Word Finding Difficulties

I just read a great article about word finding difficulties, Word-Finding Intervention for Children With Specific Language Impairment: A Multiple Single-Case Study by Anne Bragard, Marie-Anne Schelstraete, Perrine Snyers, and Deborah G. H. James

What I Know About Word Finding Difficulties: 

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Wording finding difficulties can truly impair a person's ability to communicate. It affects how a person learns new vocabulary, is able to express ideas in writing and speaking, affects confidence, and can hamper participation in the classroom.

When I started working with adult patients who suffered a stroke or brain injury, the implications were quite obvious. My therapy focused on helping my patients access previously learned vocabulary and express ideas. This was rehabilitation.

Now, as I work with children, I help students learn vocabulary correctly the first time as well as access the vocabulary they have already learned. Most of my therapy (and what I talk about on this website) focuses on semantic intervention. This means, I teach students all the parts of a definition and how to relate words together. The idea behind it is that the stronger the semantic relationship, the easier it is for a child to recall a word (the article reviews this as well). Students then can start to automatically self-cue by describing a word to help access their memory. As a bonus and a hope....students will start to learn new vocabulary with their learned components of a definition and reduce word finding difficulties in the future.  

However, is therapy evidence based? Is there carryover or generalization of progress? This article shed some light on this as well as got me thinking about other aspects of therapy. 

What I Learned:

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In this article, I didn't learn anything groundbreaking but it was a good review of word finding difficulties and really got me thinking about intervention ideas.

• First, it talked about using both semantic and phonological interventions. In this study, the students received a combination of both. I thought this was an interesting idea since most of my therapy has always been semantic based.
• What I thought was truly interesting, is that the students with apparent semantic based word finding difficulties actually improved more with the phonological based interventions (pre and post test). 
• Last, all students made progress and the progress remained stable even after 8 months post treatment. I thought this was great news!! However, the bad news is that progress made did not generalize. This is a problem!!

Clinical Ideas:

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All this information got me thinking....

1. In private practice, I did a lot of functional testing to evaluate strengths and areas of need and to get at the root of a disorder. In schools, while I completely understand the restriction of testing, I do get frustrated since I see testing in a different light. I don't want to find deficits or labels, but instead get a better picture of how a student's brain works to create a individualized goals and play off strengths. However, this is a whole other topic! Since I may not always know the root of a child's word finding difficulties, a combination approach of both semantic and phonological interventions may be the best way to cover all bases.
2. Concerning, generalization....I think this is the most important lesson I learned! Therapy may not be generalizing...in the words of my toddler, uh oh!  During my word finding interventions, I tend to grab Super Duper cards for therapy; however, this may not be the most functional. I plan on ONLY using core vocabulary and math and direction words next year during therapy!! A great reminder and motivator!!
3. I made some visual cue cards to help with learning parts of definition based on the Expanding Expressions Tools. Feel free to download and use if you would like! Cue Cards

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