Category Archives: Identification

Dr. Diane German writes a guest post – “Ask Yourself, Are You Doing Enough for Your Learners with Word Finding Difficulties?

I am delighted to welcome Dr. Diane German, author of the Test of Word Finding – Third Edition (TWF-3) and the Word Finding Intervention Program – Second Edition (WFIP -2) . Both are available from PRO.ED (see below).  Dr. German has also been my mentor in the area of word finding.   

 Ask Yourself, Are You Doing Enough For Your Learners With Word Finding Difficulties (WFD)?

Often I hear Speech and Language Pathologists (SLPs) tell me that they are concerned that they are not doing enough to facilitate the students in their schools and centers who display WFD. They ask me how and where can they improve services for these students. Because SLPs are the main advocates for students with WFD, I am happy to address this question in hopes that it will be helpful to SLPs and will improve services for students with WFD. Below, I address 3 programing areas where professionals may not be doing enough for students with WFD: WF Identification, WF assessment, and WF intervention.

It is not enough to just report that a learner has a WFD. Simply stating that a learner has a WFD may be insufficiently detailed to plan WF intervention. Research has indicated that students manifest WFD not only when retrieving single words or names, but in discourse contexts also; and that their WFD can be suggestive of three distinct error patterns. For example, it has been reported that students with WFD may manifest difficulty in retrieving the semantic aspects of the target word (Error Pattern 1, Lemma Related Semantic errors, eel for octopus, commonly know as a “slip of the tongue”,); the form properties of the word (Error Pattern 2, Form Related Blocked Error, …IDK or I Pass, commonly known as a “tip of the tongue error”); or the complete phonological schema of the target word, (Error Pattern 3, Form and Segment Related Phonologic Error noculars for binoculars, commonly known as a “twist of the tongue”).   If so, just concluding a learner has a WFD may overlook important distinctions between error patterns that could provide useful information as to the source of a child’s WFD, and likely the best approaches for his/her WF intervention.

It is not enough to assess WFD with picture naming only. WF assessment needs to be more than just naming pictures, if meaningful, strategic, WF intervention is going to be planned. Rather a deep assessment in WF needs to occur if a students WF error patterns are gong to be identified and addressed. The goal of WF assessment is the differential diagnosis of WF error patterns.

The Test of Word Finding, Third Edition (TWF-3) (German, 2015, full disclosure I am the author of the TWF-3) is a standardized measure designed to complete the needed differential diagnosis of WF in single word naming contexts. The TWF-3 goes beyond picture naming providing six informal diagnostic procedures to determine learners’ individual WF error patterns. These procedures and corresponding Error Patterns include:

(1) Contrasts between word knowledge (comprehension) and word production (lexical access) on the same words to identify performance discrepancies between knowing and retrieving a word (needed to diagnosis WFD).

(2) Phonemic cueing procedures to assess blocked pathways between semantic and phonological representations (identifies Error Pattern 2, commonly known as a “tip of the tongue”);

(3) Imitation procedure to rule out articulation difficulties (identifies Error Pattern 3, commonly known as a twist of the tongue);

(4) Response analysis to observe if access to semantic and/or form features are derailed or blocked during the WF process (Semantic substitutions can identify Error Pattern 1; no responses identify Error Pattern 2; and phonemic substitutions identify Error Pattern 3);

(5) Response time analysis to observe WF efficiency (fast/inaccurate profile identifies Error Pattern 1; slow/inaccurate profile identifies Error Pattern 2 or 3; slow/ accurate profile identifies Error Pattern 2).

(6) Secondary characteristics tally (gestures or extra verbalizations during the WF disruption) to determine the learner’s metacognitive knowledge of the WF process, (“I know it, but can’t think of it.”) and metalinguistic awareness (“It starts with the P sound.”) of the evasive target word (identifies Error Pattern 2).

In summary, an in-depth WF assessment is needed to carry out a differential diagnosis in WF so as to maximize the efficacy of intervention. Together data from all these informal assessments enables examiners to predict the nature of learners’ WF disruptions. Use of vocabulary tests that simply assess picture-naming accuracy are not comprehensive enough to identify the three WF error patterns.

