Information for SLPs
Assessment
When assessing children with word-finding difficulties, there are two types of assessments that might be done:
Direct Assessment
This type of assessment involves the use of standardized measurement tools. Some possible standardized tests include The Test of Word Finding-Third Edition, The Test of Adolescent/Adult Word Finding - Second Edition, and The Test of Word Finding in Discourse. Since word-finding problems can be related to underlying language deficits, a full language test should be completed in addition to tests looking at word-finding. The word-finding component of the assessment should look at the child's retrieval abilities for single words and during conversation.
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Indirect Assessment
One form of indirect assessments is observations of the child in real-life situations. These observations should occur in the classroom, at home and in other contexts if possible. Observations are important to determine if the retrieval issues occur across settings or if the problem is driven by the context. Language samples are another indirect assessment that allow for the frequency of word-finding behaviours to be determined. Non-standardized tests can also be used as an indirect assessment.
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In addition to these assessments, the child's word knowledge or vocabulary will be examined. This ensures that the child's difficulty is with the access and not with the understanding of the words.
Also during the assessment it is important to consider intrinsic and extrinsic factors that can influence word retrieval. Intrinsic factors are influences that come from the child or the word itself and include how common the word is, the category of the word (e.g. animals, vehicles), how concrete the word is, the part of speech (e.g. noun, verb, etc.), the age at which the child learned the word, and how familiar the word is to the child. Extrinsic factors are influences that come from outside the word or the child and include the context of the naming task, the sentence structure, recent exposure to the word, and the if the task requires isolated or continuous naming.
Treatment
Uhm
Imagery Cueing
Visualizing the target word in order to retrieve the name
e.g. picturing sand and water for beach
Gesture Cueing
Performing an action that represents the target word
e.g. swinging a bat for baseball
Graphemic Cueing
Using the letters of the of the word as a cue for the retrieval of the target word
e.g. it starts with the
letter b
Synonym Substitutions
Replacing target word with a synonym
e.g. beautiful for pretty
Multiword Substitutions
Replacing the target word with a description of it
e.g. a red fruit for apple
Reflective Pausing
Stop and take time to think about the correct word
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Phonemic Cueing
Using the first sound or syllable as a cue for the target word
e.g. /p/ for pig
Semantic Cueing
Using the meaning of the target word as a cue for retrieval
e.g. cuts wood, for axe
Hm...
To improve word-finding abilities in children, treatment should focus on increasing word knowledge, storage strength, retrieval accuracy, retrieval speed, and strategy use. Enhancing word knowledge is important as it improves storage strength and results in a larger word bank that the child can retrieve from. Improving word knowledge can be done by making connections between words, or strengthening/adding to the meaning of learned words. Speed and accuracy deficits are a large part of the word-finding problem so any improvements in these areas will be beneficial in treatment.
Treatment will also include three components which are retrieval strategies, accommodation considerations, and self-advocacy instruction. Retrieval strategies are techniques taught to the child in order to help him/her find the word they are struggling to retrieve (click here for strategies). Accommodation considerations involve changes that can be made to the home and school environment in order to reduce the retrieval demands and build off the child's strengths (click here for accommodations) . The goal of the self-advocacy component is to teach the child how to self-monitor, self-evaluate, and self-correct in order to use the learned strategies independently.
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Important principles:
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Select retrieval strategies that are suitable for the child.
Start with single word practice and then move to conversation level.
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Target words practiced in speech-language therapy should be relevant to the child's life (e.g. curriculum, daily routines, hobbies, etc.).
Start with individual treatment sessions and gradually move towards treating in a group setting.
Deliver treatment in a variety of environments.
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Teach the child to use the learned strategies independently.
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Include transfer activities to promote generalization of learned skills.
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Practice! Practice! Practice!
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Retrieval Strategies:
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