Wednesday, September 19, 2007

Speech Class Diary, Part 4

Speech Class Diary, Part 4

These speech classes entries were moved from a message board to protect them from being deleted for being too old. For entries made after May 2007 you can visit my Yahoo 360 blog at: Click Here! Yahoo is were all my current blogs will be from now on. This part of the diary starts with 2/15/05 through 6/15/05.

Jean Riva ©

Spring Semester, Feburary 15, 2005

My husband Don’s stroke was May 21, 2000 and since then he has been struggling with aphasia and apraxia. As many of you may already know, when the college semesters are in sessions he goes two days a week to a local college for their Speech/Language Pathology Clinic. There, undergraduate student clinicians work under a professor to develop and carry out an individual treatment plan for him. He just began the spring semester with the standard set of testing that they do at the beginning and end of each new semester. For a detailed description of the tests given, you can find it in one of my first posts in the winter semester diary as they are the same tests given at the being and end of each semester.

The protocol for these classes is as follows: Tuesdays Don will have an individual class taught by two students. I and several other students will be watching from an adjoining room with a one-way mirror and TV camera that focuses on Don’s face. The professor will either be in the treatment room or in the observation room---I'm guessing her choice depends on how much intervention she feels the girls need or she wants to see if they work better or worse without her presence. All sessions are video taped to use as teaching aids in the language department’s other classes. The second weekly class, on Thursdays, is a group class. They have three groups: a non-verbal, a verbal and one in between. Don will be in the non-verbal group, again, I’m sure. He’d need to be getting out mostly full sentences---no matter how halted or slow---to advance upward.

We’ll get the results of the today's testing later on but as I watched from the observation room I could tell he didn’t do as well as he did when he ended up at the end of last semester. He’s been on a break from classes since just before Christmas, which could account for part of the back slide. But one of his student teachers speaks with a slight, oriental accent which could be a potential problem---especially for a guy who wears hearing aids. He had to ask her to ‘repeat’ quite often. At home, on a day-to-day basis, I know he has been doing better in the past month. Only time will tell if the classes will work out this semester.

February 22, 2005

The new semester didn’t start out very well. The two student teachers are, of course, a lot greener at this than Don and I are so it was easy to pick up on their miss-steps. In the past, for example, Don’s student clinicians have always asked me ahead of time to tell them about something we’d done recently. This gives them a better idea how to queue Don when they do their ten minute ‘conversation’ before they get into the therapy part of the hour. These girls didn’t ask me, so they were flying totally blind and they didn’t really understand where he was trying to go when he tried to tell them about the night Don’s x-coworkers came to visit.

Next they did some testing that didn’t get done during the testing session last week: standard stuff like following directions/cognitive skills i.e. stick out your tongue, bite your lips, etc. Don scored high on this stuff, as expected. Next they tested reading comprehension by having him read sentences and match them with the correct pictures. The book they were using has a pop-down stand that puts the book at the right angle for reading but they didn’t find it until the test was almost over. This gave Don some visual problems and afterwards, when I asked if he could see the book, he said no.

The first therapy task was one he’d done last semester: they showed him photos of objects and he was supposed to describe the objects without naming the object. (This is part of learning to build sentences.) For example, looking at a photo of a razor Don was able to say, “White,” “sharp” and he gestured for its length. For a backpack he was able to say “black and red,” “zipper,” “cloth,” and “put ball in it”---he thought it was a bowling bag and so did I, you couldn’t see the straps in the photo. Half way through this session the professor got involved and started teaching the girls better queuing techniques because they’d been fumbling in the dark.

The last therapy task of the hour involved having Don look at photos and trying to get words out of him that described the actions going on. For example, with a photo of a man reading a newspaper Don was able to say: “reading,” “paper,” and “boy” and a sentence was then formed for him to repeat of, “The boy is reading the newspaper.” This exercise really was a valuable task last semester, so I hope they continue using it.

Out in the hall afterwards, one of the students who has always made a point of talking with Don asked him how it went and he came up with a brand new word: “Poor.” But we both assured him it will get better. And it will. It takes a few sessions for the girls to get know him and get over their timidness, plus the professor will not let things go too long if she sees the girls need her input. Last semester we had exceptionally good student therapies---the professor had said they both were getting A’s---so we’re a little spoiled I think.

