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One Material, Many Goals: Playing Cards

6/8/2026

A single deck of cards can address attention, memory, executive functioning, reasoning, organization, cognitive flexibility, speech intelligibility, language, and auditory comprehension with minimal preparation, making it one of the most versatile cognitive-communication therapy materials.

Card Sorting

  • Sort by color, face cards vs. number cards, odd/even, odd/even/face, and suit (listed in order of difficulty). Easy level: sort cards facing up. Hard level: sort cards facing down.
  • Targets: short term memory, attention, categorization, executive functioning, cognitive flexibility.

Sequential Ordering

  • Arrange cards in numerical order, ascending or descending. Increase difficulty by using only one suit or mixing suits.
  • Targets: sequencing, organization, problem-solving.

Following Directions

  • Give increasingly complex instructions (e.g., “Place the red queen above the 7 and to the left of the black king.”).
  • Targets: auditory comprehension, working memory, attention.

Mental Flexibility Sorting

  • Have the patient sort cards face up by one rule (color), then switch to another (number), then another (suit), switching multiple times before the entire set has been used.
  • Targets: cognitive flexibility, set shifting, executive functioning.

Short Term Memory Challenge

  • Show a series of cards, then remove them and have the client recall the cards in order.
  • Discuss internal memory strategies before/after to train use of compensatory memory strategies
  • Targets: working memory, immediate recall, attention, metacognition

Naming Cards

  • Have the patient say the suit and number of a card, one at a time
  • Targets: Speech intelligibility, attention

Planning and Strategy Games

  • Use games such as Crazy 8s, Go Fish, or simple card-matching activities while discussing strategies before and after play.
  • Targets: planning, prediction, self-monitoring, turn-taking, short term memory, attention
  • BONUS Modification: Have your patient say the name of each card as they play it in order to target speech intelligibility

Attention Monitoring

  • Read a list of cards aloud and have the client respond when they hear a target card or suit.
  • Example: Tap the table every time you hear a heart.
  • Targets: sustained attention, selective attention

Category Naming

  • Deal 5–10 cards and assign each suit a category (e.g., foods, animals, occupations, places). The client names an item from the corresponding category for each card drawn.
  • Targets: semantic organization, cognitive flexibility, word retrieval, processing speed, short term memory

Alternating and Divided Attention

  • Take any of these activities, and intermittently distract the patient with conversational topics of interest to target alternating attention.

  • Even more difficult, target divided attention by having the patient engage in conversation with you while simultaneously executing the task.

    BONUS: Modify any of these activities for a lower level of difficulty by writing down the rules and having your patient practice referring to the external memory aid throughout the activity.