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Week Three Rehabilitating Reading Comprehension after Brain Injury

 By the time week two came to an end, my brain was heading straight for a snooze on the couch . . . or at least there would be no blogging. Even now, it’s tugging at me to go nap. Needless to say week two’s progress report is a bit fuzzy in my memory. But I clearly remember that between hour one and hour two of the last day of week two, the Associate Director dropped the Sentence by Sentence task and changed my routine to Multiple Sentences and Whole Paragraphs after assessing my performance on a Multiple Sentence. Minutes after starting hour two, when my clinician asked me what story we’d read, I had zero memory of it. As the AD explained later, that was probably because she hadn’t taken me through the whole process to the end, which includes main idea and answering higher-order thinking questions. Once the AD mentioned it while going over my report, I remembered it was about crows, and I recalled bits of the images I’d created.

Today, my first clinician — one of the consultants I’d met only briefly in week one — asked me if I noticed any difference. Not really. The thing with me, though, is that any improvement I have I see as having always been like that; only in looking back over the previous day or previous session do I realize there’s been a change. Also, only later did I recall that the clinician on Thursday had noted I’d changed from the previous week. Whereas in week one, I would take a few moments to create imagery after reading a sentence, by the end of week two, I was verbalizing my images right away.

Today, it wasn’t long before I did see another change. Whereas in weeks one and two my main ideas were a tad verbose, today, my main idea was succinct. It was for all the stories in hour one —  for Multiple Sentence and both Whole Paragraphs. Less so in hour two, but as usual, the brain was straining by then. I’m still reading sentences in Whole Paragraphs slowly, pausing either midway or at the end  to allow my images to stabilize, catch up, or be created. There were some sentences I could not either image or understand a detail. But that’s why we have trained clinicians guiding us students. They ask questions based on structure words or go through elements in the story that give clues about why a detail is the way it is until we go, “Ah-ha!”

I’m gradually yet rather quickly going upward through the grade levels. I am, after all, already one-quarter of the way to my goal of reading neuroscience articles and philosophy of mind text in a way that I will follow all the way through and remember them. You can see from the progress report above that they introduced levels 7 and 8 in both Multiple Sentence and Whole Paragraphs even though I’m still partially proficient at level 6; I became proficient at grade level 7 in Sentence by Sentence. This week, they’re upping Multiple Sentence and Whole Paragraph to grade level 9.

I definitely noticed.

I asked a few times how to image an abstract word or concept, like for example, “endangered.” Sometimes they would give me examples of how they would image it. Sometimes I’d mimic that in my own imagery. But I also riffed off of their ideas and was able to develop my own image. I was relying less on my memories of movies I’d seen or news items. Only once did I. When imaging sailfish herding tuna, I recalled a scene of Orcas herding fish until, with promptings and thinking about the details given in the story, I springboarded it into my own image.

From my week two progress report: “When presented multiple sentences or whole paragraphs at a time, she sometimes requires prompting to adjust imagery to match the story as opposed to relying solely on prior experience. Once imagery is established, Shireen can verbalize a complete word summary with relative ease.” I’d agree: the latter is getting easier. I’m also learning that images stabilize and fill out and lead to the next images when I add in action, background, colour, and sound. Today, I was introduced to the idea of adding in emotion. Not so easy after having lost my affect for years and I’m still relearning emotions. Yet I can see that trying to do that may help me in my recovery of a normal emotional landscape.