a deck of cards

Practical Ways to Use a Deck of Cards For Speech Therapy

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Traveling as a speech-language pathologist transformed me into a minimalistic therapist when it comes to materials. I have become a professional at creating and using therapy materials on the go. In this blog, I discuss ways to use a deck of cards for speech therapy treatment.

I absolutely LOVE using cards in treatment. Not only because they are an easy material to carry around, but because they have so many different ways that you can use them in treatment.

Attention: Sorting by Color, Suit, and Number

Attention is the base of all cognitive processes. In order to advance goals in memory, executive function, and problem solving, you must address issues in attention.

From a cognitive perspective, if you cannot pay attention to something, you will not be able to encode and remember it. If you cannot remember, you will have difficulty solving problems.

Severe deficits in attention:

Sorting: Have the patient sort the deck of cards into two piles for 2 colors. If this is too challenging, provide prompting, visual cues, or rest breaks.

Matching: Start by putting 2-5 cards on the table of varying numbers. In your hand, keep hold of the cards of the same numbers and color (but different suit). Give the patient 1 card at a time and ask them to match the number to the number.

matching cards for speech therapy
Matching cards for severe impaired attention goals

Moderate Deficits:

Sorting: The patient sorts the deck of cards into the 4 suits.

Sequencing: Put 10 cards of the same suit on the table from Ace to 10. Have the patient arrange the cards into number order from 1-10.

To advance this task, instead of putting the cards on the table, you can give the patient the cards in a pile for them to sort from 1-10.

arranging cards for speech therapy
Sorting cards from 1-10

Mild Deficits:

Sorting and Sequencing: Give the patient a deck of cards and ask them to sort the deck into the 4 suits by number order.

Left Neglect

If you have a patient with left neglect, you can do everything above, with a focus on the left neglect. If the patient has severe left neglect, begin with the activities for severe attention deficits and then advance as indicated.

You can place the cards only on the left side to encourage left side scanning. You can also place cards from left to right to encourage scanning of the whole visual plane.

When completing table tasks for left neglect, you can start by introducing a visual anchor.

A visual anchor is something bright and colorful that you show the patient and then place on the patient’s far left side. During therapy tasks, you can encourage the patient to look left to the anchor. Remind the patient that they want to look until they see the anchor.

Another task that you can do for severe left neglect is to hold the playing cards in front of the patient; both center, left and right. Have the patient reach for the cards or tell you which card you are holding.

using a visual anchor to encourage scanning in speech therapy
Sample visual scanning task for left neglect. Visual anchor (bright box) used to encourage patient to scan to the far left.


Immediate Memory:

Show a patient 2 cards and ask them to remember the cards. Tell them you are going to be turning the cards over and you want them to remember which card is in which location. Turn the cards over and then ask the patient to identify the cards. E.g. “Show me the number 2 card”. Advance this activity with more cards based on memory deficits.

Delayed Recall:

Complete the same activity above, except tell the patient that he will have to remember the location of the cards over time. Start with 2 minutes. In 2 minutes, ask the patient to identify the cards based on the location.

In the beginning of your session, have your patient pick a card from the deck. Tell the patient to remember that card by number and suit (help the patient identify the suit if they do not know). Then, tell the patient that you will be asking them to remember that card over the course of the session. Encourage the patient to visualize the card, repeat the card, etc. Over the course of the session, ask the patient the name of the card.

Executive Functions

The highest level of cognitive-functions can be the most fun! This is the therapy when you get to play cards with your patients! Playing card games combines all of the cognitive domains.

My Favorite Card Games For Executive Function:

Go Fish: How To Play
500 Rummy:  How To Play

A deck of cards is practical to carry with you into therapy sessions and also has a variety of uses. A deck of cards can be used with patients who have severe attention deficits to mild executive function deficit. Do you use cards in treatment? Comment below how you use cards in your therapy toolkit!

Next Up: My Go-To Cognitive-Communication Speech Therapy Materials

4 thoughts on “Practical Ways to Use a Deck of Cards For Speech Therapy”

  1. For higher level patients, I like to pull 4-5 cards from the deck and have them identify the missing cards to assess how they plan, organize, sequence and reason to solve the problem. To target recall or direction following, I will have them sort the cards by suit and then remove all the Jacks (or any card).

  2. For attention and working memory I have clients mentally add cards as I show them (all picture cards are worth 10 and all others are face value, or I wouldn’t be able to do it!) when they’re able to make it to 100 then I have them subtract til they get to 0. If they’re really high level I start at 50, and add black cards and subtract red.

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