When you think of numbers, do you think of math or language? Numbers can be added, subtracted, multiplied, and divided, but numbers also represent concepts. Numbers communicate important information about who we are, what we do, and how we move through the world.

“I am 67 years old. I have 3 children and 7 grandchildren. My stroke was 2 years ago. I want to get stronger so I can attend my 1st granddaughter’s college graduation in 2016.”

The ‘transcoding’ of numbers, or moving between digits (14), written words (fourteen), and spoken words (“fourteen”), is an essential communication skill. It is not as simple as it sounds.

Each type of number (e.g. time, money, dates) has its own special format, and a different way of saying it. We say 4:30 as “four-thirty”, $4.30 as “four dollars and thirty cents”, and 430 as “four hundred and thirty.” Numerical transcoding is full of rules, exceptions, and variations that must be mastered for accurate communication.

Number Therapy is a speech therapy app for Apple and Android mobile devices. It offers visual cues to teach users the rules of how to say each number. Numbers can be presented as written or auditory words to match to digits.

Numbers and Aphasia

It’s the communication of numbers that is often lost when a person has aphasia. Basic skills like understanding amounts in a store, conveying important dates, and punching in phone numbers become difficult. Lacking confidence in these skills may leave a person with aphasia feeling dependent for help.

Speech Therapy Can Improve Numbers in Aphasia

Numbers are everywhere in our world.

Numbers can prove especially difficult compared to general conversation. A person with aphasia may understand enough of the words and context to get the gist of the message; however, when numbers are involved, accuracy is essential.

Consider this message:

Come to the 2nd floor at 459 East 23rd Street at 4:15 on August 18th, 2015. Bring $5 and 2 pieces of ID. Call to confirm at 607-555-3459 between 10 and 6.

One digit off and suddenly you’re at the wrong address, you’ve called the wrong number, or you’re an hour late or a day early. How frustrating!

While numbers can be difficult, there are many people with aphasia who communicate in numbers all the time. They trace out digits in the air, count up from 1 to their target number, or write numbers on paper. They ask speakers to write down the number so they can understand it better by reading. They know how powerful these words are, yet they still struggle to be quick enough or accurate enough to understand, say, and write numbers.

Speech Therapy for Numbers

A speech-language pathologist can help people with aphasia improve their number communication skills. They will assess where breakdowns in number processing occur and design a treatment program to practice these skills. By mastering one type of number at a time – learning the rules while working up the hierarchy of difficulty – people with aphasia can become faster and more efficient with numbers. Home practice is the best way to get the required intensity to change the brain when time with a therapist is limited.

Number Therapy allows people with aphasia to master each type of number in isolation and then practice with mixed number types, focusing on listening, reading, speaking, or typing. Practice as much as you want; the app is yours forever with a one-time purchase. And if you don’t have a therapist to guide you, Number Therapy offers recommendations of what to work on next based on your performance.

Counting up on fingers and writing numbers in the air can be good compensatory strategies in the beginning, but working on visualizing these tricks instead of acting them out can build independence. Running speed drills on naming the numbers (from 1-10, 11-20, or up to 100 by tens) can help to automatize these words and eliminate the need for distracting strategies.

While numbers may not be the first goal to address after a stroke, they are important to communication and many stroke survivors want to work on them. Whether you’re “good with numbers” or not, the communication of numbers is essential for everyone.


Number Therapy is free to try by downloading Number Therapy Lite on the App Store for iOS or Google Play for Android. Try it for yourself to see why people with aphasia are shouting “Thank You” in response to this new app.