Question
Are there any documented methods to improve word-finding skills? Is there a way to measure progress with word-finding skills short of standardized assessment? Is a goal of ''will exhibit (two) or less instances of word-finding difficulty in (ten minutes
Answer
In fact there is quite an extensive literature on treatment of word finding difficulties, drawing upon a number of different treatment techniques (cueing hierarchies, answering questions about semantic and phonologic attributes of target words, semantic feature analysis, pairing gestures with word production). A number of recent references review some of the options.
June 2001 issue of Special Interest Division 2 (Neurophysiology and Neurogenic Speech and Language Disorders) continuing education newsletter: Treatment of Lexical Impairments in Aphasia: Focus on the Evidence.
A.M. Raymer & L.J.G. Rothi (2001). Cognitive Approaches to Impairments of Word Comprehension and Production. In R. Chapey (Ed.), Language Intervention Strategies in Aphasia and Related Communicative Disorders (4th ed., pp. 524-550). Philadelphia: Lippincott Williams & Wilkins.
L. Nickels (Ed.) (2002). Rehabilitation of Spoken Word Production in Aphasia. East Sussex, UK: Psychology Press.
Your question hits upon some unanswered issues in word retrieval treatment research, however. Numerous studies show that practice with a number of treatment protocols lead to improvement in retrieving specific words that are trained in a picture naming format. It is less common to see generalization of treatment effects to untrained words, and infrequent to see reports of the impact of treatment upon conversational measures, what some would argue is the true measure of the effects of word retrieval treatment. Therefore it may not be an appropriate goal to say that general word retrieval abilities will improve. We might need to tailor the selection of treatment stimuli to the individual needs and interests.
On the other hand, I might suggest that the overall goal should be articulated in terms of improving ability to retrieve words in particular communication activities. Audrey Holland has written about identifying goals that specifically reflect items on the ASHA-FACS, several of which depend upon word retrieval abilities as a component behavior. Improvement would be measured in the changes in assistance needed to accomplish each communication activity. Mayer and Murray (in press, Aphasiology) discuss a new method for measuring word retrieval at the conversational level, considering proportions of word retrieval failures relative to overall proportions of words spoken.
Although I use word retrieval treatments all the time, I think we still need better research to support the contention that treatments for word retrieval are effective and valuable.
Anastasia Raymer, Ph.D., CCC/SLP, is an associate professor in the Department of Early Childhood, Speech-Language Pathology, and Special Education at Old Dominion University in Norfolk, VA. She is the Coordinator of ASHA Special Interest Division 2: Neurophysiology and Neurogenic Speech and Language Disorders for 2003-2005. With colleagues at the Brain Rehabilitation Research Center in Gainesville, Florida, she is involved in research investigating the effects of treatments for word retrieval, sentence production, and spelling in individuals with stroke. Their research is supported by an NIH (NICDC) Program Project Grant (P50 DC03888). Dr. Raymer has published her work in numerous scholarly journals (Aphasiology, Journal of Medical Speech-Language Pathology, Archives of Physical Medicine and Rehabilitation) and several review chapters.