Using Word-Finding Strategies

SKILL: Talking

DIFFICULTY: 4/5

LEVELS: None

BRIEF RATIONALE: This treatment teaches word-finding strategies in the context of naming and picture description.

SUGGESTED MATERIALS: Paper and pencil

In Using Word-Finding Strategies, you will name three pictures, describe a picture scene, and reflect on word-finding strategy use. Speech recognition technology is available to help you practice talking aloud.

STRATEGIES: A strategy button is available in the lower-left corner of the screen to activate the Tell, Show, and Choose strategies. Using a strategy will mark the item as incorrect (as it was not answered independently) for progress monitoring, but it may help you retrieve the target word. You are encouraged to use these strategies during moments of word-finding difficulty in everyday conversation.

Tell: You can record a description or say related words. If you think of the word on this step, press the Answer button.
Show: You can write, draw, or practice using a gesture. This is where the pencil and paper will come in handy. If you think of the word on this step, press the Answer button.
Choose: You can identify the word given 3 choices, then practice saying it aloud with the mouth model.

In the picture description task, you are expected to use words 1, 2, and 3 that you just named. Use the Review button to help you recall the words without penalty. In the written feedback, the target words will appear bolded & green. The other bolded text represents content words related to the scene.

SELF-SCORING OPTION: If speech recognition is not right for you or your patient (e. g. due to accent, background noise, or lack of a microphone), you may choose the self-scoring version of this treatment. Name the picture and check your answer. Within the Tell strategy screen, you can see an example description by pressing the Example button.

FOR THE CLINICIAN:

This treatment includes lower frequency nouns (e.g. thermometer), abstract concepts (e.g. love), and proper nouns (e.g. the Eiffel Tower) as research shows that increased language complexity supports generalization to less complex language.

The strategies were inspired by a conversation-level intervention called Ecologic-TX, where the SLP requests a circumlocution (Tell), then non-verbal communication (Show), and then a forced choice (Choose). In the Ecologic-TX protocol, the SLP purposefully avoids prompts like phonemic/semantic cues because those are not "typical" in regular social interactions. In Using Word-Finding Strategies, we include socially-acceptable prompts in-line with this approach:

Tell- "Can you tell me something about it?"

Show- "Can you show me another way?"

Choose- "Can you choose what it is?"

The picture description task is included to allow word-retrieval practice in connected speech, and to support the progression from single words to conversation. We highlight content units within this task because content units are directly correlated to communication success (this is also referred to as informativeness).

The reflection step allows persons with aphasia to build metacognitive awareness around word-finding strategies. Increased awareness of strategy effectiveness can increase the chance of intentional use in everyday life.

Selected References:

Leaman, M. C., & Edmonds, L. A. (2024). Pilot results for Ecologic-TX: A new conversation-level intervention improving language in people with moderate to severe aphasia. American Journal of Speech-Language Pathology, 33(1), 153–172. https://doi.org/10.1044/2023_ajslp-23-00141 Kiran,
S., & Thompson, C. K. (2003). The role of semantic complexity in treatment of naming deficits. Journal of Speech, Language, and Hearing Research, 46(4), 773–787. https://doi.org/10.1044/1092-4388(2003/061)
Webster, J., & Morris, J. (2019). Communicative informativeness in aphasia: Investigating the relationship between linguistic and perceptual measures. American Journal of Speech-Language Pathology, 28(3), 1115–1126. https://doi.org/10.1044/2019_ajslp-18-0256