Artwork of a Challenged client with an Acquired Head Injury

See below for examples of artwork by this client.


Please note that the last work is in the medium of coloured (plasticine) clay.  A new technique has been devised for this challenged client who has the use of one hand only, with which he rolls the cylinders of clay.  This technique is called ‘picture-forming’.  The process (carried through on a glass frame), is directed and assisted by the therapist.

Note the use of white for contrast in the case of this sight-impaired, colour blind client


Progress Report from 25 Nov. 2005 to 11 Nov. 2006.

Therapist-Katherine Rudolph

Client-A challenged client (age 43)

Acquired Head Injury (at age 26+)


Having known this client since 1992, when he had his initial treatments, I was amazed at his progress and transformation since that time.  He has redeveloped a sense of self which can now express:  “This is good for me”, instead of:  “This is good for Sam” (as he would have articulated in 1992).

Sam was able to adjust, almost immediately, when we began this therapy anew.  Only once at the beginning, did he have a problem beginning the session (due to his request for a cigarette).  The nursing staff has been supportive and cooperative with my efforts, for which I am thankful.

Sam is entirely open to the theme of creation and is particularly enthusiastic about the “Madonna and Child”, fashioned from the coloured plasticine clay which he has rolled into long cylinders of the same size.  This new technique was developed for Sam and will be described later on.

Work with self-made puppets was carried on for the first few months, as adjunct to the “Speech Word Games”; these arose primarily out of the Nativity scene, the stable of which is still standing (awaiting the Christmas to come).

Sam appreciates dialogue greatly; but in order to work with his disposition, one has to orient to his own viewpoint and work the therapeutic elements into it – the point of departure is where he already is “at home”.  For that reason, the “Speech Games” have come about (which will also be described later in this report). Sam is very interested in numbers, music, and languages.  His interests are the touchstones for his therapy.


The flowing colour helps Sam to experience merging and contrasting elements.  This has a relationship to breathing.  It is similar to the balance and well being experienced when looking at a rainbow.  Water colour flows quite naturally, facilitating the process.  Sam does not see all the colours.  It is likely that he has “tunnel vision” as well.  His temperament holds to the centre of the painting.  Indeed he is the centre of his own world.  I assist him to breathe into the periphery.

It is a similar situation with Sam’s breathing process in articulation and flow of speech.  The in-breath is stronger than the out-breath.  This is sometimes worsened by dyspepsia, which he is however able to control.  Ordinarily, speaking from the diaphragm and throwing the ball “on the breath” (at the time of the outbreath) is the ideal way to augment his flow of breath.  At the same time, continued work of this sort at the appropriate time, can stimulate healthy peristaltic action. It promotes assertiveness, and gets rid of aggression.

Certain sequences of consonants, such as : K,L,S,F,M and G,D,SH,V,B etc. direct the speech outwards from the palate to the teeth and lips.  Word games, such as the first consonant of the second word being the same as the last consonant of the first word: “room – move”, can gradually make the last sounds of the words in Sam’s speech stronger.

The singing which Sam often naturally gives voice to is also a great help to releasing pent-up energy.


Sam’s personality is expansive and tends to emphasize the “ah”, “I”, and “oh” vowels in which the larynx expands.  The “ee”, “a”, and “uu” polarity is less evident in his character.  He enjoys these contractive vowels as well, which also help him to contract his consciousness.  The English “I” (as in “I am”) is actually the combination of “ah-a-ee”.  Words beginning with this sound tend to be mistaken for words beginning with “ah”.  This could easily happen to anyone whose native language is not English.


LIPS: M B P F V W.  Sam continually mistakes “P” for “B”.  Although he can articulate “P”, he cannot yet consciously put it into a sentence.  “W” is sometimes misheard as “U”.

TEETH: TH S Z R SH CH.  Sam can differentiate all of these, but he has to consciously listen to “S” and “SH”.  The “Z” sound has to be brought to consciousness as well.  “TH” and “F” are sometimes confused.

Palate: Y G K H : Sam  pronounces “Y” for “U”, at times.

Similar to seeing , Sam’s sense of hearing seems to fluctuate, depending on his mental alertness.  He is more aural than visual.  Sam has a vibrant, warm, palatal tone in his speech as well as in his singing.  He is sometimes able to accompany himself on the lyre which I have given him.  (The following day, however, he may not remember the intricate fingering which came to him.)  Pentatonic tuning of the lyre corresponds to many songs which he knows.  Other western tuning is not familiar to him at this time.

Sam has managed to acquire increased consciousness and manual proficiency for the work we do together.  There is no reason why this transformation might not feasibly extend to changes in his articulation (with patient repetition), as well as to an extension of his vocabulary.

Work with puppets facilitated his interest in the “Word Games” in the beginning months.  Now he is always eager to begin that part of the session.


The therapy is designed to benefit Sam’s well-being.  It has been successful.  The secondary attribute, of improving his articulation and manual dexterity, has also begun to show progress.

Sam’s attention span must be engaged.  He speaks almost constantly.  This activity centres him and gives him a sense of self.  He is repetitive in his utterances, which often express his feeling nature: love of family, celebration of birth, and especially of the Christmas Festival.

One must understand that Sam has undergone a kind of rebirth experience himself.  Since his injury; he has arisen out of tragedy to confront life with joy.  This factor is always acknowledged in activities such as counting the days until Christmas, celebrating his birthday, and making a Nativity scene for him, etc.  Sam is very sensitive to feeling.  He needs to be answered, and treated with respect, encouragement, and positive approaches.

The clay rolling to make vessels and crosses has been extended into a coloured plasticine picture forming.  Sam rolls the clay in strips.  He has the use of one hand only; and I assist him in forming it into the picture.  The result can be seen in the forthcoming CD of his work which I will contribute to his process.  On the CD, the penmanship exercises can also be viewed.  This attests to his sense of form.  Songs and religious litanies are recorded in Vietnamese.  Numbers in Vietnamese, Japanese, French and English are part of the spoken therapy.

Since Sam is a “player” of sorts, it corresponds to his being to have the companion paintings, which have so often evolved since the beginning of the therapy.  The page is coloured in two colours.  He paints on one side and I on the other, then we reverse the process.  It is like the dialogue which is inevitably going on verbally at the same time that we are painting.  Many companion paintings are pictured in the following examples.

F. Prognosis

I believe that this therapy should be continued in the next six to twelve months.  The forming process in the coloured plasticine clay picture, which Sam can clearly see, the music, and the speech are of special benefit to his health and well being.  I would plan on doing more of the plasticine clay work and more speech.   I would like to see if Sam can make a conscious attempt for better articulation.  He enjoys this now and can differentiate more than before.  The painting can be continued , with approximately two painting per session.  Cards and prints can be made of his work, to send to friends and relatives.  In this way, Sam can enter more into social life.

Katherine Rudolph

Exploring the Word in Colour and Speech








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