I can’t wait to see who will be in our group class on Thursday. We saw a lot of familiar faces in the lounge area and a lot of new ones, too. One of Don’s student teachers from last semester even brought him a little gift she’d picked up for his gas station memorabilia collection. He was sure pleased about that. Over a semester, it’s easy for him to grow attached to girls…and I think in many cases, they get attached to him, too, because he’s their first real patient.

I also got a chance to ask the head of the language disorders department about the aphasia constraint therapy I’ve been reading about on the internet. She says it’s kind of a marketing technique for an expensive therapy. It involves going somewhere to live for 8 to 12 weeks and spending three to five hours a day with a speech therapist. They use every day things like eating, showers, grooming, etc., to drill speech all that times. She said it doesn’t really differ from the philosophy that they teach there at the college---there they have a clients see a ST once or twice a week and teach a family member how to make every day, all day long into a speech session the way I do with Don. She wasn’t sure the aphasia constraint therapy would work any better than a traditional therapy backed up in this way with an aggressive homework plan. But she’s going to ask her field therapies if there’s been in studies comparing the two. This explains why I wasn’t impressed with the results I’ve seen sighted on the internet of the before and after test scores on the Boston Naming Test for constraint therapy patients. i.e. Don had done as well in the same time frame with our $40 dollars a week, two hours a week, classes with the student teachers. However, for someone with no one in their life to work with them on a daily basis, all day long, I could see why they might want to pop with upwards of three or four grand.

February 24, 2005

Group class looks really promising this semester. Returning from last semester were Don and “V” plus we have a new guy, “TL” who goes to daycare part of the time. All three are wheelchair bound and all three guys are pretty evenly matched speech-wise. They interact quite well together and there was lots of laughing today. “S” the woman with fluent aphasia is coming back, I’m told, but wasn’t there today. One kind of funny thing about the new guy is that, according to the professor, he’s as big a flirt as Don is only he takes it a step farther---he likes to kiss all the ladies’ hands. The poor student teachers, if these two get out of control!

The student teachers all have the right demeanor for the class, too, which I was happy to see. They’re out-going, had good interaction going with the guys, and they seem to have a sense of humor. “MJ” and “L” are new to us but we’ve had “K” in group before. The same professor we’ve been working with since Don’s second semester here (in the spring of 2001) was there to supervise. She’s a very good teacher for both the student teachers and us spouses.

The first two thirds of the class was taken up with having the three guys introduce themselves, name their hobbies and wives and with the girls generally picking conversational information out of them. “V” and “TL” are both fishermen, so I’m sure we’ll be talking about that a lot this semester. The guys found out another common thread with the mention of old cars.

The last third of the class was taken up with playing a form of picture bingo. The cards had three pictures, in three categories: food, vacations and sports. For markers they used miniature chocolate bars and the guys got to eat one for every ‘bingo’ they got. Each word had to be said out loud several times over the course of the game---things like: corn, apply, tent, suitcase and skis. It’s a running joke in the department that the student teachers don’t have a chance of getting an ‘A’ out of this particular professor’s classes if they don’t bring chocolate to these group classes. So chocolate is usually the prize for winning the games played. All in all, I was pleased with this first group class of the spring semester.

Footnote: "V's" wife told me today that he had gone to one of those concentrated, high-priced aphasia programs and it didn't do him any good at all. But she said they had a neighbor who also went and he did very well.

March 1, 2005

We're snowed in and can't make it to speech class today. Don is disappointed. I'm just glad I don't to drive in all the drifting and blowing snow. We got ten inches over night.

March 3, 2005

Today's speech class started out with the student teachers having the three clients do a common word search exercise of naming things in a particular category. The category was things that relate to spring. Each guy was to name something, going around the room several times. When the list was nine words long, each of the guys had to read the list, which was written on a dry/wipe board. Each guy had to be queued about the same amount of times and each struggled with a few words during the reading phase.

Next they played 'go fish' with homemade picture cards. The object of this game is to get the guys to do repetitive phrases of 'go fish' and 'do you have a _____ ." Each guy needed queuing, but each guy also got out a few of these sentences on their own. They have fun with this game and the majority of the hour was spent playing it.

