This page has been inspired by one of my clients, Lauren. She is an amazing 13 year old girl…..that has overcome many challenges in her life. I truly have learned from her. Her spirit, love and energy are evident everyday in all that she does. Lauren and I have worked together for the past three and a half years…..and she really has been an inspiration to me. I am confident to stay that her therapists, teachers, nurses, friends and family are all better off because we were lucky enough to cross paths with her in this lifetime. For more about Lauren……please visit her on her blog: www.laurensvision.com
Who can have word finding difficulties??? Children with language delays, children and adults that have suffered from a TBI (traumatic brain injury) or have a brain tumor, and an adult that suffered from a stroke. A stroke in an adult may cause them to have what is called aphasia. There are different kinds of aphasia and sometimes aphasia can cause word finding difficulties. The strategies below will help those struggling with word finding difficulties. For specific questions please be sure to post a reply.
When a child or an adult has word finding issues….this means that they struggle to find the right word when communicating. Sometimes they can tell you something about the word, other times they just say the wrong word completely(which I often do) and other times it is evident that they just can not retrieve the word…..it is “stuck” somewhere in their brain. My job as the speech and language pathologist is to do two things: use the strategies listed below to help them retrieve the word and MOST importantly help them to utilize the strategies below on an independent level…..so they learn on their own how to retrieve words.
This cue is provided to the WFS (word finding struggler) when the listener is sure about the word she is struggling to retrieve and produce. If the WFS was struggling to retrieve and then say the word “mom”, you would provide the beginning sound of the word mom (which would be the phoneme /m/-mmmmmm)-giving her the phonemic cue and helping her to retrieve the word. This cue is one of the easiest word retrieval cues for the person struggling with word finding concerns. Usually when the WFS hears the beginning sound of the word it helps them to retrieve the word almost instantly.
The goal, then, is for the WFS to realize that if she is able to say the beginning sound of the word she may be able to cue herself to retrieve the word (sometimes she may not be able to retrieve the word mom, but she knows that it begins with /m/, so the WFS may cue herself with the sound that m makes…..mmmmmm). Once she gives herself the cue, she maybe able to retrieve the word all on her on. So remember to use the phonemic cue when you are communicating with someone that is struggling to find the right word. Also remember that this cue ONLY works when you know what the word is she is struggling to say.
Finally, in order to continue to help the WFS become a better communicator…be sure to have her restate the entire sentence. What this means is: if she said: “I bought flowers for my………” and struggled to find the word mom. Next you cued her with the /m/ sound, which helped her to retrieve “mom”, and then the last step is for her to go back and restate the sentence: “I bought flowers for my mom”. As she continues to respond to the phonemic cues, as she continues to restate the sentences….she will build on her word finding abilities…..and MOST importantly learn to use the strategies.
Also are utilized in order to help the WFS with word retrieval skills. When the WFS is struggling to retrieve a word and the listener is UNSURE of what word she is trying to retrieve, the listener/therapist provides the WFS with words that might be related to what she is trying to express. For example if the WFS was trying to tell you about something she ate at an Italian Restaurant (now there are many possibilities-so you can’t use the phonemic cue because you do not know what she ate). So the next step would be to provide her with as many semantic cues as possible (you may have also heard the term circumlocution). This means that you can say words that are related to eating at the Italian Restaurant. For example: pizza, pasta, do you eat it with a fork, a spoon, sauce, did you sit at a table or eat at the counter, can you eat it in a bowl, is it round or square……continue to try and provide as many cues as possible. I was once working with Lauren and she was trying to tell me that she ate Rigatoni Ala Vodka for dinner. She struggled for about 20 minutes……but she got it…….we talked about the fact that she ate it with a fork and that you could not use your fingers (so it could not be pizza)…..she remembered what she had to drink…..who ate at the restaurant with her….that it was a pasta……but not a long pasta like spaghetti and I continued to provide her with semantic cues……and we kept rephrasing the sentence….”I went out to eat for dinner with my mom and I ate……” until finally she was able to recall “rigatoni ala vodka”.
Now the ultimate goal is for the WFS to begin to use this strategy on her own….so that when she is struggling to find a word…..she can try and recall other words that are related to this word….and then hopefully she will be able to self cue and retrieve the word.
In order to help the WFS become a better self-cuer you can play this enrichment activity.
Categories: Provide the WFS with a word…..the word should be a noun…as it makes this activity a little easier….but also the most beneficial for word retrieval. If you give her the word APPLE, she has to provide three attributes related to the word, and the first attribute must be the category….and she also must provide the answer in a full sentence. So it would sound something like this: An apple is a fruit, it is red and it has seeds in it.
Carrier phrases are effective in helping the WFS to retrieve words and use them functionally. Functional and spontaneous language is language that we use to obtain a need, or get what we want or to express a thought or an idea. Carrier phrases are simple phrases such as peanut butter and ___________.
This strategy can only be used when you know the word that the WFS is trying to say. If you are not aware of the word….it would be impossible to provide the carrier phrase. When you know what word the WFS is trying to retrieve…..you can use a phrase or sentence that basically has a blank______________ at the end of the sentence. And this blank then needs to be filled in by the WFS. So if the WFS was trying to retrieve the word “toothpaste”….you could say something like this…..”I brush my teeth with a toothbrush and_________”
Remember the goal is for the WFS to learn how to formulate her own carrier phrases. The young girl that I work with has started to use not only the phonemic cues…but the carrier phrases as well. It is amazing when you see how successful the WFS can be as a speaker when she learns on her own how to retrieve those “stuck” words.