 

It is not enough to teach only word meanings to learners with WFD. Although current models of vocabulary instruction result in most learners being able to access known words, their focus on learning semantic representations of words is not enough for learners with WFD. This is because students with WFD are not successful in bridging their newly learned vocabulary and their lexical access skills. They thus have difficulty retrieving learned words in school assessments, classroom discourse, and in conversations (German, 2005).

Learners with WFD need a differentiated approach to vocabulary instruction. After learning word meanings (Montgomery, 2007), these students need retrieval strategies to anchor target words for automatic usage. For these words, instruction needs to focus on elaboration of words’ retrieval strength, thereby increasing the ease with which these known words can be accessed. The Word Finding Intervention Program, Second Edition (WFIP-2) (German, 2005, For full disclosure I am the author of the WFIP-2) provides retrieval strategies for words students know. For students who demonstrate Error Pattern 1 (commonly known as a “slip of the tongue” meta cognitive strategies are recommended to reduce semantic-based WF disruptions. These include Strategic Pausing, Self Monitoring (Hanson, 1996), and Self Correction (Paul, 2001) designed to reduce fast inaccurate responses. Strategic pausing helps the learner slow down the speaking process by inserting a pause before the noun in the noun phrase and/ or before the verb or adverb in the verb phrase. When strategically placed, the pause provides the speaker time to inhibit competing names or words and select the target. Self-Monitoring and Self-Correcting are taught with strategic pausing to reduce misspeaking and aid self-corrections

A three-pronged strategic approach is recommended to stabilize retrieval of words whose form learners cannot access consistently (Error Pattern 2, commonly known as the “tip of the tongue”) or retrieve partially (Error Pattern 3, commonly known as the “twist of the tongue”). This approach strives to make evasive words salient in the learner’s lexicon, anchoring retrieval of these words for future usage. It begins with the metalinguistic reinforcement of target vocabulary, e.g., segmentation to reinforce awareness of the word’s syllabic structure experiment (ex per i ment). This metalinguistic strategy is used in tandem with the second strategy, the phonological mnemonic strategy.

Mnemonic retrieval strategies target lexical access between semantic and form based processes. Learners associate phonological mnemonics to their evasive targets to anchor their retrieval for future usage. This involves linking words (e.g., X and spear for experiment) or phrases (cumulate junk for cumulus) similar in sound form to the target word or word parts. The third strategy is rehearsal. Learners are taught to think of their phonological mnemonic cue (X and Spear), while rehearing aloud their target alone (experiment) and in a sentence (We did an experiment in science.) until they are automatic in its usage.

In conclusion, the phonological mnemonic protocol makes the word’s form more salient by providing (1) metalinguistic reinforcement of the word’s syllabic structure; (2) a phonological prompt as a mnemonic link to the word form; and (3) rehearsal. It differs from other intervention protocols as its focus is on anchoring word forms to facilitate future retrieval rather than retrieval on demand, the purpose of cueing with the first sound of the target word.  

So this New Year, ask yourself are you doing enough for your students with WFD? If not, empower yourself to do more on behalf of these students. You are the only one who has the needed background in child language to do so.

References

German, D. (2014). Test of Word Finding, Third Edition (TWF-3). PRO.ED. Austin, TX.

German, D. J. (2005). Word Finding Intervention Program, Second Edition (WFIP-2). PRO.ED. Austin, TX.

Hanson, M. (1996). Self-management through self-monitoring. In Jones, K. & Charlton, T. (Eds.), Overcoming learning and behaviour difficulties: Partnership with pupils, Routledge, London, pp 173-191.

Montgomery, J. K. (2007). Evidence based strategies for vocabulary instruction/intervention, In Denti, L. & Guerin, G. (Eds.), Effective practice for adolescents with reading and literacy challenges, Routledge, Taylor & Francis Group, New York, NY, pp. 25-43.

