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Self Care

Cognitive & Speech Rehab

There are exercises and therapy techniques that you can try to help manage your PASC symptoms related to brain fog and trouble speaking clearly. Cognitive skills are how your brain thinks, communicates, remembers, and solves problems. People with PASC have reported the following symptoms related to cognitive dysfunction:

  • Short-term memory loss
  • Confusion
  • Forgetfulness
  • Disorganization
  • Difficulty concentrating
  • Difficulty putting thoughts into words.

Cognitive stimulation therapy is one way to manage these symptoms. For example, it can improve thinking and memory problems among people with mild fogginess to more severe dementia or cognitive problems after a stroke. Cognitive stimulation involves participating in activities to improve cognitive and social functioning. If you are experiencing PASC symptoms related to speech, you may also find the fluency and word finding exercises below helpful. These activities are designed to be relaxing and fun and create opportunities for you to learn and grow.

Getting Started

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Activities of cognitive stimulation, like the ones listed below, can be performed on your own and at home.

Cognitive Stimulation Activities by Skill Level


  • Listening to music or singing
  • Reciting the alphabet
  • Sorting items by color and shape
  • Thinking about words that rhyme


  • Reading a book or newspaper
  • Solving puzzles like sudoku
  • Remembering words, places, or names
  • Doing the laundry
  • Playing video games


  • Cooking a meal with a recipe
  • Making a shopping list
  • Playing a musical instrument
  • Discussing current news stories

Word Finding Exercise

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If you are having difficulty remembering words, try the following:

  • Describe the word.
    • What category does it belong to?
    • What does it look like?
    • What are the parts of it?
    • What is it used for/who uses it?
    • Where do you find it?
  • Visualize the word.
    • Picture the object in your mind.
    • Try to describe the picture you see as much as possible.
  • Use a similar or related word.
    • Find a synonym.
    • Example: Use the word “comb” if you can’t find the word “brush”.
  • Use a gesture of what the object looks like or what the object does.
    • Use your face, arms, hands.
    • Example: Pretend to brush your teeth to trigger the word toothbrush
  • Use an associated word.
    • Find other words go with the object.
    • Example: Say “Pillows, blanket, sleep” when you have trouble finding the word “bed”.
  • Put the word in a sentence.
    • Give the word context.
    • Example: If the word is “door”, you could say, “I shut the front door”.
  • Take a break from trying to find the word and RELAX! The more you stress about the word, the more frustrated you will become which then make you less likely to find the word.

Exercises to Improve Your Speech Fluency

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  • Breathing Technique: Inhale through your mouth in a relaxed manner with attention to relaxation of the throat and a smooth downward movement of your diaphragm. Start your voice and airflow at the same time.
  • Gentle/Easy Onset: Take a full breath and release it in a relaxed manner just as you are starting to speak. Focus on decreasing any tightness within your vocal cords, articulators, breathing muscles and neck area.
  • Stretching: Stretch out the beginning sound of a word to ease into the word without getting stuck.
  • Light contact: Instead of pressing your articulators (meaning lips, tongue, teeth, and palate) tightly against each other during speech, focus on light and soft touch.
  • Cancellation: After having stuttered a word or phrase, wait a few seconds before producing the word or phrase again in an easier manner that is slower and more controlled.
  • Preparatory Set: Use a slower rate and light articulatory contacts when before saying an upcoming word that will be stuttered.
  • Pausing and Phrasing: Break up sentences or utterances into smaller units. This will help manage your breathing and allow you to apply the speech fluency strategies while talking.

Strategies to Help You Remember

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  • Rehearsal:  Repeat to yourself out loud what you want to remember several times.
  • Association: Link what you are trying to remember with something that is well known.  For example, if you are trying to learn a few names, associate the person’s name with a good friend or relative with the same name.
  • Visual Imagery: Make a mental picture of what you want to remember.  The stranger the picture, the more likely it is that you will remember it.
  • Categorization: If you want to remember several items, group them into categories. For example, if you need to get groceries, remember the items by grouping them into categories like meats, dairy, snacks, etc.
  • Rhymes: It is easy to remember items when you put them in a rhyme or song.
  • Mnemonics: The first letter of each item can be used to make another word and then the words can be linked into sentences. For example, to remember Peaches, Apples, Nectarines, and Strawberries, you can use the acronym PANS.  Similarly, for items Charcoal, Matches Meat, and Lighter fluid it might be easier to remember the phrase “Charley Makes Me Laugh”.
  • Written Reminders: Write notes of to-do lists, reminders to take medications, reminders for turning off the stove, or checklists of items to be completed for easier recalling of information.