You may find in your own day-to-day life…when struggling to recall someone’s name…..a place that you shopped at……..or a movie that you saw……you may re-cap the events of the day….and then say to yourself…..”I went to lunch today at the diner and had a salad with my friend….______________…….MARY!!!” Sometimes recapping the events and then formulating a sentence that acts as a carrier phrase helps you to retrieve the word that is “stuck” or on the “tip of your tongue”.
When I am working with children on improving memory and understanding skills….it is most important that they understand that they have to “listen so that they understand and remember.” Children will often hear what you are saying….however….do not remember the details to what you said.
When I working on memory and understanding I like to start off the session with activities I call: “Jump Start” questions. These are simple memory exercises….that should be easy for your little one to answer. When I work with Lauren….a young girl I have been seeing for services since 2008 (working on cognitive rehabilitation)….we start off the session with the “Jump Start” questions. You will see below what they look like. Initially, Lauren could not answer the simple questions…and she also had the most difficulty in answering the questions in a full sentence. Okay…so read below what my “Jump Start” questions are like:
What is your name?
My name is Lauren.
What is your dad’s name:
My dad’s name is Mike.
What is your brother’s name?
My brother’s name is Eric.
Initially….just formulating the sentences was difficult for Lauren….also due to word retrieval issues. However, after repeatedly answering these questions….Lauren was able to answer them fluently.
Next I made the “Jump Start” questions more challenging….by telling Lauren that she needed to answer the question and then add detail to the answer. Giving me one fact about herself…her mom or dad or brother….so she may have answered the question like this:
“My name is Lauren and I love macaroni and cheese.”
Next….to address her memory skills….I would give her information about myself and see if she could recall the details…..so my statements would sound like this:
I would be sure to state the following first:
“Listen so that you understand and remember.”
“My birthday is in March and my favorite color is green.”
Next, Lauren would be asked:
When is my birthday?
Your birthday is in March.
What is my favorite color?
Your favorite color is green.
Now, most important!!
I would write the “Jump Start” questions down….and every session I would ask her the same “Jump Start” questions….and add a new one. Eventually…the answers were transferred from her short-term memory to her long-term memory. Most importantly, though, she learned how to listen so she understands and remembers.
I use the next activity to continue to work on memory and understanding skills…..and teaching the child to “listen so they understand and remember.”
“THREE PARTS TO SMARTS”
Be sure to start off the activity with….”I want you to try to listen so that you understand and remember.”
“I am going to tell you a story. There will be three details in the story. Listen so you understand and remember. Then you will answer questions about the story in a full sentence.”
“Anne went to Stop and Shop to get bananas.”
Who went to Stop and Shop?
Anne went to Stop and Shop.
Where did Anne go?
Anne went to Stop and Shop.
What did Anne get at Stop and Shop?
Anne got bananas.
As simple as this three-part story may seem….children that have difficulty with memory and understanding may struggle to answer the questions, to recall the details, and to formulate a full sentence when answering. Repetition of activities like this will help your little one’s memory and understanding skills.
As she improves her ability to complete these activities…make the stories longer…add more details…..and make the stories more challenging:
“On Saturday it was raining so Anne and I could not go to the park. Instead we went bowling and then went out to the Diner for lunch. I had macaroni and cheese and Anne a cheeseburger. We had fun. Hopefully, on Tuesday we can go to the park.”
Again see if your little one can answer questions about the story above….there is more detail…it will be more challenging…..and you may have to use the strategies that are listed above in order to help her recall the details. Strategies such as phonemic cues and carrier phrases.
IMPROVING VOCABULARY KNOWLEDGE, ABILITY TO DEFINE WORDS, RECALL OF INFORMATION, AND AUDITORY PROCESSING:
I also love the activity below when working with Lauren (you can read more about her under the word finding page). Lauren has been an inspiration to so many people….and I have been lucky enough to have worked with her over the past four years…..addressing her cognitive recovery. When addressing cognitive recovery……it is important to engage the person in numerous language activities……you goal as the therapist is to help make new connections in the brain.
The HINT GAME…..as described below is a favorite of Laurens……and now has become less challenging for her. We see that it is less challenging for her as she continues to make new neural connections in her brain, stores more information and is able to recall more information. Yeah Lauren!
The goals of the HINT GAME: improve vocabulary development, improve ability to categorize: people, places and objects, improve receptive language skills, improve ability to define words, improve expressive language, and improve ability to understand attributes (describing words).
This activity can be played ANYWHERE……and here’s how it goes…..
Say to your little one that you are going to play the HINT GAME….and that she is going to be like the detective…..and that she has to guess what you are thinking of……when giving your little one the clues….I start off with three or four clues…more may be needed if she is unable to guess with just three or four. The first describing word should always be the category the object belongs in…and the next two or three words are describing words.
So you may say something like this:
I am thinking of something…it is a fruit…..it is yellow…..you peel it and it grows on trees.
Hopefully your little one will guess BANANA.
I like to then go back and see if she can recall any of the attributes related to the banana…..she may need some help in the recall….and also see if she remembers the category that the banana belongs in. This simple activity is very helpful for little ones once they are in school and need to define their vocabulary words. Understanding that the category should come first…and then the describing words after.
To make this activity a little bit more challenging….see if your little one can give you the clues….and you have to guess what she is thinking of. I find that the little ones at first really need some prompting. You can have an older sibling, friend or another adult help your little one with giving you the describing words. You may find….as I have seen….that when they first try to describe a word….it may sound something like this:
I am thinking of something that’s…ummmm…..yellow….ummmmm…..it’s a banana…..do you know what it is? Funny…..kids know information about the banana….but it may be challenging for them to actually use their words to describe the banana.
Hope this was helpful….and as I said if you know of someone who is presently in the cognitive recovery stages following a traumatic brain injury…this is a great strategy to help her with the process.