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The putting steps in order task: recover neurologic hierarchy through neuroplasticity

Constant Therapy | Clinician

Learn about the Put steps in order task from Constant Therapy, and the research that has proven that new instructional sequences can be learned, even after neurologic damage.

Organizing the steps to accomplish a final goal can be very difficult after a brain injury or any trauma to the brain (such as a stroke). As we go through the daily processes that seem so natural to us when accomplishing our daily chores, many of us don’t even take into account the many steps required to complete any single chore.

For example, doing the week’s laundry is a multi-step task – first one must gather the dirty clothes; then one must take them to the washing machine; then the appropriate detergent in the appropriate amount must be selected, the clothes put into the washing machine, the correct setting for the clothes at hand selected, and the cycle begun. And then the timer must be set, and then the clothes must be dried. 

Even without traumatic brain injury or stroke, daily tasks can be complex processes many struggle to complete. Yet add to this basal complexity difficulty sequencing each of these complex steps, and suddenly a once annoyingly complicated daily task becomes impossible.

Enter the Constant Therapy Put steps in order task. We take daily activities, break them into steps, and then ask the user to organize them in a logical order. By organizing these steps, we assist users to bring order to the disorder that their aphasia or brain injury has created.

And as always with Constant Therapy tasks, the research backs these tasks up. See below for a particularly interesting study about Put steps in order that supports our overall task:

Ehlhardt, L.A., et al., TEACH-M: A pilot study evaluating an instructional sequence for persons with impaired memory and executive functions. Brain Injury, 2005. 19(8): p. 569-583.

  • Patients: In this study, patients with traumatic brain injuries, with severe memory and executive funciton deficits were treated using a seven-step e-mail task.
  • Major Take Home: Patients were able to learn and maintain that learning of multiple steps of the e-mail process, despite their significant neurologic difficulties. This suggests that despite neurologic deficits, patients can and will improve their ability to learn various sequences.
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