The third and last task was called 'gesture guessing.' They were each given a sheet of paper with pictures of nine things on it to act as their queuing or cheat sheets. Then each guy took a turn being shown an object (comb, hammer, spoon, etc.) which the others couldn't see. The goal of the task was for that client to act out a gesture that would tell what the object is, and the other two were to guess, using their cheat sheets. All three guys did good on the guessing part, but "V" and especially "TL" had a hard time gesturing. The student teachers had to move their arms for them. It made me remember how far Don has come in this cognitive task. Last year Don couldn't gesture very well, either, or it would be a gesture that was so far off, it was useless.

All and all, a good class today.

March 8, 2005

The individual class today started out with the student teachers giving Don a script that they want to use at the beginning of each class. It’s common conversational stuff like, “How are you?” “I am fine. And you?”---a dialogue that he can read and say out loud.

The first therapy task involved showing Don pictures and he was to name the ‘who’ and the ‘what’ for each picture. For example: Don was be able to get out “woman” and “washing” or boy/raking, man/sweeping, and woman/vacuuming. Once he got the ‘who’ and ‘what’ out for each picture, the girls would have him say the words together in sentence form i.e. “The woman is washing.” The professor was in the observation room with me and some of the other students and she remarked that the “L” was doing well at queuing today (big improvement from last week) and that Don was very fluent in repeating back the sentences. At one point he got side-tracked with “L’s” dimples and she doesn’t quite know how to handle his distraction tactics yet….but she’ll learn. She’d better! Don was pretty easy on her and backed off quickly when she got embarrassed. (Maybe he’s just getting his impulse control issues under control; God knows we’ve worked on it enough. I got the impression out in the hall that all the students had been 'trained' on how to stop a hug from Don in progress, it was mentioned that one of their goals for him was to get his hugging reprogrammed into more appropriate situations.)

The second task was designed to work on listening skills. They girls would put down four photos on the table, and then say a sentence. Don was supposed to point to the picture that matched what that said. This seemed easy for him and I could see the improvement from last semester.

For the third therapy task the girls laid two dozen picture cards down on the table and then they’d have Don pick out, first, all the vehicles, then the tools, fruits, and finally the buildings. The professor says this is stepping it up a notch to have Don thinking (and sorting in his mind) words in categories, functions and similes groups. He was in full ‘entertain the masses’ mode while he was doing this task---making sound effects like a car complete with squeaky brakes, horns, high speed and crashes as he ran his finger up and down the rows of cards in his search. He didn’t make but a few mistakes of omission in finding all the cards. All of us in the observation room were laughing at his antics and the poor students in the room with Don were trying their best to remain professional and not laugh. Don was once a terrific story teller and you’ve got to admire the fact that he is still able to find a way to be the center of attention without his speech.

The forth and last therapy task had everyone in the observation room rolling on the floor with laughter. The exercise is one where they role-play. One girl is a waitress, the other plays me. They use real menus and place settings, place orders, ask for refills of coffee, order desert, etc. Don did really well getting out the words he needed until the pretend waitress gave him the bill for almost $50.00 for two pretend sandwiches, two coffees, a piece of pie and a malt. He caught that it was too high and keep saying “no!” and pushing the bill away. Finally, the professor wanted to roll-play, too, so she went in the room pretending to be the manager to talk to an unhappy customer. The object---I think---in giving him a bill that was too high was to get Don mad so that words would flow better. They did. When the professor said, “What would you like me to do with this bill?” Don said: “Stick it!” God, it was funny and I was relieved it wasn’t something worse….this is a Christian college we go to.

After class the professor said she thinks that Don is an ideal candidate to get a Lingraphica, a communication and therapy device. It looks like a laptop but it has communication and therapy stuff programmed in it and it’s a lot of mouse work instead of keyboard, she said. It’s some government approved program that is covered by most insurance companies and by Medicare and the school can train him on it. I’m excited and will get the paper work done soon.

March 10, 2005

Don had to miss the group speech class today. He is SO sick with either the flu or food poisoning! We were up half the night. Next week is spring vacation for the student teachers so no classes. I hate these delays! One step forward and two steps back.

March 22, 2005

The first task of the day was the same as Don’s been doing in past individual classes where he looks at a picture and has to try to get out 2 or 3 words. Then when he names something like “girl” and “kite” then the student teachers queue Don to say a complete sentence like: “Girl flies the kite.” The professor wasn’t there for part of the session so she didn’t see that one of the student teachers kept trying to change Don’s word of “boy” to “man” or “girl” to “woman.” It bugged me because in the past when he’d come out with a word that was in the right category, the students weren’t supposed to put their words in his mouth, to change it if he had the gender right. On the good side, one of the students did good queuing today for action words---she’s learned fast. For example, when they were trying to get the word ‘bake’ out of Don she’d say: “you don’t fry the pizza, you……” or “you don’t boil the pizza, you…..”