Paul, R. (2001). Language Disorders form Infancy through Adolescence, Second Edition. Mosby, Philadelphia, PA.

Thank you, Dr. German!  Boldface emphases are my own.  

 

Thinking Routines for Word Finding

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Those of you who read this blog regularly will recognize that I feel it’s very important for kids to be aware of why they are working on their word finding, and how it can help them communicate in school, at home, and with their friends.  Learning metalinguistic strategies helps them apply their improved word finding skills to a variety of contexts.  In that vein, I want to pass on an interesting article about how “thinking routines” help kids (and adults) learn to think more deeply and with real understanding.

At a Learning and the Brain conference, Ron Ritchhart, senior research associate at Project Zero at Harvard University (http://www.pz.harvard.edu/who-we-are/people/ron-ritchhart), stated, “When we have a rich meta-strategic base for our thinking, that helps us to be more independent learners.” Project Zero teaches a thinking routine they call “See, Think, Wonder”.  The idea is to use a simple, easy to remember metalinguistic process that learners can apply to all their learning. The thinking routine becomes a habit that promotes deeper learning across the board.

Here’s the link    http://ww2.kqed.org/mindshift/2016/03/31/when-kids-have-structure-for-thinking-better-learning-emerges/

http://ww2.kqed.org/mindshift/2016/03/31/when-kids-have-structure-for-thinking-better-learning-emerges/

Let’s apply this to word retrieval.  When kids internalize a process of “anchoring” their words in their memory, they develop a habit of consciously supporting the retrieval of a word in the future.  Their metalinguistic skills send the message, “I am deliberately thinking about this word and I will be able to ‘find’ it in my brain at a later time.”

Teach a word finding “thinking routine.”  Practice the word ALOUD, reinforce each syllable, and use a “word finding 5” (A word finding 5:   Say the word aloud 5 times, create an original meaningful sentence, and get a ‘high 5’).  Here is the link to the entire process: https://www.wordfindingforkids.com/an-endorsement-from-the-word-finding-guru/

SEE, THINK, WONDER, RETRIEVE!

 

Back in the saddle

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Oh, my goodness.  I haven’t posted since April.  Think of how critical we can be of children who “just don’t feel like” doing their work.  I have no excuse.  I just have to jump back in the saddle.  Young kids can’t always do that however.  We have to break down their work into manageable parts so they are not overwhelmed.  The opening days of school are over, and most kids are adjusting to their new routines.  Let’s take another look at how word finding may impact them at school.

Word finding has a tremendous impact on many, many children. Whether or not your students have a diagnosed word finding problem, please be alert for potential retrieval difficulties.  When kids don’t respond to auditory messages, how do we know whether the problem is input or output?  How do we know that their failure to answer questions correctly is because they have not understood?  Perhaps they are not retrieving the words they need.

The quick and easy way to sort out the difference between kids who don’t understand and kids who don’t retrieve promptly and accurately is to provide a recognition task.  Offer a choice of 3 responses and ask for the correct one.   Or provide a possible answer and ask them if it’s correct.  This isn’t foolproof.  But it is a start toward providing your students the type of help they need.

 

 

 

 

Differential Diagnosis in Word Finding – part 2

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Word finding therapy should focus on the types of errors your client exhibits.  This is another in my series of 3 posts after listening to Dr. Diane German’s presentation at the Illinois Speech-Language-Hearing Association (ISHA) Convention on Saturday, Feb 14, “Picture Naming is Not Enough to Identify Semantic and Phonological Word-Finding Errors.”

Yep…Valentine’s Day in an ISHA seminar- how romantic.

You can read my post about Type 1 errors here: https://www.wordfindingforkids.com/differential-diagnosis-in-word-finding/   Dr. German calls Type 1 errors “slip of the tongue.”

Type 2 Errors are “tip of the tongue” errors.  These are the s-l-o-w retrievers.  These word finders experience a lot of delays and time fillers “…uh, um, it’s a…..uh, you know….”.   They may say things like “It starts with a t” or “Wait a minute, I know it”. They may not provide an answer at all.  They may use gestures that tell you they know the word for which they are searching (e.g., pounding to indicate “hammer”)  or secondary characteristics of frustration such as hitting their fist on their thigh, snapping their fingers,  or looking up to the ceiling.  These “tip of the tongue” errors are perhaps the most common word finding errors.

