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7 Cognitive Communication Therapy Activities in Speech Therapy

Communication involves many skills like attention, understanding, speaking, and remembering. Cognitive speech therapy activities can help improve communication and brain function when a brain injury affects these skills.

This article will examine what causes cognitive communication disorders, their symptoms, and some cognitive community therapy activities you can do at home.

What Is Cognitive-Communication Therapy?

Communication skills are crucial for speech and language processes. Speech is not just about forming words; it also involves the cognitive ability to understand information and respond. Key cognitive skills needed for speech include attention, listening, comprehension, memory, and problem-solving.

After a brain injury, these cognitive skills may be impaired. Cognitive speech therapy, or cognitive communication therapy, aims to enhance communication skills and rebuild cognitive functions.

Brain injuries can damage neural pathways responsible for speech and language. However, the brain can adapt and create new pathways through a process called neuroplasticity. Neuroplasticity is triggered by frequently repeating exercises—this practice helps heal the brain and improve cognitive and communication abilities. Regular therapy sessions are essential for recovery, as consistent practice increases the likelihood of regaining these skills. This simplified explanation can help speech therapists understand the fundamentals of cognitive speech therapy and its importance in recovery.

Causes of Cognitive-Communication Disorders

Traumatic brain injuries can damage both the cortical (outer layer) and subcortical (deeper) structures of the brain that handle cognitive functions, potentially leading to cognitive communication disorders. These disorders can manifest as difficulty paying attention during conversations, remembering information, or following instructions. Depending on which brain areas are impacted, they may appear alone or alongside other language impairments like aphasia, dysarthria, or apraxia of speech.

For instance, damage to Wernicke’s area, typically located in the left hemisphere near the back of the temporal lobe, can cause fluent aphasia. This condition allows individuals to speak fluently, but their sentences may be nonsensical, using made-up words or illogical sequences. This impacts their ability to understand both spoken and written language.

Another critical speech and language area is the frontal lobe, usually on the left side. Damage here can lead to expressive aphasia, which hampers the ability to articulate thoughts verbally. Those with expressive aphasia generally understand what others say but struggle to respond; finding the right words is slow and laborious. Despite intact motor functions needed for speech, the cognitive aspects required for effective communication are compromised.

Symptoms of Cognitive-Communication Disorders

Every brain injury is unique, and as a result, survivors may exhibit different symptoms of cognitive-communication disorders based on the type of traumatic brain injury (TBI) they have sustained. Symptoms can overlap with other medical conditions and may include:

  • Executive dysfunction
  • Difficulties in learning or recalling information
  • Problems with memory and attention
  • Challenges in social communication skills
  • Issues with speech or comprehension

If you or a loved one begins to experience any new cognitive or communication difficulties, it’s crucial to consult a speech-language pathologist (SLP) for a proper assessment. SLPs are skilled in distinguishing between cognitive, language, and speech disorders and can develop a personalized rehabilitation plan that includes cognitive speech therapy exercises specifically tailored to your needs and abilities.

Cognitive Communication Therapy Activities

Cognitive communication therapy plays a vital role in helping individuals recover and enhance their communication abilities after experiencing cognitive impairments due to brain injuries. Regular participation in specific therapy exercises is essential for promoting neuroplasticity, which enables the brain to adapt and create new neural pathways. These exercises not only improve language skills but also strengthen a range of cognitive functions.

Here’s a simplified guide to some effective cognitive speech therapy activities designed specifically for speech therapists to implement:

1. Response-Elaboration Training (RET)

RET uses visual prompts like pictures depicting various actions to help patients elaborate on their verbal responses. By asking a series of WH questions (“Who?”, “What?”, “Where?”, “When?”, “Why?”), therapists encourage patients to expand their brief responses into more detailed explanations.

This approach is beneficial for enhancing spontaneous speech and helping patients develop the ability to express complex ideas clearly.

2. Naming Therapy

Naming therapy is a common approach in cognitive speech therapy that helps individuals with language impairments, such as aphasia, improve their ability to recall words and enhance their expressive language skills. This therapy is particularly beneficial for improving vocabulary, strengthening connections in the brain related to language, and facilitating communication.

Here are some sample naming therapy exercises:

3. Object Identification

Objective: To improve word retrieval and verbal expression.


  • Gather various everyday objects (e.g., a pen, watch, book, cup).
  • Present one object at a time to the patient.
  • Ask the patient to name the object.
  • If the patient struggles, provide cues such as the word’s first letter or the object’s function.