Tips for Success

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  • Pick activities that are challenging but doable so that you can stay motivated.
  • Increase your level of difficulty as you make improvements.
  • Focus on activities that are specific to your symptoms. For example, if you are struggling to concentrate, activities related to attention may be more productive.
  • Work on several tasks each day and shift tasks after a few days to provide variety.
  • Make cognitive stimulation part of your normal routine, like reading the newspaper when you drink your morning coffee or joining a book club that meets regularly.
  • Find activities that you enjoy because it can take a long time to see an improvement.

Group-Based Cognitive Stimulation Therapy

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While activities of cognitive stimulation can be performed individually, cognitive stimulation therapy in a group setting can be helpful too. Therapy sessions may be led by a trained nurse, occupational therapist, or a caregiver. Ask your healthcare provider for more information about cognitive stimulation therapy to see if they can connect you with a class.

A typical cognitive stimulation therapy session might include:

  • Singing a song by memory as a group at the start of a session
  • An opening exercise such as recalling specifics about the day such as the day of the week or date
  • A facilitator initiating a conversation, perhaps about family, vacation, or events in the news
  • Group members connecting ideas and recalling memories related to a topic of focus
  • Group reading and discussing a current topic

For Family and Friends

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The key to maximizing memory is to keep a routine where things are constant and familiar. Any change in routine or familiarity will make it more difficult for a person with an impaired memory.

  • Calendar: Keep a large calendar in a central location of the house so that the person can look at it frequently (ex. kitchen).  Write important things on the calendar and have the person check it every day at a set time so that it becomes a routine. Try not to fill in the calendar with too much information, otherwise, it may become difficult to read.  If the person has difficulty keeping track of time, cross off the days on the calendar as they are completed.
  • Review Daily Events: Review activities of the day with the person at the end of the day or as often as needed (ex:  after each activity, after meals, at end of day, etc.)  Those with more severe memory impairments may find a list of routine day helpful. For example, post a daily schedule on their bedroom door, and post-it notes could be used for changes to the routine.
  • Repeat Instructions: When giving directions, have the person repeat to you what you just asked him or her to do.  It may also be helpful to limit the length of the direction (ex: Ask the person to do only one thing at a time.)
  • Reminders: Post reminder notes or objects to be remembered where the person will see them (ex: Post a note on the door saying ‘take out the garbage’ or ‘place the garbage can next to the door’).  It may be helpful to begin discussing an event several days in advance because repetition aids memory (ex. ‘In two days it will be our 25th wedding anniversary’).
  • Memory Journal: Have the person keep a daily memory log and/or a personal journal in which he or she records daily events, things to do, accomplishments, feelings, etc.  Your speech pathologist will have developed a journal for use in the hospital if it was determined that it would help.  Tips will be provided for modification of the journal for use after discharge.  Journals may be any size; pocket-sized notebooks are nice for those who are active.
  • Personal Items: Put important things like keys, glasses, etc., in the same place all the time.  This makes items easier to find and they are less likely to be misplaced.
  • Assistive Devices: There are items available such as labeled pill containers and programmable phones that can assist a person who has memory impairment be more independent.  Timers or alarm clocks may also be helpful. For example, if the person likes to watch a TV program, set an alarm to go off just before the program begins. Watches and dates are also helpful for the person who has difficulty remembering the date.
  • Good Communication Skills: These may aid the person’s memory by providing hints as you speak (ex: ‘You remember Jane and Bill’.) or emphasizing important points by repeating them more than once.  Please, however, do not quiz the person. Also, good communication will ensure that the person was paying attention and was able to hear the message. Try to: ** Make sure you have the person’s attention. ** Speak to each other face-to-face in good lighting. ** Talk about important ideas in a quiet place (ex: turn off TV, wail until the grandchildren or friends are gone, etc.) ** Discuss important ideas with the smallest number of people present as possible as it is often harder to hear or follow directions in a group.

Further Reading and Other Resources

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Additional Exercises

For more structured cognitive exercises that you can do at home, check out the In-home Cognitive Stimulation Guidebook developed by researchers from the University of Alabama Traumatic Brain Injury Model System (UAB-TBIMS).

Read More about Cognitive Stimulation Therapy

Peer-Reviewed Scientific Publications on the Benefits of Cognitive Stimulation Therapy

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