Children who experience Type 2 errors are more likely to err on less common words.  The words may be longer in length than Type 1 errors and may come from less dense phonological neighborhoods.  In other words, there aren’t a lot of words that sound similar to them.  In oral reading, their errors reflect the same patterns:  lower frequency words with less common phonological patterns.    Errors on irregular past tense verbs can be a red flag for Type 2 errors.  Another potential difficulty is labeling a category.

In conversational speech, these are the students who fail to provide pronoun referents.  They come home from school and tell their parents, “She took us there today.”  Who is “she”?   And where is “there?”.  They talk about “guys” and “thingies” and “stuff.” “Doohickies” and “whatchamacallits” are among their favorite terms.

Phonemic cues are highly effective for Type 2 word finders.  They often retrieve the word when their listener provides the beginning consonant+vowel  or first syllable of the word for which they are searching.  Dr. German explains that this “jump starts” the search process in the brain.

So how can we help a child learn to cue himself when he experiences these Type 2 errors?  Try to help him anticipate the vocabulary words he will need and provide phonemic cues for the more difficult words (described here:  https://www.wordfindingforkids.com/an-endorsement-from-the-word-finding-guru/   )  .  Errors of this type suggest that a child needs a stronger connection between the word’s meaning and its phonological representation.  So repeat, repeat, repeat!

But what about words he has not anticipated?  Some students help themselves by silently going through the alphabet and thinking of beginning sounds (NOT letters, but sounds).  Help him learn to use specific words so his listener can understand his intent.  If he makes a lot of gestures, help him realize that those gestures help provide a path to the word he needs. Practice automatic associations, categories, and common word associations.  Encourage him to repeat the word aloud once he “finds” it.

Please remember that retrieval is affected by frequency of use and recency of use.  Help a child plan ahead:  what words will he need?  Practice those words aloud!

Please go to Dr. German’s website http://wordfinding.com/ for more info.

 

Helping preschoolers with word finding difficulties

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Preschoolers with word retrieval difficulties are tricky.  We need to be sure theirs is not a deficit in vocabulary or a phonological disorder that makes them difficult to understand.  Sometimes I have worked with preschoolers in language therapy for a while before I realized their underlying difficulty was actually word finding.

Please read my posts of October 14, 20 and 21, 2014, about identifying word retrieval problems.  Some preschoolers do not respond well to formal testing, and it’s very important to look at their use of language in a natural environment.  One of the most helpful strategies for preschoolers is to offer a choice of 3 or 4 responses and ask them to choose the correct one:  “Are you telling me about your elbow, your shoulder, or your ankle?” or “Would you like the purple, the orange, or the yellow marker?”

Remember that a failure to respond does not necessarily mean the child does not know the answer.  Give him extra time, and provide advance warning if possible.   “I’ll ask you to tell me what your favorite project was yesterday.  You can share about making a snowman, drawing a caterpillar, or sharing a snack.  Be thinking about what you’d like to tell your friends.”

Encourage gestures and actions.

“Can you tell me another way?”

Establish a signal or a key phrase for the child to let you know he needs some more “thinking time.”

For some children, providing the beginning sound (not beginning letter) is helpful.  This is generally more helpful with older children, but some preschoolers are aided by this prompt.  I suspect it is related to their phonological development, but I truly don’t know.

Any activities you are currently using for language development are helpful for kids with word finding problems.  Develop vocabulary, categories, and associations among different words.  Expand their “safety net” of a rich language base. Most important, have fun!  A happy, engaged child is ready to learn.

 

 

 

Identifying Finding Difficulties – other test ideas

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I talked last week about the Test of Word Finding and Test of Word Finding in Discourse.  What other standardized tests can give us clues about a child’s word retrieval, or word finding?

