Communication fitness: the stuff

{Blogger's note: the 4/23/17 post titled "Communication Fitness" drew a lot of response, so - there's more to be done. In light of my discovering a real - world equivalent of this clinical idea in use @ Northwestern University, we need to keep pushing the envelope}

It shouldn't be a surprise to us in the professions, that getting adults onto video game platforms would be touted as critical for boosting their cognitive fitness. When there is a chance to publicize our clinical advances, news organizations like to see people hooked up to, in circuits with, or dependent upon technology!! It's cutting edge. It's SEXY...and in some training scenarios, it has been shown that computerized "brain training" can raise scores on cognitive assessments, e.g. those for attention. The effects of this computerized training being transferred to everyday life? The jury is still out. Yet customers (to distinguish them from  persons served  in clinical treatment) for communication fitness programs, will gravitate to computer-based cognitive games as easily as 'gym rats' ramble to a treadmill.

[PROBLEM: customer wants to improve her concentration for things she hears. SOLUTION: customer presses a button whenever she can name a popular song played aloud, given four possible answers on the computer screen]. 

Yet Wii, XBox, and other game, tablet, laptop and smartphone - accessible cognition - canoodling formats are here in our bag of tricks for the foreseeable future. They encourage buy - in with adults for the "brain fitness" enterprise. They are portable and often intuitive to use. Fun is contagious, and using computer-based games as part of a cognitive fitness program fuels the social need to communicate and to think. Yet, playing games is not what most adults do all day. When I ask persons served who enroll in clinical programs with me, "How will you know when you're better? What do you want to gain from working with me?", they mention their abilities for cleaning the house, or staying focused and efficient on the job, or not being surprised by their family members appearing - even though the customer had communicated with family re a visit, earlier that day.

In this role, the speech-language pathologist is not the game master but instead, a take on the interior designer. The SLP immerses the cognitive fitness customer in real environments, tailored to the customer's needs - so that the skills that need support are exercised; that real-time feedback is available, and that it is a supportive environment that yields specific learning opportunities. The customer is then prepared to re-engage in real life, with her skill set bolstered. The context - dependent learning available, helps ensure the customer can apply what is learned, back in her real world.

[PROBLEM: customer wants to improve her concentration for activities done in the kitchen. SOLUTION: customer makes a meal for herself and cognitive fitness staff in the training kitchen]

What does each cognitive fitness approach have in common?

* An SLP constructs and supervises the activities.
* Regardless, this is not skilled treatment that requires the intervention of an SLP. A cognitive fitness customer may interact with a volunteer or a paraprofessional to complete a fitness program.
* A successful outcome of fitness training = customer returns to her everyday activity at previous level of independence.
* Cognitive fitness training is NOT paid for through insurance.
* The SLP should initiate cognitive fitness programming for adult customers, to extend the influence of the professions.
* Cognitive fitness can be seen as a preventative intervention, supporting adult wellness programs to help keep adult customers viable and safe in all their customary (residential, occupational, social) environments.

Structuring the successful cognitive fitness program: that will require patience and fortitude.