Practicing Meaningful Words

This article is for: Virtual Rehab Center (VRC)

SKILL: Talking

DIFFICULTY: 1/5

LEVELS: 3, based on the length of the delay

BRIEF RATIONALE: Improve communication of basic wants and needs using an errorless approach.

COMING SOON TO THE VIRTUAL REHAB CENTER 2026!

In Practicing Meaningful Words, you will practice a set of 10 words. Create your own by pressing +Add Custom Set at the bottom of the screen, or choose a pre-selected set from the list. It is best practice to create a set based on the individual's preferences. You can see a list of 60 recommended words, or search for any word in our database. Remember to name the set before saving.

You will see and hear a word from your selected set. Repeat the word aloud to receive feedback. Words you say incorrectly will be reviewed throughout the exercise.

You will practice each word in the set twice before completing the treatment. The difficulty will automatically adjust based on your performance.

HINT: A hint button in the lower-left corner of the screen lets you review the target word. Using the hint marks the item as incorrect, but the additional model may help you say the word.

NON-ASR 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.

FOR THE CLINICIAN:

The treatment, Practicing Meaningful Words, uses an errorless naming approach that prioritizes accurate production over effortful retrieval. The target word is provided in spoken and written form before the patient is asked to name the picture (e.g., "This is coffee. Say, coffee."). This minimizes opportunities for error and ensures repeated practice of the correct word. 

In errorful approaches, the patient may unintentionally practice the wrong word multiple times (e.g., cup/bowl), making them more likely to produce the error again. This is based on Hebbian learning, the principle that repetition strengthens whatever is produced, regardless of accuracy (Nunn et al., 2023).

Errorless naming may be particularly helpful for individuals with severe anomia, reduced self-monitoring, or limited tolerance for naming errors. Because treatment gains are typically specific to the words that are practiced, target selection matters. Choose personally relevant, functional words that help the person communicate their wants and needs in everyday interactions.

There is good support for errorless naming in the literature. Studies have found similar outcomes when comparing errorless naming to errorful approaches, and patients may prefer it (Fillingham et al., 2006). In fact, a meta-analysis identified errorless learning as one of the most efficacious confrontation naming treatments (Yousefzade et al., 2024). Clinicians might consider a hybrid approach where errorless techniques are used early in treatment and retrieval demands are gradually increased, since effortful retrieval may have better long-term retention (Nunn et al., 2023).

Selected References:

1. Fillingham, J. K., Sage, K., & Lambon Ralph, M. A. (2006). The treatment of anomia using errorless learning. Neuropsychological rehabilitation, 16(2), 129-154.
2. Nunn, K., Vallila-Rohter, S., & Middleton, E. L. (2023). Errorless, errorful, and retrieval practice for naming treatment in Aphasia: A scoping review of learning mechanisms and treatment ingredients. Journal of Speech, Language, and Hearing Research, 66(2), 668–687.

3. Yousefzade, F., Memarian, A., Rahimi, A., & Ghasisin, L. (2024). The efficacy of confrontational naming treatments for Aphasia: A meta-analysis. Aphasiology, 39(7), 942–967.