What are the exercises like, and what do they cover?
The therapy exercises in Cuespeak address a wide range of difficulties with word finding and sentence processing, covering semantics, phonology and mapping. Exercises are designed to be enjoyable to carry out, with smatterings of gentle humour here and there.
Most exercises use an interactive question and answer format, with a range of help available for when the questions prove difficult to answer. There is spoken feedback on errors and spoken cues designed to help elicit words and sentences. Exercises are customisable to individual needs, using a wide range of psycholinguistic parameters.
Questions & Answers
The largest and most flexible exercise collection in Cuespeak is a format called QA (short for “Question and Answer”). QA contains over 1000 questions, which combine two related tasks: a semantic task and a word-finding task. QA can be used to address difficulties with understanding spoken or written questions, word-finding and articulation, as well as non-verbal semantic difficulties.
Since virtually all people with moderate to severe aphasia have difficulties in at least one of these areas, QA tends to be suitable for most users, and is usually the best starting point in a therapy programme, even if the person’s problems aren’t primarily semantic in nature.
Senfill (short for “sentence fill”) addresses word-finding at the sentence level.
A question is seen and/or heard, and the user needs to touch the written word that answers the question. The selected word will appear in the Response TABs below, and the resulting sentence will be heard. The user then needs to judge whether or not the choice was correct, by touching the check button (the green smiley face). As with Perspectives, spoken feedback is given on errors.
Soundspell is a spelling task which uses units of sound rather than single letters. For example, ch is treated as a single unit, since it represents only one sound. This format aims to re-familiarise users with the relationship between word structure and sound, since many people with aphasia lose some or all of this ability. It can serve as an effective facilitator for spoken word production.
Perspectives is a sentence processing module. This is aimed at anyone who has difficulties understanding or producing sentences.
The main task in Perspectives does not actually require the user to produce a sentence, although it can be used for this. Research has demonstrated that exercises involving judgements about how thematic roles relate to syntactic roles in a sentence (mapping) can have positive benefits for the ability to produce sentences, even when the therapy does not itself require any language output (e.g. Jones 1986).
We often focus on a person’s ability to say the word without considering the extent to which they have accessed the sound of the word internally. This inner speech as it is sometimes called is an important consideration when diagnosing and treating difficulties with spoken word production.
Asking & Offering
Asking and Offering is designed for practising word retrieval in the context of phrases and sentences that mirror those occurring in everyday conversation.
Syllable sorter is identical to Soundspell (see above) except that the units here are syllables rather than phonemes.
Letterspell is a more conventional spelling task – no sounds are heard when the tiles are touched. A point is scored for each correct letter, yielding a sensitive score.
How Many Letters
Some people with word-finding difficulties show some preserved knowledge of aspects of the written form of words which they are unable to say. Encouraging people to tap into this knowledge can sometimes facilitate spoken word retrieval. How Many Letters? is designed to do this.