 I'm Ruth. I am a speech language pathologist in Portland, Oregon, and I use improv to work with people who have a variety of speech and language issues. You can do that too. You may be thinking to yourself, why do I need to see a speech language pathologist? What could this possibly bring to my realm of improv? Well, there are people, I guarantee you in your city who are speech pathologists, who are teachers, who are OTs and PTs and other clinicians, who work with these same populations, and also the populations themselves are there, and you may be able to find some way of addressing those folks through local medical centers, rehabs, assisted living, and so forth, and schools, of course. So I'm going to talk about three specific areas that I address in today. One of them is I'm going to actually start with the pragmatic skills and social conversations piece. So the why of this, why do I use this in any realm? It's because I want to use the tools that I learned as a speech pathologist, those formats in a more engaging way, because engagement is 90 percent of getting people to follow through on the things that you teach them as a speech pathologist. So that's reason one. Reason two is I can address a lot of different goals for a number of different people in a single setting. So if I have a group and they all have different goals, I can do that with some of these games and they can all get something out of it. Also, I can bring in my OT and PT friends and have them be part of this and make it, because a lot of our exercises have a physical component and they can add whatever the physical component is that they feel is appropriate to that particular population. So this is a lot of the population that I see, these kinds of folks. So let's go to, we're not going to see any of this because we just don't have time, but I will say that evidence of course is extremely appropriate. We're going to go to the game of hype man. How many of you know the game of hype man? Raise your hand if you do. So the game of hype man, what we're going to see here in this particular instance on the far side is a speech pathologist and in the middle, the young woman sitting is a woman with a brain injury or traumatic brain injury, and the guy on her other side also has had a traumatic brain injury. The young woman in the middle after her brain injury became very introspective and it became very hard for her to talk to people about herself or indeed about much of anything. The guy was just the opposite. This guy talked his head off and about nothing but himself. He was very into talking about himself and very perseverative. He had about the same three or four stories that he told everybody in any context that he met them in and the people who he lived with were like, yeah, we've heard that story a couple of thousand times. So what she said to me was, what can you teach him to help him get out of that mode? So we're going to watch this now. I think. Oh, no sound. Is that fixable? I understand you're also a violin player. Is that right? Yes. Tell me about your violin. Did you guys hear that? That's great. It got some hard accident. It reached on backwards for a few years. And recently, too recently. Look at him listening to her. He's never heard this information before. Only then on Parkinson's patients. And it worked and I got my hands back. So I'm going to a cartway. Boys, violin, violin, anyone I've ever heard. She plays my one so much. She plays my one so much. Good, nice. Okay, good work. Very good, good, good. Okay, so everybody had a chance to take at least one. All right, so you can see what he's done as listen to the few things that she said right in the moment. And prior to this, we had worked on a bunch of listening skills. And, you know, he took exactly what he heard from her and he put it out there. He's her hype man. She's the celebrity for once in her life. And he is her hype man. He's telling the audience everything about her. And that speech pathologist called me about three weeks later and said, so we've been playing this once a week at home. They took a bunch of my games home and played it in this independent living setting that they all lived in. And do you know, he is actually asking people questions now. He is not just 100% talking his head off. He asks questions and then he'll actually hype man people every once in a while when they're out like they'll be out in a public setting and he'll start hyping people. So that was great. I love that piece of it. Good, so, oops, I went too far. So the next piece I do, another piece that I do is comprehension and cognition. So I have a lot of folks who have Parkinson's disease. I have a lot of people with strokes and I've worked with kids who ADHD and things that get in the way of listening well to comprehend and then also being able to put things together cognitively. So one of the games I really like using is Up, Down, In, Out, Diagonal. And have you played that before? Okay, we're gonna play it right now. So here you go, here's the commands. Ready, up, and you're just gonna say it with me, sorry. Up, in a good loud voice. Down, in, out, diagonal. So what I would do is I would, for example, I might say to cat, if we'd all be in a circle or if there's only two or three of us, that's fine too. And I might say to cat, I'd show her my first one and she would do nothing. And I would say up and then on my second one, I would say one thing and do another. So I might say, I might put my hands down in the down position but say diagonal. So in other words, I'm going up diagonal. And then cat takes what she heard and not what she saw and her first one is, and she says diagonal, diagonal. And then she makes up, she does a new one and says something different than what she does. Down, so she went up and said down, okay? And we go around the circle doing that. Why? Because it promotes divergent thinking. You have to be able to think about one thing while you are saying another. And do we do that in life all the time? If you're a Parkinson's patient and you're walking down the hallway with your walker and you need to be able to have a conversation because somebody is talking to you and you have to do all the things you have to do to process to walk and speak, that's divergent thinking. Also, I bring my PT and OT in on this. I have a group now that we've just started doing where she's going to be coming in and whatever exercises I have, we sit down and talk about them beforehand. And I say here is the physical component I've been using in this. With these four patients who are in this PD group, what physical things do you want them to do? And maybe it is these things because maybe they have a frozen shoulder so they need to go up and down or whatever. But maybe it's something with their legs. Maybe it's something with walking. So we come up with a new command and we add that in and that becomes part of the game. There you go. So that's the comprehension and cognition. As you see, I've got several games up there and if you want to see me at any point at lunch or email me, I'll be happy to share those with you. I am very much goal-driven. I have to be. In my game, there is no... I don't call them games. I call them activities because Medicare does not give one fat rat's ass about games. And so you've got to be able to go in and say this is the goal, this is why I do it and this is gonna be the outcome. And if it's not the outcome, why not? Alrighty then. Expression is the third piece. So I work a lot with people with strokes. And as it happens, I now have a lot of people with Parkinson's and people with Parkinson's whereas at one time we thought it was primarily gonna be physical issues for them. We now know that as they live longer than they used to, they develop a lot more cognitive issues and many times they also develop word-finding problems as you would see with a stroke. So these games also address articulation, they address fluency. So whether somebody's got speech coming out right and whether they're fluent, that is, are they stuttering? So I have used this game with stuttering kids and adults. But one of the games I really like to do is what's in the box. And that is because it does what I call what the realm of speech pathology calls semantic feature analysis, which is if you can't get a word out of your mouth, is there a way you can describe it in another way? So in what's in the box, I literally pass an actual small box around and in the box because it's hard for my participants at least in the beginning to self-queue on this, I put pictures in. So they pull out a picture, it might be an object or it might be an activity picture and then they have to describe that picture without using the actual word. And you might say to yourself, well, if they can say the word, what's the point? Sure, maybe they can say that word, but maybe they can't say it 10 minutes from now. Or maybe they can say that word, but there's a bunch of others that they can't say and all I'm trying to do is teach them the skill of semantic feature analysis description. So maybe the picture is a toothbrush and they have to say mouth and clean and whatever it is that they need to do to get that piece across. And if they're not a speaker, I have them gesture it. If they literally have no verbiage, then they gesture it. A great example that I had is after playing this game for quite a little while with a woman, I came into her one day and she said, oh, it was my birthday yesterday and my daughter brought me a, and I foolishly said present and she said, no, you know, it's round and like this and frosting and cut. And I said, oh, she brought you a birthday and she said cake because she had expressed it so much that she knew what it was. That's what I do. Please email me or talk to me at the lunch or whatever you'd like to get suggestions from me. Thank you for your time.