When I administer the CELF (Pearson), I make a note to myself in the margin of the test booklet when I hear what could be a word retrieval difficulty. That information doesn’t go into the official scoring, but when I see a lot of “WF” “WF” “WF” notes, I raise my eyebrows.  “Word Classes” and “Formulated Sentences” are subtests that seem particularly sensitive to word finding issues.  I was sad to see the CELF-5 eliminate the expressive portion of “Word Classes,” because I have found many children with word finding difficulties have trouble pulling up labels for categories (such as musical instruments, tools, transportation).

The Word Test (Linguisystems, now owned by Pro Ed) asks for synonyms, antonyms, definitions, and flexible word use. All that information is helpful.   The “semantic absurdities” subtest, however, is the one that seems to stump some word finders.  Their circumlocutions and revisions don’t affect their official scores.  But the path they take to formulate their answers is sometimes revealing.

I mentioned in a previous post that some SLPs watch for a discrepancy between receptive and expressive vocabulary.  I totally agree with that strategy; I just don’t think it should be the sole determiner to qualify a child for therapy. But certainly consider a  receptive/expressive discrepancy as important.

I am also intrigued by Elizabeth Carrow-Woolfolk’s new Test of Expressive Language, or TEXL.  I haven’t used it yet, have you?  Reading about the test makes me think it would also give some clues about a child’s word finding abilities.  If you have experience with this test that you can share with my readers, please post a comment. I would like your ideas!

 

 

 

Identifying Word Finding Difficulties, Part 2

My husband and I spent the weekend with our almost 8 month old granddaughter in Washington, DC, and her parents.  Such fun!!   Observing a young child’s emerging language skills is like watching a miracle unfold.  It was fun to watch the intricate communication between her and her parents, both verbal and nonverbal.  Word finding was not high on my priority list, but language development certainly was!

There’s nothing like a new city to bring out word finding difficulties in the best of us!  Think of Emancipation Proclamation, Smithsonian Institution, and National Mall.  Of course you know what those things are, but you might be hard pressed to retrieve the words quickly on demand.  Word retrieval is primarily impacted by (1) recency of use and (2) frequency of use.  So when we’re in a different environment and retrieving words we haven’t needed for a while, even typical language users sometimes have more difficulty.

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The same thing happens with holiday vocabulary:  I explain to my students that even though they know what a wig, a skeleton, and a vampire are, they may need some hints to “refind” these words in their memories, because these words may have been tucked away since last Halloween.  Likewise, our students’ conversational speech may give us cues to their retrieval difficulties when we ask them to talk about topics they haven’t discussed recently.

This is good to remember when we are trying to elicit language samples.  We can learn a lot about a child’s articulation, vocabulary, and syntax by asking about a birthday party or his/her favorite sports team.  Those topics are not as likely to give us good information about word retrieval, however:   such topics may be highly rehearsed.   Instead, try asking about a movie they have seen or a book they are currently reading (“Oooh, what happened to Olaf?  Why?” or “What do you think will happen next?” ).  The trick is to get them to formulate some language they haven’t practiced recently.   Remember that a word retrieval difficulty is NOT the same as a vocabulary deficit:  I am talking about efficiently retrieving (“finding”) a word that is already in their receptive vocabulary. Try to avoid highly rehearsed or highly ritualized conversations.

What else affects retrieval?  Word finding is definitely impacted by stress.  Even hormones may play a role. And we all know that retrieval becomes more difficult as adults age (sigh).  This weekend was a reminder that when we are very tired (think young parents with a new baby) we may not retrieve words as readily as at other times.  Everyone experiences word finding difficulties sometimes. When we are identifying children with word finding challenges, we are looking for patterns.   We are watching for those red flags that make us wonder why they are having expressive language problems that aren’t explained by a vocabulary, syntax, or social language deficit (or temporary sleep deprivation).  Some “word finders” are very slow to come up with specific words, yet others name items very quickly but have to correct themselves.  And don’t forget to watch for those nonverbal secondary behaviors such as looking up to the ceiling, snapping fingers, or hitting one’s thigh with a clenched fist.  All these are clues that a child may benefit from word finding intervention.   Look beyond the standardized test scores:  Use your professional instincts.  Is the child frustrated in his or her attempts to explain a sequence of events clearly?  Is his classroom performance impacted?  Is his budding social life impacted?  Does he raise his hand to volunteer, only to say, “I forgot” or “nevermind”?

