Clinical Observation Paper

What was happening? Be specific. Include in this discussion your clinical observation of what skill areas the clinician was targeting.

The client had a right temporal craniotomy. In this session, the clinician was targeting recent memory and recall/rehearsal strategies. For example, one activity required the client to look at different color pegs on a peg board. The clinician then removed the pegs and asked the client to put the colored pegs back where they were. The client and clinician worked through different strategies to recall/remember where the pegs were (see feedback section). Another activity consisted of the clinician asking the client to list different types of animals. The client also had to repeat as set of words given to him by the clinician.

Client’s cooperation with procedure:
Overall, the client responded well to all activities. When he spoke, it was in a very soft voice. The client displayed great insight into his deficits. He started to seem upset and frustrated when he could not remember where the pegs went in the peg board activity. He mumbled to himself during the activity. I assume he was using rehearsal strategies to remember where

the pegs went. The client was able to come up a list of animals fairly easy. He states he grouped the animals together. He started with farm animals and then moved on to safari animals, and then common household pets. I can tell this was a strategy previously targeted in prior therapy sessions. The client struggled with repeating a list of words the clinician gave him. He stated to the clinician, “my mind is just blank.” See feedback section for further information.

Client’s rapport with clinician:
The clinic displayed a good rapport with the clinician. During the first few minutes of the session, they engaged in small talk. They conversed about the cold weather and what they did over the weekend. Throughout the session, the client was not afraid to ask the clinician for help on a difficulty activity. He also expressed his frustrations to the clinician and she responded accordingly.

Feedback given to client:
The client had the most difficulty with the peg activity and repeating words. The client was visibility frustrated and upset that he could not remember which color peg went where in the peg board. The clinician assured him it was okay and that she would help him complete the activity. First, she tried to give the client prompts. “In this spot, the peg is either blue or yellow.” The client still could not complete the task with the prompts. She then asked the client how he was remembering where the pegs went. He stated he was simply staring at the pegs and trying to remember them. The clinician instructed the client to group the color pegs together (three blues, 4 yellows) and remember which color pegs were next to each other (green is next to purple). For the repeating words activity, the client struggled to remember what words the clinician said. The clinician told the client to listen carefully and try to group the words together like he did for the previous activity. This strategy was successful.

Describe communication characteristics you observed (use specific examples, including observations on receptive and expressive language skills of client):
At first, the client did not speak a lot.

He seemed to warm up and speak more during the activities. He spoke in a soft, timid voice. He seemed to mumble to himself through the therapy session. I could not hear what he was saying, but I assume he was using rehearsal strategies. Other than the soft voice, the client displayed good expressive language skills. Client displayed good insight into his deficits. It was clear he was upset when he could not complete certain activities due to lack of memory. The client seemed to be taking in and understanding what the clinician was asking him to do. Overall, the client displayed good receptive language

abilities.

What were the strengths and weaknesses of the client observed this session? Discuss at least one example of each.
Over all, memory was the client’s greatest weakness. As stated earlier, remembering 3-4 simple words and repeating them back was extremely difficult for him. However, the client was able to compensate for this weakness by using rehearsal/recall strategies. This was definitely a huge strength for the client. The clinician gave the client strategies he could use when he had trouble remembering. The client puts these to use and there were great improvements.