read and/or listen to the story. Stories may be taken from the news or from history. They also have videos at different levels of difficulty.
https://www.newsinlevels.com/