Reflective log - personalised cuing therapy

Reflective Log 17.04.13 – Personalised cuing therapy

1. Think of a recent therapy session or event.

The patient I had a session with had a severe expressive aphasia and moderate receptive aphasia. He was able to generate single words and some sentences but this was very effortful for him. I had a joint session with his son (who he lives with).

2. Describe the session/experience

I did not fully assess the patient as he was unlikely to engage with formal testing and was likely to have extreme difficulties with expressive language tasks. I assessed his ability to read single words by using written words e.g. days of the week, to support the patient with answering autobiographical and orientation questions. I also informally assessed his comprehension by observing a functional cognitive screen and having a conversation with the patient and his family. I printed out picture symbols and written words to support the patient during conversations. The patient was able to access AAC (written words and picture symbols) for comprehension and expression. However during a family meeting and outside of therapy sessions e.g. in groups, the patient refused to use AAC.

I interviewed the patient’s son asking for 12 words that would be functional for the patient at home and then created personalised semantic prompts for each word. E.g. Target: football, Prompts: your son has a pub team called army and navy, you coached ….. at hackney fields, you support Millwall. I included sentence completion cues and phonemic cues. The patient was able to name half of the words with the cues and engaged with the activity. I handed over to the patient’s son that he could continue the activity.

3. What did this session make you feel?

I felt out of control when the patient refused to use AAC support to communicate during the family meeting. I had not considered that the patient would want to concentrate on who was talking to him in the family meeting and not on the key words I was writing or my attempts at facilitating his communication. Once I knew that the patient was reluctant to use AAC functionally I was able to plan for a functional therapy program around speech.

4. What has this session has taught you?

I would visit the patient before the family meeting to explain what would happen and to hand over any important information. This may have helped the patient to feel prepared and they then might have accepted some support to communicate. I have also learnt that involving the patient in choosing therapy targets and interviewing the patient’s family to find out what would be functional for them is essential in order to engage a patient in therapy.