For the second task, one of the girls would read a sentence and Don was to finish it. Examples: “I’ll drink my coffee from a _____. I can write with a pencil or a _______. My hands are dirty, so give me a bar of ______.” Don did well with these ten fill-in-the-blanks.

For the last half hour of the session I was asked to leave the observation room and go into the treatment room for a demonstration of the Lingraphica communication device that Don is going to be doing a trial on. It’s like a laptop that’s been programmed so that someone like Don can use a mouse to point to various categories with pictures inside. When you open up a category with a click, you can drag one of the pictures into a storyboard. (An example of a category would be ‘people’ and the Lingraphica is customized to have all the people in it that the client would want to talk about.) You keep point and dragging pictures to the storyboard until you’ve built a complete sentence. Once the sentence is put together, you can hear the sentence spoken by the machine, see it written out with words and see it as a storyboard of pictures all lined up. You can set the machine to speak in different speeds and the client can keep clicking to repeat the sentence as often as he/she wants to practice saying it out loud. It seemed to take forever to build one sentence and I was impatient with the process, but after not being able to communicate for nearly five years, I don’t know if Don would agree with me. I’m anxious for him to actually get to try the machine for himself.

March 24, 2005

Today’s group class started out with a word association task where the four clients were to name words related to Easter. Then they put all the words on index cards and each client was given some of the cards. Next they’d go around the table and each client tried to say the following sentence: “I will put the (item read off an index card) in the basket.” The third task was a game that was a total floppy because the clients didn’t understand it. So the professor stepped in and tweaked it so that the clients at least got a little practice repeating a sentence about Easter, then game was cut short. Last, they played picture bingo using picture cards with 16 Easter related pictures on them. Everyone had a good time and got out some good words with little or no prompting.

P.S. Just as I was finishing up posting this, Don yelled from the other room: "Wake me up [in] ten minutes." A totally unprompted and nearly complete sentence! This is so awesome because they don't come often.

March 29, 2005

Don and I talked about his classes and we both agree that they aren’t going all that well this semester. It’s still worth the time and money to attend---especially since there is a long waiting list to get into these classes and should we drop out one semester, the likelihood of getting back in would be low. But in past semesters the students were more creative in their choices of therapies to try, they pushed harder, and they were more engaged with Don. One girl, for his individual class, seems to just be there for the grade which is something we’ve never had before in all the time we’ve been going to these classes.

For today’s tasks they repeated two from last week: the one where they showed Don pictures for him to build sentences with and the one I call the pretend-you’re-at-a-restaurant exercise. Added to these was another familiar task. They brought in a coffee pot and Don was supposed to tell them how to make coffee. But they gave him too much help, in my opinion, filled in too many words for him. I know he could have done better, had they pushed more.

March 31, 2005

Today’s group class was a lot of fun for the clients. Don and “T” seemed to have found a way to communicate with each other with facial expressions that have them both laughing at each other a lot. And “V” got so excited every time he’d get out a word and that it was fun to see. He’s really improved lately. His wife was getting trained on the Lingraphica and was not there today.

The first task was word retrieval about Easter---who they saw, what they ate, etc., etc. The second task was a complicated game that was too hard for the clients to grasp so the professor stepped in and simplified it. It was kind of funny that “T” kept yelling out the answers when it was either Don and “V’s” turn but when it was his turn, he couldn’t always say what he had to get out. The third task was twenty minutes of “go fish.” The clients got a lot of opportunities to do their repetitive sentences of “Do you have______” and “Go fish” but the girls somehow screwed up making the game cards and no on got any bingos. They got their candy prizes anyway.

Silent Cry

“A complete sentence, please!” I say
And I see it in his eyes
A promise on a wing
But the words can’t make it to his lips
They are lost
And yelling, “Which way is out?”

I scream back!
Silently of course
“Go around the aphasia,
Crawl underneath apraxia!
Don’t be shy---
Come out COME OUT, wherever you are!”

My silent cry echoes between our eyes
But his words are lost
Like a little lamb in the forest
Waiting in fear
For the wolves of night to come
And rip its belly open.

I see him here beside me, but he is gone
Like the words, words, WORDS!

