Client– Sam          

Therapist– Katherine Rudolph

                 ‘Exploring the Word in Colour and Speech’


Impulse for Artistic – Recreational Therapy


Sam has an acquired brain injury and uses a wheel chair. He has use of his right arm and hand, with which he does all the hand movement involved in the therapy. He always shows enthusiasm and willingness to participate in the painting, speech and number games, and picture forming with coloured clay (plasticine). He appreciates the activity and the communication. The tactile movement is rhythmical and conducive to harmony. 

Sam especially loves singing the songs he learned as a child in Vietnam. This activity stimulates his brain and he has recently remembered yet another song. He plays the wooden and metal xylophones and small drums while we sing. For his birthday this year, I gave him a ‘warbler’ , a wooden whistle in the shape of a bird, which he can play using one hand. When it is partially filled with water, the piping sounds , as well. This music activity we save until the end of the session.


Breathing – Flow of Speech


In his constant flow of speech and song, Sam exhibits a healthy breathing. He tends to need a lot of out-breath and often is quite exuberant. Sometimes his voice shows a strong capacity. This expression has an assertive quality and allows him to release much pent-up energy.

To communicate with Sam is a process of asking and answering questions, offering details of the course of the day, and about his family, etc. To satisfy his curiosity is an active process and brings reciprocal dialogue. Sam lives very much in the present and has little short – term memory; therefore he loves and needs repetition. Sometimes in the flow of language memories of his early days come forth.



Balance of Vowels


Being a person who has strong feelings, Sam feels the vowel sounds especially intensely. In the speech games he enjoys sound and rhythm. One hears more of the Ah, O, UU in him than the EE, A. This shows his expansive nature. The way he expresses himself shows a love of language.  He sometimes says, for example :

 ‘I’m not a hundred percent, I’m not a lot, I’m not a little. I’M ENOUGH!’ He has a poetic nature and enjoys playing with words.


Balance of Consonants  K L S F M ( a consonantal outbreath)


Lips – M B P F V

Sam can differentiate a but B and P. Both are B to him. Sometimes, after repetition, he can differentiate them, but it is not predictable.


The TH sound is still hard for Sam, as well as Z and SH. J is pronounced like Y.

Palate – Y G K H

To speak G still requires patient repetition.




Sam is quite able to make himself understood. Sometimes he slurs the sounds out of a need to speak quickly. He loves French and Japanese numbers and will make an effort to pronounce French correctly, when I teach him simple sentences in French. This reminds him of early youth and his mother in Vietnam, who is no longer alive. However he has adjusted to the loss. It makes him happy now to remember French.


Course of Therapy


Sam paints two painting in quick succession; in the following session, he sometimes continues a painting. His tactile rhythm helps him paint, and he can see strong contrasts the best. His vision fluctuates. He can blow a cigarette ash into a small hole in a can, at times; yet cannot always concentrate on his work. Blue seems to be his favourite colour. His enthusiasm carries him.

Sam has tunnel vision to some extent. This might explain his accuracy at bowling. His two abilities with picture forming are rolling the plasticine, and softening and mixing the colours to make a marbled effect, He is comfortable with this and enjoys it. 

Sam can count forward and sometimes backwards to ten. He is slowly learning the French song ‘Allouette’. When possible I try to bring new elements into his work, avoiding a tendency for him to become fixed in a particular pattern of activity.




I would recommend that Sam continue with the present therapy, which he enjoys. He improves in his ‘small motor’ skills with the plasticine. He is open to innovations. His musical and poetic talents are being expressed and are growing constantly. I would like to further this process in the coming year. The sudden remembering of songs and incidents from his early childhood is to be fostered by the singing itself. I remember for him, and as soon as he has heard the melody, he can sing and later, recite the song.