USING YOUTUBE VIDEO CLIPS AS A CLINICAL TOOL FOR LOW COGNITIVE PATIENTS

By Clara Zambrano-Canizares, MS-CCC-SLP

In school we were taught that when teaching a child with low cognitive abilities always start at the easiest, “most concrete” level and work your way up. For the most part, when teaching a child with a low cognitive function a word like “cup” or “spoon” instead of showing a picture of the object we will show the real object as a starting point during matching or pointing activities. So far so good, but what if you want to teach a word like “dog” and you can’t bring to your office a real dog? Or what if you want to do a matching activity and you do not have another set of the target item, for example “maracas”?

Before the internet era some years ago, the answer would have been: “well, if the child can’t grasp the concept of a dog by looking at a “toy dog” or a picture of a dog, then you must limit yourself to the real objects you can find and bring to your office”. Does that mean that my patients’ vocabulary skills are going to be confined to what objects I was able to compile over the years? In the following paragraphs I will share with you how I was able to utilize the net, specifically “youtube” video clips to improve the cognitive abilities of one very challenging patient I worked with for many months at this clinic.

Her name was “Balqis” and she presented a severe global developmental delay due to cerebral palsy. She was non-verbal and had receptive language skills at approximately the 9-12 month level when she started speech therapy at this clinic about 6 months ago. She did not: follow simple commands, reach for or point to objects or pictures upon command, imitate verbal or non-verbal actions, match objects. She did: attend and explore toys presented to her, attend to a computer screen, enjoy music, reach for only desired objects around her, throw a ball, anticipate feeding, indicate yes/no with facial gestures, attempt to fit puzzle pieces without matching them, and smile, laugh or cry/whine in response to stimulation.

During the course of treatment once I realized I wasn’t getting very far with Balqis by using what to her were “meaningless objects and pictures”, I decided to show her “youtube” video clips of the animals and other nouns we had been working for many sessions.  Little did I know that for Balqis this strategy ended up being a “breakthrough” that allow her to move forward in her cognitive/language development. She was intensely attracted from the very beginning to short videos of a dog barking, a horse neighing, a cat meowing, a cow mooing, children playing maracas, etc.

Every time I showed her a video I would pair it with the matching object. You could see sometimes how she would look at the object and then the video, back and forth, like if her mind was making the connection that these two things were the same thing. After a while, I would put 2,3,4 different target objects on the table in front of her and turn on the target video with the command i.e. “Get the dog, Balqis!” or i.e. “Get the maracas, Balqis!”. She learned in this way 22 video clips of animals and toy items. The next step was for her to pick the animal video that she wanted to watch. In this way, Balqis will pick a frog and immediately after I would let her watch the “frog video”. After she was able to do these tasks consistently, we moved up to pictures with great success. I also noticed that her ability to match the puzzle pieces correctly improved significantly once she was able to recognize and use the pictures with the youtube videos.

Cognitively, Balqis was now able to recognize 2 dimensional pictures which explain how she was now able to successfully match puzzle pieces. Balqis’ imitation of non-verbal actions also began to improve simultaneously to her cognitive improvement. She was able to play the maracas herself while watching a short youtube video of children playing them. Even her verbal imitation improved since she said the word “ish” for “fish” for the first time while watching the video of the goldfish and holding a goldfish figurine.

Unfortunately, Balqis left our clinic- her father needed to go back to Malasya for work reasons- before I could continue working on what my ultimate goal was for her “developing a personalized functional alternative communication device”. All I can do is hope that once she is back in her country and her speech therapy continues there, Balqis will continue gaining more skills now that the groundwork is there so that she can in a short future learn to utilize a communication board or device in order to communicate her basic wants, thoughts and needs. Bon Voyage, Balqis!

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