Jean Riva ©

April 12, 2005

I haven’t written anything for the classes on the 5th and 7th because there just wasn’t much new going on. Today’s individual class was interesting because I happened to be alone in the observation class with the professor. I’m not sure if she sensed that I’ve been a little disappointed in the classes this semester or if she started her talk because the opportunity just presented itself. Either way, she told me that they had paired Don up with two of the shyest students because they thought he would help draw them out of their shells. And with the one girl from Malaya the professor was very pleased at the changes in her. She (the student) quickly learned proper queuing techniques, is making wonderful eye contact now and is really involved with the patient (Don). I’ve noticed the changes, too. I was honest with the professor and I told her Don and I had talked about it and we thought that the semester was a wash for Don. The professor answered that this is the nature of a teaching college---that they never really know which students will blossom out and be good with the patients until they actually get to try out what they’ve been learning in the classroom. She also said that Don is really good at getting all of the girls in the department to open up and be natural with the patients. He is, too. He doesn’t let anyone be a wall flower in the waiting area.

The second part of the hour session today was spent training Don on the Lingraphica and I am now getting excited about it. (I was wavering a little after reading another post in this forum.) Don picked up quickly on the technique of retrieving sentences and clicking on them to hear and read them, and then he’d say them out loud. And he COULD say them out loud! I think he’s going to be able to navigate the little laptop just fine to self-tutor and to build communication. The professor said we’ve only seeing a 10th of what that machine is capable of doing and she is strongly recommending it for him. She thinks it fits his needs to a tee. I had checked out other systems on the internet and I even got a couple of samples of aphasia software to try out, but this one still seems the best for Don with his severe apraxia and aphasia.

April 14, 2005

Instead of me being in the group speech class with Don today, the two student teachers trained me on the Lingraphica. It has a lot of pre-programmed sentences in it, but for customized sentences, I would be the one who would program them in. It was pretty simple to do, but very time consuming because you have to find pictures for each word. For example, I was building the storyboard/sentence of, “I want help with my socks” and for the word “socks” I had to first click on a picture of a house, then in a bedroom on a floor plan diagram, I clicked on a closet. In the closet were pictures of all kinds of clothes that could be retrieved. Some words are not in the vocal part, so you have to also program them much like you would record an outgoing message in an answering machine. The system has room for 2,000 sentences and you can organize them into folders by topics to make them easier to for the patient to find.

The system’s pre-programmed sentences are organized in groups of ten by categories like: bathroom, doctor’s office, garage, etc. You can customize sentences, too, to add into the pre-programmed categories. In theory, a patient with aphasia would practice reading and speaking the difference categories recommended according to difficulty. I also got a taste of some of the advanced therapy exercises in the system that Don would not be using for a long time.

After my hour, then Don came into the treatment room where he practiced setting up the Lingrapahica (plugging it in, connecting the mouse and power cords, etc.) and turning it on and off. That didn’t take up much time and the bulk of his practice session was spent on him retrieving sentences, saying them with the machine. He did really well, especially for someone with zero computer skills before his stroke. All of the functions done by the patient are mouse functions but the mouse is a little different from a standard mouse---larger with an oversized tract ball and a button that stays down for dragging, if you can’t do it the standard way. He was able to self queue sentences, using the machine, saying them out loud with the voice of the machine. He could repeat certain words that were giving him trouble by clicking on its picture to repeat individual words as many times as he wanted. It was amazing to hear his voice pace out the sentences in a natural rhythm. It has four speeds, and it was set at the third level.

All and all, I’m looking forward to our two week trial at home. And if the works out, the professor will sign off on it then we’ll get the doctor’s order and we’re on the way to owning it!

April 19th 2005

Individual speech class went good today. The students did well with their queuing techniques and with Don’s ability to build sentences with the picture cards, I could see improvement. He even did two of the ten cards without any queuing at all!

One funny thing happened, though. During the second half of the hour he was getting more training on the Lingraphica and one of the sentences was suppose to be, “I need help with my shirt.” Well, Don couldn’t say ‘shirt.’ It kept coming out as sh#t which, in that setting, embarrassed the heck of out him. After letting the machine queue him a few more times without success, one of the students tried. Both girls did an admirable job of holding a straight face and trying to tell Don it was okay. Yadda, yadda, yadda. But those of us in the viewing room were cracking up with each, “I need help with my sh#t.” It’s getting near the end of the semester, so the viewing room was standing room only. They have to get so many hours of viewing to graduate. One of girls remarked that she’d viewed Don last semester and she was impressed by his improvement.

