Many of my patients want to improve auditory memory, or memory for what they hear. They complain that they can’t remember recent conversations. Some report they no longer enjoy watching TV because they lose track of what’s going on. I’m sure many other people have this difficulty, so I’m sharing an easy exercise that has helped many of my patients improve their auditory memory.
Free DIRECT download: Improve auditory memory (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- Who is this exercise good for?
- Why use this particular exercise?
- What is the exercise, in a nutshell?
- What you need for the exercise.
- How to adapt the exercise to your patient’s level.
- Share your tips for improving auditory memory!
- Related Eat, Speak, & Think posts.
Who is this exercise good for?
This exercise is a potentially good exercise for anyone who wants to improve their ability to pay attention or remember conversation, or what they hear, in general.
I’ve used it successfully for people with a variety of conditions: Mild Cognitive Impairment, Traumatic Brain Injury, stroke, different dementias, and brain cancer, among others.
I’ve modified the exercise to work with people who have anywhere from a mild impairment to a moderately-severe impairment. (For severe cognitive impairments, we tend to include a focus on external memory aids.)
My patients and I define “success” as a noticeable improvement in being able to remember information and details in daily life.
Why use this particular exercise?
This exercise builds an increasingly stronger auditory sustained attention by using progressively longer material.
To promote active listening, it directly engages the patient in using strategies such as repetition, visualization, and association.
The teaching method incorporates principles of learning such as repetition, spaced retrieval, and progressively increasing the challenge of the task.
What is the exercise, in a nutshell?
The exercise is simple to do, as well as extremely adaptable. Here’s the basic method.
Step 1: Get a baseline measure
First, obtain a baseline measure of your patient’s ability to remember what they hear.
Optionally, you can probe their recall or assess their comprehension with a few quick questions.
- Select an appropriate text that is interesting to the patient. (See below for what “appropriate” means.)
- Instruct the patient to listen to the passage and tell it back in their own words.
- Read the text aloud to the patient.
- Ask them to retell it. Keep track of correct, specific details versus generic or incorrect information.
- Optional: Ask wh-questions or yes/no questions to probe their recall or assess their comprehension.
Step 2: Teach your patient how to remember
Next, assist your patient in encoding the information. This process can be modified to your patient’s ability level by making it easier or more challenging. But here is the basic format.
- Read the first sentence aloud.
- Together, identify the key piece of information.
- Ask your patient how they are going to remember that: repetition, visualization, or association. Have them describe in detail what they are imagining. (I only suggest writing as a strategy under certain circumstances.)
- Read the first sentence aloud and ask your patient to retell the information.
- If they are correct, move on to Step 3 by increasing the material to include the first two sentences. Focus on encoding the new information, then ask them to retell all the material studied to that point.
- However, if they are incorrect, spend more time on encoding the material in the first sentence until they can recall it before adding any new material.
Step 3: Practice increasingly longer material
After you encode each new piece of information in Step 2, practice strengthening auditory memory by asking your patient to listen to all of the sentences studied to that point and retell all that material in their own words.
Your patient would begin by retelling one sentence. Then two sentences. Then three sentences, and so on until their able to retell the entire passage.
If your patient is successful in encoding new information under Step 2, then Step 3 will be progressively longer with each turn. If they’re not successful, then you would want to modify the exercise to make it easier in some way (see below).
If they are doing well with the exercise, then you can make the exercise harder in some way (see below).
If they miss any details you practiced encoding, you can do any of the following, based on your patient’s needs and goals:
- Give hints based on how they encoded the information.
- Ask a wh-question.
- Ask a yes/no question.
- Give multiple choices to select from.
- Read the sentence again and spend more time encoding the information. You can also have your patient write the information for added support.
What you need for the exercise
A patient and a helper
You need two people: the person who wants to improve their memory and an assistant.
What if a helper isn’t available?
If the person who wants to improve their memory doesn’t have someone who can help, they can still do this exercise by using audio that can be paused and replayed. For instance, they could use a recorded news report, a book on tape, or a TEDx talk on YouTube.
An appropriate text
The second thing you need is reading material, for the assistant to read aloud.
I’ve learned over the years that I can’t reliably use reading material I find in my patient’s house. There are a variety of possible issues:
- The sentences may be too long and complex.
- The vocabulary can be too difficult.
- There can be filler sentences that don’t offer any new information.
- The material may not be interesting to the patient.
- The language many be non-literal , requiring inferencing skills that the patient may not have.