4. Picture Naming

Objective: To enhance visual processing and naming skills.


  • Use flashcards with images of common items, animals, or actions.
  • Show each card to the patient and ask them to name what they see.
  • Provide graded hints if necessary, starting from general to more specific (e.g., “It’s a type of fruit,” followed by “It’s red and you might eat it in a pie,” for an apple).

5. Task Sequencing

Task sequencing activities are essential in cognitive speech therapy, as they help patients improve their planning, organization, and comprehension skills. These exercises involve ordering the steps necessary to complete everyday tasks or activities.

Here are some sample task sequencing exercises suitable for cognitive speech therapy:

Making a Cup of Tea

Objective: To enhance procedural memory and executive functioning.


  • Break down the task into simple steps, like selecting a mug, placing a teabag in the mug, boiling water, and pouring the water.
  • Provide the patient with cards or pictures representing each step in a mixed order.
  • Ask the patient to arrange the cards or pictures in the correct sequence to make a cup of tea.
  • Gradually introduce more complex beverages or multiple-step beverages like making coffee with a French press.

Getting Ready for a Walk

Objective: To improve memory for daily routines and sequential planning.


  • List the steps involved in getting ready for a walk, such as putting on shoes, grabbing a coat, and taking a key.
  • Mix up the order of the steps and present them to the patient.
  • Have the patient organize the steps in the correct order.
  • As progress is made, increase the complexity by adding steps like locking the door or checking the weather.

6. Spaced Retrieval

Spaced retrieval, also known as spaced repetition, is an evidence-based learning technique that involves reviewing information at gradually increasing intervals to enhance memory retention. This method is particularly useful in cognitive communication therapy to help individuals remember new information more effectively.

Here are some practical examples of how spaced retrieval can be implemented:

Learning New Vocabulary

Situation: A patient is learning new vocabulary words to improve language skills after a stroke.


  • Introduce a new word, such as “arboretum.”
  • Ask the patient to recall the word and its meaning after 2 minutes.
  • If the patient recalls correctly, ask again after 5 minutes.
  • Continue increasing the intervals to 10 minutes, 30 minutes, and several hours over the course of a therapy session.

Remembering Personal Information

Situation: A patient needs to remember important personal information, such as their address or phone number.


  • Have the patient repeat their phone number.
  • After they successfully recall it, ask them to repeat it again after a few minutes.
  • Gradually extend the interval before the next recall—first 10 minutes, then 20 minutes, and later, after an hour.

7. Rhythm Matching

Rhythm matching exercises are effective in cognitive speech therapy as they help enhance auditory processing skills, attention, and memory. These activities involve patients listening to and then replicating specific rhythms, which can be adjusted in complexity according to the patient’s ability.

Here are some sample exercises you can use in therapy sessions:

Basic Rhythm Clapping

Objective: To improve auditory processing and motor coordination.


  • The therapist claps a simple two-beat rhythm (e.g., clap-pause-clap-pause).
  • The patient listens and then attempts to replicate the exact rhythm.
  • Gradually increase the complexity of the rhythm as the patient improves (e.g., clap-clap-pause-clap).

Rhythm and Word Association

Objective: To combine cognitive processing with rhythmic skills.


  • Assign a specific clap or tap to different words (e.g., “apple” = one clap, “banana” = two claps).
  • Say a sequence of words and have the patient clap the corresponding rhythm.
  • Increase difficulty by speeding up the pace or using longer word sequences.

These activities are flexible and can be tailored to meet each patient’s specific needs. Consistent engagement with these exercises is crucial for effective rehabilitation, as regular practice helps integrate improved cognitive and communication functions into everyday life. Ensure the exercises are challenging yet achievable to encourage continuous improvement and patient motivation.

Conclusion on Cognitive Communication Therapy Activities for Speech Therapy

Cognitive communication therapy activities are essential components of language rehabilitation that significantly enhance how individuals understand and interact with their environment. These activities go beyond simply improving the mechanics of communication to enrich overall communicative competence.

By incorporating a range of stimulating and engaging exercises, therapists can greatly enhance a person’s ability to process and articulate information effectively. This approach not only aids in rebuilding language skills but also bolsters cognitive functions, critical thinking, and social interactions. Engaging in cognitive communication therapy is instrumental in developing both verbal and non-verbal communication capabilities, ultimately supporting broader life skills.

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SLP Team
Author: SLP Team

Our Speech-Language Pathology (SLP) team is a dedicated group of professionals committed to sharing industry expertise to help you grow your practice and improve how you treat your patients.

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