After class we had to wait for another client to train on the Lingraphica because we needed to take it home with us to start our at home part of the trial. Several of the students hung around in the waiting area with us to keep up company. It was late in the day and their classes were over, so this was really nice of them. This is one of the perks of going to the college program for speech---all the interaction with young people who are eager to try out the things they are learning in books. One girl said Don doesn’t even need language because he’s go good with facial expression and they taught us some sign language.

At home, I played around with the Lingraphica for over an hour, trying to program new sentences into it. Some are easy, but if there isn’t a built-in picture to come up for a certain word you want to use, and you have to go looking for a picture that will fit and that is so time consuming! I also couldn’t figure out how to record words, even though I did it last week in class. I’m going to have to sit down and read the manual.

Don did better than me. His job is to learn how to set up the machine, turn it on and bring up the correct storyboard to practice sentences, then turn it off and put it away---all by Thursday when we go back. He could do it all pretty well by the end of our hour of homework. I’m not worried about him catching on. The jury is still out on me.

April 28th, 2005

Today was the last of Don's speech classes for this semester, except for next Tuesday when we get the results of the individual testing that was done today and the discharge party.

While I watched from the observation room, I couldn't help compare this testing day to the one done the first day of the semester. And, boy, have the girls improved over this semester! They were professional, didn't grop around for the how-to of doing testing, and they only screwed up a few times by queuing Don for answers. (For testing purposes, queuing would not be allowed in the real world where the amount of improvement made, or not made, is the difference between getting insurance coverage, or least this is the way his previous speech therapies all operatored when they'd do those every six weeks testings.)

Don whipped through the tests and appeared to me to have made some good gains from the first of the semester....I won't know for sure until Tuesday though. They finished early so the professor took over saying she wanted to step in the field for a little while. She took Don through the Boston Naming Test again. She was trying to teach him how to slow himself down when he is stumping over syllables. I know he knows what she means and I'll have to reinforce that at home when I see him doing it 'cause he always makes joke gestures when that happens.

She then called me into the treatment room for a report on how he is doing on the Lingraphic. We've decided to go for it, so she'll take care of her end before the party at which time we give her back the trainer machine to sent back to the company, and they'll send us a brand new one. They take care of all the insurance billing issues, too, and getting our doctor's prescription, etc.

At home, Don's branching out from just practicing with the storyboards on the Lingraphica that I've constructed to learning how to pulled down catergories of words to practice on his own. There are 2,000 picture/word combinations so it's going to take time for him to be able to pick out words at will and contruct his own storyboards...but that is one of the goals. He can't write because of the apraxia, so traditional writing or typing out a sentence is not possible. I'll update this thread on how he's doing on the machine once a month through the summer. Three of us from group speech class, who have wheelchair bound husbands, are getting the guys together once a month for cards, so I'll update then as two of us couples will be using the Lingraphicas.

May 4, 2005

Today was the final day of classes at the college speech pathology department’s clinic. It wasn’t actually a class. It’s an evaluation session where they discuss the progress over the semester, followed by a discharge party. The parties are fun. The college provides a luncheon and all the students take turns telling something that they learned from the clients and they also tell what their plans are for the future. Here’s a few of the comments the students made: 1) “I learned you have to be flexible when working with clients.” 2) “I learned how important it is for the clients to carry their speech lessons over into their daily lives.” 3) “I learned that it’s important to get to know a little about the client’s life.” I wish I could remember more but there were too many and I didn’t have my note pad.

During Don’s evaluation session, it was a relief to know that he’s being recommended to be a returning client. I always hold my breath on this part….he’s the only client they have whose been going there for four years. (All but one of the other clients have been going there under two years.) Don’s ‘verbal expression’ tested better from the first of the semester and they recorded some three word spontaneous phases out of him. For ‘social pragmatic communication’ they girls wrote down that “Don’s sense of humor was helpful in therapy and he was generally socially appropriate”---Not sure I agree on that last part. He got scored high in “cognition’ and in ‘auditory comprehension.’ The auditory comprehension really struck a note with me because at the end of his very first semester his auditory comprehension was fairly low.

