Cognitive-linguistic therapy seeks to address difficulties that patients experience related to their thinking and to their language. The term “cognitive” refers to processes that involve information processing. This includes attention, memory, executive functions (i.e., planning, organization, sequencing, problem-solving, decision-making, etc.), and social communication. “Linguistic” refers to aspects of a person’s language, both language production (output), and language comprehension (input). Individuals who may benefit from cognitive-linguistic therapy include patients who have undergone neurological trauma, such as a traumatic brain injury or stroke, patients who have dementia, and even older adults who are experiencing cognitive-linguistic challenges associated with normal aging.
Any type of speech intervention, including cognitive-linguistic therapy, begins with an evaluation. During an evaluation session, the speech-language pathologist (SLP) will ask questions about the patient’s medical history, their perception of their current challenges, and their goals for speech therapy. This is typically followed by questionnaires about the impact that cognitive-linguistic challenges are having on a patient’s life. Then, to obtain more objective information about a patient’s cognitive-linguistic skills, the SLP will administer a standardized test that assesses these areas, such as the Cognitive-Linguistic Quick Test. Based on the results of this assessment, the SLP will collaborate with the patient and generate goals to be targeted in therapy. These goals should be directly related to the patient’s life and daily functioning, so that the skills targeted in therapy have a direct impact on areas the patient has concerns about.
In a cognitive-linguistic therapy session, the SLP will target the generated goals using various activities that have been prepared or by providing education regarding strategies that can be used to support a certain skill. For example, if a patient demonstrated difficulty with planning and organizing their thoughts during the evaluation, the SLP might devise a scheduling activity in which the patient needs to read clues and generate a plan based on them. Before the patient initiates this activity, the SLP might provide strategies that can be used to support their completion of the activity (e.g., crossing out clues as they are used). The SLP would also provide assistance throughout the activity, as well as debrief with the patient afterwards to discuss their use of strategies and perception of how the activity went.
The goal of cognitive-linguistic therapy is for the patient to eventually be able to become their own therapist! The role of the SLP is to support patients in their development of these skills and provide strategies and aids that can be used during the activities of a patient’s daily life.