Program Plan Description Form

Center for Life Skills

Please Note: This form must be submitted one week prior to your programs implementation.
Title of Program: Heads Up
Clients to be involved in the program: There are ten clients who have survived stroke and traumatic brain
injuries
Program goals and measurable objectives:
1. Clients will be able to interpret body language and gestures to identify the word that their partner is
acting out at least 10 times out of 20 tries.
2. Clients will be able to word find by recognizing the word on the card which is measured by acting out
the word they see at least 10 times.
3. Clients will be using their fine motor skills 40% of the time by holding the card up to their head for
their partner to read

Program Description:
Each client will be partnered up.
Richard and Jennifer
Matthew and Natalie
Meredith and Marion
Betty and Alana
Mary Ann and Shau Chen
Each pair will be given a set of cards. Those sets of cards will have words or phrases on them that connect
with the letters of the BREATH Pathway. For example one word could be smile and that could go under
happiness, another word could be tree and that could go under environment and so on. There will be two
rounds. For each round one partner will be holding the card to their forehead for the other partner to see,
however the one holding the card will not be allowed to see the word. As one of them holds the card to
their forehead, the other partner will read the card to themselves and either act out the card or describe the
word/phrase without saying the words on the card. Before we start, each pair will decide which person
will want to hold the cards to their forehead first and guess which one will be acting it out or describing
the word and in the second round they will switch. In the first round they will be allowed to talk about the
word but in the second round the one who is acting out the word is not allowed to talk. As they guess the
words, there will be 6 piles, one for B, R, E, A, T, and H. As they guess the word they have to put the
card in which pile they believe the word connects to and explain why to their partner. In the end they get
to see how many of the cards they got right and see who got the most correct. At the end we will debrief.
Supplies and Equipment:
Cards made prior to intervention.

Staff interaction/intervention strategies:

To provide support when necessary

Words:

Weather
Air

How are you?

Lungs

Crowds

Tranquility

Quiet

Inhale

Large Group

Exhale

Small Group

Meditation

Laughter

Yoga

Smile

Guidance

Friends

Voice

Family

Money

Are you ok?

Rain

Writing a card

Snow

Love

Bus schedule

Hugging

Sleeping

Food

Paying Bills

Saying Thank You

Asking for help

Eating a chicken wing

Getting Dressed

Putting a seatbelt on

Panting

Looking both ways before crossing

Deep Breath

Emotions

Whispering

Scanning the room

Cold

Ingredients

Warm

Cooking

Yawning

Listening to music