Using Montessori-Based
Reading Stories
to Improve Treatment
with Older Adults
Megan L. Malone, M.A. CCC-SLP
Myers Research Institute, Beachwood, OH
Jennifer Loehr, M.A. CCC-SLP
HCR Manor Care, Austin, TX
Presented at the 2007 Annual Convention of the
American Speech and Hearing Association
Strengths of the Older
Adult Client
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Important to evaluate a client’s strengths
as well as deficits during evaluation
Older adults have many remaining abilities
to capitalize upon in treatment
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Long-term memory
Motivation
Procedural memory
Reading ability
The Importance of Reading
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Reading is a preserved habit/skill that can be
used to help clients meet & maintain therapy
goals.
Physiologic changes to the eye as we age affect
our ability to read material effectively.
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Reduction in pupil size
Loss of focusing ability
Yellowing of lens of eye
Diseases of the eye, such as cataracts, glaucoma, &
macular degeneration
Preserving a Preserved Habit
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Circumvent Deficits:
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Use large-size print
Use easy-to-read font, such as Arial or
Helvetica (sans serif)
Use high-contrast between back and
foreground
Eliminate distractions
Make material meaningful and interesting
Can you go
We are here
Where is it
One and only
Not now
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Vision Test Documentation Form
CLIENT: _______________
UNIT: _____________________
DATE: _____/_____/______
EXAMINER: ________________
INSTRUCTIONS: ** STOP when the person makes ANY mistake.
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We are trying to find out how big to print words so people can read
read them easily. Would you please help us by
reading this first sentence [POINT to “Can you go”
go”] out loud? (Client reads sentence).
Thank you! Please read the next sentence
[Point to “We are here.”
here.”]. (Client reads). **
Now this one [Point
[Point to “Where is it?”
it?”]. (Client reads) .**
.**
How about this one? [Point
[Point to “One and only.”
only.”] (Client reads.) **
And this one. [Point
[Point to “Not now.”
now.”] (Client reads.) **
Thank you so much for helping us.
Please indicate the smallest size lettering that the client was able to read by placing a check mark (√
(√) next to the
sentences read correctly.
If the client was only able to read individual words during the test, circle the words they were able to read.
72 point
(Can you go)
48 point (We are here)
36 point
(Where is it)
24 point (One and only)
16 point
(Not now)****Vision test results:____________________________________
results:____________________________________
© Myers Research Institute 2007
Vision Test
Reading Roundtable
®
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Montessori-based reading and discussion activity
„ Montessori-Based Dementia Programming® uses key principles
of Montessori education to teach older adults meaningful skills,
engage them in activity, and fulfill meaningful social roles.
„ see work of C. Camp & Myers Research Institute for more
information
Original concept by Alan B. Stevens, Ph.D.
„ QAR: Question Asking Reading
Initially used as activities programming in facility settings
Concept expanded as part of 3 grants:
„ Retirement Research Foundation Grant #2001-397
„ National Institute of Mental Health 5R21MH063395
„ National Institute of Mental Health 1 R34 MH075799-01A2
Reading Roundtable
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Stories can be used in group format or in
individual treatment
Activity Structure:
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Choose topic (provide choice of 2)
Each person in group receives own copy of story
Leader (therapist or client) reads first page aloud
Next reader is cued to read subsequent page, etc.
Clients ask one another questions provided in story
related to topic
Structure remains the same each time, but story
topics change
Making Reading Roundtable
Readable
®
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Shorter story length; 4 to 5 sentences on each
page of story
High-contrast, bright white paper with black
print
Print placed only on one side of booklet to
eliminate distractions
No pictures used within story
Visual cues used to help initiate action
Adult content and vocabulary used
Retirement Research Foundation
Grant #2001-397
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Development of RAMP program
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“Resident Assisted Montessori Programming”
Enables persons in the early stages of dementia
to serve as leaders for small group Montessoribased activities played by persons with more
advanced dementia
Recruiting occurred in nursing home, assisted
living, independent apartments, and adult day
center.
Retirement Research Foundation
Grant #2001-397
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Clients and activities (RAMP v. standard
activities) were observed using the Menorah
Park Engagement scale
„ 11-item scale focused on areas such as
passive or constructive engagement, pleasure,
anxiety, leaving activities, & distraction.
More constructive engagement (Did/Commented
item) in during RAMP programming than during
regular programming
Retirement Research Foundation
Grant #2001-397
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Comparisons approached significance (p<.059)
in adult day care,
Reached statistical significance in nursing home
units and overall (combined) sample
comparisons.
All groups combined, overall sample showed
significantly greater constructive engagement
and pleasure, and significantly less time spent
doing something other than the target activity or
sleeping, during RAMP activities v. standard
activities.
National Institute of Mental Health
5R21MH0633951 R3MH075799-01A2
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R21: Focused on implementing & disseminating
Montessori programming in different care
settings
„ Used Reading Roundtable as a main activity
in study; trained facility staff to implement,
tracked resident overall engagement.
®
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R34: Recently funded; Focused on expanding
work of RRF grant
„ Working with clients with dementia in LTC to
lead groups using RRT & other activities.
Video Example of Reading
Roundtable
®
Case Studies
Arden Courts of Austin
„Population and Caseloads
„Group therapy
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Case Study #1
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Mrs. B. a 79 yo female with a diagnosis of
Alzheimer’s dementia.
Moderate cognitive deficits
Moderate expressive language deficits
Increased social isolation
Case Study #2
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Group participation
Four residents aged 72-89
All with Alzheimer’s dementia
All with moderate cognitive deficits
Two with expressive language deficits
Case Study #3
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PT/OT/ST Group therapy
Group of 8 individuals
All with Alzheimer’s dementia
All with mild to moderate cognitive
impairment
Three with expressive language deficits
Case Studies
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Group therapy goals:
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Increasing verbal communication
Increasing use of functional words in sentences
Increasing socialization skills
Improving turn taking skills
Improving short term memory skills
Compensatory strategies for aural rehabilitation
Take Home Messages…
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Evaluation should focus on finding client’s
abilities; screen for ability to read, print size, etc.
Clients with cognitive impairments can use the
ability to read to reach therapy goals.
Montessori techniques & principles can help in
structuring & implementing client goals.
Adapted reading stories, such as Reading
Roundtable , can be used to achieve a variety of
therapy goals with a variety of clients in group
and individual settings.
®
For More Information…
Visit the Myers Research Institute website at
www.myersresearch.org
Thank You!