Target Attention and Memory Deficits Using Peg Boards
EVEN THOUGH the peg board in the therapy closet may be labeled “OCCUPATIONAL THERAPY” doesn’t mean you can’t use it for speech therapy too! I recommend asking as you are dragging it out (because if you drop the bucket of pegs it will be VERY obvious).
Not a day of therapy goes by that I do NOT use the peg board. Oh yes, I am given LOTS of excuses from the patients such as, “I have already done this game!” or “This is for little children!” and my favorite, “I just can’t see that!”
All of these comments send me into full swing USED CAR SALESMAN/Speech Therapist MODE!
“If you have already done it today, then THIS will be super easy and quick for someone as experienced as yourself!”
“If your grandkids stop in, you can let them give it a whirl!”
or… for those ‘can’t see anything’ people who just swept the crumbs from the last person who ate graham crackers off the table, “You won’t have to see the holes because I am going to fill it up for you!”
Oh they love that, watching me stick all of the pegs in, row by row. If you are lucky, the OT may have put it away full of uncoordinated and mismatched rows of random pegs (because they just don’t do it like the speechies do)!
Once the peg board is full of pegs all mixed up and untidy-like, tell the patient it’s now their turn to do the work.
For a simple direct task, ask them something like: “Remove all of the RED pegs. Only remove the RED pegs.”
For a more difficult task, give instructions like: “Remove the red and yellow pegs only. You must take turns removing them in order of red, yellow, red, yellow etc.”
If you want to see how good their attention is, write down the instructions and step behind them so that they do not see you watching them. I like to use a small dry erase board propped up on a metal picture easel I bough at the dollar store—fancy I know.
I write instructions like: “Before you pull out the green pegs, pull out all but one yellow peg.”
If they are putting in their own pegs, I might use directions like these:
Obviously with THIS patient, I met my match!
Let’s just say that by the time we are finished with a 30 minute cognitive activity, they are more than happy to let their grandkids do it! Patients like to be challenged but there is a fine line between challenging and frustrating. Offer just enough cueing to make them feel successful. It’s a good thing when they realize their deficits are there. It’s not a good thing when they see their deficits as defeat.
Oh! And if you drop the bucket of pegs at ANY point in the session, just hand the patient (and any others waiting to exercise) a reacher and have them get busy picking them all up!
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