It was a rocky start to this semester, but in the end we got enough positives out of it to make it worth our time. Over the summer Don will be working an hour a day on the Lingraphica, six days a week, and we made plans with “V” and “T” and their spouses to get together once a month for cards. Don and these two guys had a lot of fun in group classes and I’m hoping we can all become social friends outside of the college. I don’t really think that will happen, though. The two other couples have an awful lot in common and I can see them bonding well, but I’m not sure it will happen for us and them. I’ll update this thread with Don’s and “V’s” progress (or lack there of) on their Lingraphicas after our three summer card dates.

May 26, 2005

From time to time, I'm planning to do a summer update on this thread to record Don's experiences and progress (or lack there of) on the Lingraphica communication device.

It got delivered last Friday, but we've been so busy that I haven't had a chance to start customizing it until this morning. That was not exactly fun! It's a slow progress to find pictures to go with every single word you want to use. The system has more than 5,000 words and phrases already represented with pictures and those are easy to find---just type them in and the pictures appear in a storyboard. But specific words like the names of people and places, animals, etc. I had to put in with a re-named picture that can represent the word in the storyboard; every word MUST have a picture, not just typing. For example, I was trying to use the word "snowplow" which isn't in the system, but the closest picture I could find was a pickup truck that I renamed to 'snowplow.' At one point, I kept making a stupid mistake in the progress of recording a word vocally, so I called techical support. I got through in less than a minute toll free, a nice surprise. Once the storyboards are customized, I won't have to do them again in mass, just add or delete as needed. I've got other folders to create storyboards in but I'm burned out right now.

The sentences that I got into storyboards today are in a folder of storyboards labeled, "Biography." These are the things that Don tries to say to strangers where every we go and that I end up having to say instead because he'll only get one or two words out per sentence. God, I hope someday he can say these things for himself! He'll start practicing this afternoon. What he does is open up a storyboard which contain one sentence represented in both pictures and typed words. He is first to listen to the sentence, then try to say it on his own. If he can't then he can listen to it as many times as needed. If only one word is giving him trouble, he can click on that one word to hear it over and over and say it with the machine. The voice on the machine has four speeds and we might have to adjust that a little to be sure it's paced right for where he's at right now. Keep your fingers crossed for us!!!

1) My name is Don
2) I grew up in Rockford
3) I live in the north end
4) I was a die maker at GM
5) I had a snowplow business, too
6) I plowed snow at the 28th street mall
7) My wife is Jean
8) I have three brothers
9) I hunted out west
10) I hunted elk, antelope and mule deer
11) I had a stroke five years ago
12) Doctors said I would be a vegetable
13) I fooled them
14) We built a wheelchair accessible house
15) I go to speech therapy at the college

June 17, 2005

We had two couples over last night that we met in our group speech class, to play cards. We haven’t seen them since classes ended. Both guys have severe aphasia, like Don and are in wheelchairs. Gosh, those guys were happy to see each other! That alone made the night worth planning and cleaning house for and what surprised me was that I had a good time, too. I think we all did.

The evening reminded me that I should update this thread about Don’s experience with the Lingraphica. First I need to say that “V” (one of the guys who came over) got a Lingraphica at the same time that Don did and we four (me, Don, V and his wife) all trained on one at the same time on during speech classes. So naturally the topic came up of “how are you doing?” Well, it seems that the other couple hasn’t touched their machine. She can’t figure out how to program in the customized practice sentences! She doesn’t have any computer skills---not that you need a lot for this machine---and she hasn’t called their support line for help. Hopefully, she’ll call and have their tech guy walk her through the steps.

Don, on the other hand, has over a hundred practice sentences in his laptop in addition to the practice stuff pre-programmed into it. He’s been doing an hour per session, about four times a week. I’ve been trying to nag and bully him into working on the machine six times a week, but so far I’m losing that battle. Is there progress in his speech? I’m pretty sure there is. In day-to-day life he’s getting out more particle sentences---two and three words strung together. Nothing major, but several a day. He’s even getting out one or two full sentences on his own every day like, “Turn it on" and "I don't know.” And queuing him for full sentences seems to be moving along faster. Like all of us dealing with speech issues, it’s often hard to judge progress because we’re with our spouses so much.

The six of us all getting together next month for cards again at one of the other couple’s house, so I’ll update again then.

NOTE: Part 4 of this diary is the last of the entries that I've moved to another site to protect them from getting deleted off a message board for being old. For classes Don's had after this, they are mixed up in my archived entries in this blog.

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