You would want to select topics and reading levels that are appropriate for each specific patient. Things to consider when choosing the text you’ll use for therapy:
- “50% of adults [in the US] can’t read a book written at an eighth-grade level.” (The Literacy Project)
- Approximately 14% of Americans can’t read above a 5th grade level. (same source as above)
Practically, what I do is start with an easier text than I think is appropriate. I have a small set of articles I often use. I either pick one based on the length and level of difficulty, or I offer them a choice between two articles.
If they do find it easy, we’ll move on to longer or more complex reading material.
After that first session, I find different articles based on their specific interests.
Where you can find appropriate texts
CommonLit is one of my favorite sources. It provides free access to reading materials from Grade 3 to Grade 12 in a variety of genres in English and Spanish. SLPs and adult patients can also sign up for free accounts to access more features.
Another popular option is TalkPath News. This is a free daily news exercise from Lingraphica designed for people who have had a stroke. You can read the passage aloud to your patient, or they can operate the controls themselves, covering the printed text with a piece of paper.
I’ve written before about how you can use podcasts in therapy.
TEDEd (TED Education) offers short, educational videos. These are interesting videos designed for kids and curious people of all ages. The material is well-organized and clearly presented.
Adapt your own text
You can also copy a public domain text into a Word document and simplify the language yourself. Writing readable, plain-language text is a complete topic in its own right, but here are some general tips:
- Shorter words and shorter sentences are generally easier to read.
- Give one main idea per sentence.
- Create short paragraphs with lots of white space on the page.
- Use 14- or 16-point font in Arial or Times New Roman.
- Check your readability score (for instance, through readabilityformulas.com).
- Aim for about 5 grade levels below the last grade your patient completed.
The above tips are from Helen Osborne’s book, Health Literacy from A to Z: Practical Ways to Communicate Your Health Message*.
*This is an Amazon affiliate link. As an Amazon associate, I may earn a small commission on qualifying purchases. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Optional materials
- Pen and paper for your patient, if you are practicing writing or following the ARCS protocol.
- Clipboard as a supportive writing surface.
- Voice amplifier, if they are hard of hearing.
How to adapt the exercise to your patient’s level
Make the exercise easier
If your patient has difficulty progressing through the exercise with your typical level of assistance in encoding information, then you may consider doing one of the following.
- Re-assess the difficulty or interest level of the material you’ve chosen. People are more likely to remember information that is interesting to them.
- Ask your patient to write or repeat the key word(s) 5 or 10 times, while thinking about that word.
- Find something in the environment to stand for that idea, using the Location Memory Technique.
- Instead of adding a second sentence, focus on entrenching the first sentence in your patient’s memory.
- Unfilled pause: Sit silently for several seconds, then ask them to retell it again. (You can use the time to do a little documentation.)
- Filled pause: Talk about something that is not cognitively-demanding for several seconds, then ask them to retell it again.
- Simple intervening task: Ask your patient an unrelated question, then ask them to retell it again. The unrelated question can be easy or hard.
- Complex intervening task: Ask your patient to perform a working memory task, or some other task that would require some thought. Then ask your patient to retell that first sentence again.
- Allow your patient to read the material first.
Once your patient can recall the information from the first sentence after a complex intervening task, then go back to Step 2 and assist them to encode the information in the second sentence.
Make the exercise harder
If your patient breezes through the basic activity, then you can make the task harder in a number of ways. As I tell my patients, our goal is to find exercises that are challenging, but not so challenging that they’re frustrating.
Here are some ways you can increase the difficulty of the exercise:
- Withdraw your support for encoding the information.
- Do an unrelated task for 5 or 10 minutes, then ask them to retell the article.
- Take the article with you and ask them to retell the information later that day or the next day via email, text, or leaving you a voice mail.
- Increase the length of the article.
- Choose articles with more complex sentence structure.
- Select an article that is of lower interest.
- When you study a new article, do so in pairs of sentences instead of each sentence on its own.
Share your tips for improving auditory memory!
I’ve been using this exercise for as long as I can remember. I don’t recall how I learned it or modified it in my own practice, but I’d bet most speech-language pathologists do something similar.
If you do an exercise similar to this to help your patients improve auditory memory, please share what you do in the comments below!
Related Eat, Speak, & Think posts
- How to improve short term memory.
- 5 easy steps to remember names.
- How to use spaced retrieval with errorless learning to improve memory.
- Attentive Reading and Constrained Summarization tutorial.
Free DIRECT download: Improve auditory memory (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by Antoni Shkraba from Pexels.
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.
Excellent work Ms. Lisa
Thank you!
Thank you so much for all of your great ideas! I just switched from outpatient to SNF/Independent living, and these leveled tasks are so helpful as I’m trying to pivot my therapy!
You’re very welcome! I’m happy you’re finding some useful things! Good luck 🙂