Verbal Working Memory

SKILL: Memory

DIFFICULTY: 3/5

LEVELS: 6 levels based on the length of the number string

BRIEF RATIONALE: This treatment works on verbal working memory with extended benefits to language.

In Verbal Working Memory, you will hear a string of 2-7 numbers. Press the record button and say the numbers in reverse order. Press the button again to end the recording. Submit your answer to receive specific feedback using speech recognition technology. You will get the opportunity to reflect on your strategy usage after each trial. The treatment auto-adjusts in difficulty based on performance.


HINT: A hint button is available in the lower-left corner of the screen to replay the number string. Using the hint will mark the item as incorrect (as it was not answered the first time the auditory stimulus was presented), but may help you recall the numbers.

TYPING OPTION: If speech recognition is not right for you or your patient (e. g. due to limited verbal expression, unclear speech, background noise, or lack of a microphone), you may choose the typing version of this treatment. Listen to a string of 2-7 numbers. Type the numbers in reverse order and press Submit.

FOR THE CLINICIAN: This treatment is based on a common working memory task called reverse or backward digit span. A simpler task called forward digit span requires only the repetition of the numbers heard, focusing on attention and working memory. The more difficult backward digit span requires both storage and manipulation of data, requiring cognitive control and executive function in addition to working memory and attention.


Why work on working memory? The central executive system (CES), the phonological loop, and the visuospatial sketchpad (key components of working memory) play important roles in language processing. In fact, many individuals with aphasia also experience working memory deficits that can persist even after language deficits have resolved. Neuroimaging studies show the prefrontal cortex and Broca's area are involved during working memory tasks.


Working memory training is now recommended to be included in aphasia rehabilitation plans as it can result in positive cognitive and language outcomes such as improved auditory comprehension, repetition, naming, and fluency. The typing version of Verbal Working Memory is ideal for patients with impaired language skills because it may improve language and cognition without requiring speech.


Selected References:

  1. Baddeley, A. (2003). Working memory and language: An overview. Journal of Communication Disorders, 36(3), 189–208. https://doi.org/10.1016/s0021-9924(03)00019-4
  2. Barde, L. H., & Thompson-Schill, S. L. (2002). Models of functional organization of the lateral prefrontal cortex in verbal working memory: Evidence in favor of the process model. Journal of Cognitive Neuroscience, 14(7), 1054–1063. https://doi.org/10.1162/089892902320474508
  3. Cicerone, K. D., Dams-O’Connor, K., Eberle, R., Fraas, M., Ganci, K., Langenbahn, D., Shapiro-Rosenbaum, A., Tate, R. L., & Trexler, L. E. (2022). The ACRM Cognitive Rehabilitation Manual & Textbook: Translating evidence-based recommendations into practice (2nd ed.). ACRM Publishing.

  4. Nikravesh, M., Aghajanzadeh, M., Maroufizadeh, S., Saffarian, A., & Jafari, Z. (2021). Working memory training in post-stroke aphasia: Near and far transfer effects. Journal of Communication Disorders, 89, 106077. https://doi.org/10.1016/j.jcomdis.2020.106077



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