Numbers are all around us: Whether it’s saying the date, hearing the cashier tell you the cost of groceries, reviewing charges on your receipt, or writing down a phone number. It’s nearly impossible to count the number of times you’ll find yourself speaking, listening, reading, and writing numbers each day.
Many people think of numbers in terms of calculations, but numbers are also a part of language. Just like non-numeric words, like “cat” “eat” and “help,” numbers are stored in your brain as word forms – therefore, they are often impacted by aphasia.
Numbers can also be more challenging than other forms of speech because they are abstract concepts.
If you think of the word “table”, you may also picture an actual table in your mind. You conceptually know it belongs in the furniture category, looks like a flat surface with four legs, feels smooth and hard, and is used as a surface to put things on. But with numbers, this knowledge is much more abstract.
You don’t store numeric features the same way as objects.
If you saw the number “ten” alone, you might ask, ten what? This is because numbers quantify or represent something else (e.g. “ten tables” “ten o’clock” the “tenth”). There are also multiple representations of numbers. Both the symbol “10” and the written form, “ten” have the same meaning.
Language is a complex skill. So there are many different goals to target in a therapy session.
You target different forms and levels of speech (e.g., nouns, verbs, adjectives, prepositions, sentences, paragraphs) and must also target them across the four language modalities (i.e., auditory comprehension, verbal expression, reading comprehension, and written expression).
Because of the prevalence of numbers in our daily lives, practicing numbers should not be overlooked. Since they are used to quantify or represent a concept, they communicate important details in a message. When numbers are missed, it can result in communication breakdowns, such as difficulty following directions, incorrectly reading financial documents, or writing down the wrong information.
Instead of reinventing the wheel, you can use apps like Constant Therapy to target numbers practice in sessions and for carryover homework outside of the session.
Why is it important?
Reading numbers is prevalent in printed materials, online and on mobile devices. With this task, you can practice reading aloud numbers of increasing length. This task targets reading, word retrieval, and speaking.
How is it leveled?
There are 4 levels:
- Level 1: Numbers 0-10
- Level 2: Numbers 11-100
- Level 3: Numbers 101-1,000
- Level 4: Numbers 1,001-10,000
How is it scored?
Scoring is binary (response is either correct or incorrect). Clients can listen to their response for feedback and try again if they wish.
Why is it important?
In many situations, you read more than one isolated number. You read a series of numbers that represent things like an area code, pin number, zip code, or phone number. This task facilitates practice of reading, word retrieval, and speaking these functional number sequences.
How is it leveled?
There are 5 levels:
- Level 1: 3-digit area codes
- Level 2: 4-digit pin numbers
- Level 3: 5-digit zip codes
- Level 4: 7-digit phone numbers
- Level 5: 10-digit phone numbers
How is it scored?
Scoring is based on the percent of numbers read aloud accurately. Clients can listen to their response for feedback and try again if they wish.
The Science Behind the Tasks
Rationale behind oral reading is best explained by the Model of Lexical Processing. Here is the process for how a written word is read aloud:
Efficacy of oral reading treatment at the single word, sentence, and paragraph level is well documented in a variety of treatments including Oral Reading of Language in Aphasia (ORLA) and Multiple Oral Readings (MOR) (Cherney, 2010; Lacey et al., 2010).
Here, we cite at a few studies that examine oral reading at the single word level:
“Used oral reading treatment with an individual with deep dyslexia. Post-treatment, the individual showed significant improvement in single word oral reading for targeted syllabic structure nonword reading and reduction in semantic errors in oral reading. Maintenance was documented in one-month post follow-up.” - Yampolsky, S., & Waters, G. (2002). Treatment of single word oral reading in an individual with deep dyslexia. Aphasiology, 455-71.
Oral reading was used in combination with phonological processing training. Results showed:
“phonological processing and oral reading of real words and nonwords improved significantly posttreatment; these gains were maintained 3 months later.” - Brookshire, E., Conway, T., Pompon, R., Oelke, M., & Kendall, D. (2014). Effects of intensive phonomotor treatment on reading in eight individuals with aphasia and phonological alexia. American Journal of Speech-Language Pathology, S300-11.
"An individual with pure alexia participated in oral reading of content words targeted 3x/week over the course of 22 weeks, and functor words (words with little semantic information) over the course of 3 weeks. Post-treatment, the individual learned trained words with 90% accuracy. Findings showed that this individual with pure alexia could be taught to reliably recognize trained content and functor words presented at an exposure duration of 30 ms." - Friedman, R., & Lott, S. (2000). Rapid word identification in pure alexia is lexical but not semantic. Brain and Language, 219-37.
While oral reading treatment is an important aspect of therapy, there is a tendency for sessions to focus on content words. However, the literature states that all parts of speech and word categories are affected in aphasia, and some studies suggest targeting other word classes such as actions, letters, numbers, and colors be targeted in people with aphasia (Chapey, 2008). For example, Katz & Wertz (1997) incorporated reading of numbers into their study where they used computer-based reading treatment on a variety of tasks. Over a 26-week period, there was significant improvement in 5 language measures.
Brookshire, E., Conway, T., Pompon, R., Oelke, M., & Kendall, D. (2014). Effects of intensive phonomotor treatment on reading in eight individuals with aphasia and phonological alexia. American Journal of Speech-Language Pathology, S300-11.
Chapey, R. (2008). Language intervention strategies in aphasia and related neurogenic disorders. Brooklyn: Wolters Kluwer.
Cherney, L. (2010). Oral reading for language in aphasia (ORLA): evaluating the efficacy of computer-delivered therapy in chronic nonfluent aphasia. Top Stroke Rehabilitation, 423-31.
Friedman, R., & Lott, S. (2000). Rapid word identification in pure alexia is lexical but not semantic. Brain and Language, 219-37.
Katz, R., & Wertz, R. (1997). The efficacy of computer-provided reading treatment for chronic aphasic adults. Journal of Speech, Language, and Hearing Research, 40(3), 493-507.
Lacey, E., Lott, S., Snider, S., Sperling, A., & Friedman, R. (2010). Multiple oral re-reading treatment for alexia: The parts may be greater than the whole. Neuropsychological Rehabilitation, 601-23.
Royal College of Speech & Language Therapists: Clinical Guidelines. (2005). Oxon, UK: Speechmark Publishing Ltd.
Yampolsky, S., & Waters, G. (2002). Treatment of single word oral reading in an individual with deep dyslexia. Aphasiology, 455-71.