Again, on my references and materials page, I have posted observation checklists for both classroom teachers and for parents.  Those checklists provide some additional examples of behaviors to watch for.  Keep your eyes and ears open.   In my next post, I’ll suggest some  standardized tests that can provide more clues to identifying word finding, or word retrieval, difficulties.

 

 

 

Identifying Word Finding Difficulties

Hooray! The TWF-3 is now available! In my first post, I mentioned that I was postponing discussing “identification” of children with word finding difficulties until I had discussed “awareness.” The 3rd edition of the Test of Word Finding, by Dr. Diane German, is now available (published by Pro Ed; see below), and now is a good time to discuss how to identify children who need word finding intervention. I have to disclose that I have not yet administered the TWF-3; my experience up to this point has been with the TWF-2.

The TWF-3 is a valid and reliable test to identify children who experience word finding difficulties when naming individual words. The TWF-2 has definitely been my instrument of choice to administer when I suspect word retrieval difficulties. I can’t wait to use the TWF-3! Some SLPs also look at the discrepancy between receptive and expressive vocabulary scores. This can be tricky – you may not be actually comparing comprehension and retrieval of the same words.

In addition to the Word Finding Index derived from the Test of Word Finding, I think it is important to look at the informal information the test provides:

Phonemic Cueing: Is the child able to provide the correct response when you  provide the beginning sound or syllable? If so, he almost certainly has the               item in his lexicon. This is a big red flag telling you “I know that word, I just couldn’t get it out!” I frequently include a narrative in my evaluation                           reports describing the number of words that a child named correctly once he was provided with a cue.

Imitation: Is he able to repeat multi-syllable words once he hears you model  them? This is an easy way to distinguish children with retrieval                                     problems from children with motor-planning problems.

Delayed Response Procedure: How many words were correct, but delayed?  Some kids name words quickly, but make errors and self-corrections.  Others             are frequently very slow.

Secondary Characteristics Tally: What facial expressions or body language did the the child display that suggested he was having difficulty coming up                   with a  word? Did he look up to the ceiling? Did he make a fist and pound his thigh to get the word out? A perceptive SLP notices the differences                              between a child “stuck” retrieving a word vs. a disfluent child who is displaying secondary characteristics associated with stuttering.

 

All of these informal analyses can be applied to the child’s spontaneous speech. Listen to his or her expressive language. What do you hear and see when he is describing his visit to the library or his experience during his last soccer game? Does he seem frustrated trying to convey his experiences?  Does he use a lot of vague words (guys, stuff, things)? It is extremely important to remember that there are some children who experience word retrieval difficulties in their connected speech even if they don’t experience difficulties naming individual items. Please don’t discount “word finding” as an area of difficulty based on a child’s TWF score alone.

We can look at a child’s word finding in a more “connected speech” context by using The Test of Word Finding in Discourse. This test, also published by Pro Ed, is quick to administer but very time-consuming to analyze. I tend to use the non-standardized procedures described in the manual, and look at the child’s delays, self-corrections, and substitutions compared to typical children. To be honest, a busy school-based SLP has a difficult time spending the time required to transcribe and analyze the connected speech samples the TWF in Discourse requires.

I have found I get a great deal of information in a shorter time by using 2 observation checklists I developed. My starting point was Dr. German’s “Word Finding Referral Checklist,” published in 1993 by Word Finding Materials, Inc.. I adapted some items from the checklist, and tried to quantify responses by asking teachers and parents to label behaviors as occurring “often,” “sometimes,” or “rarely or never.”   I have kept data for several years, and am finding that the responses correlate fairly well with TWF-2 scores. They also identify some children who are experiencing word finding in their spontaneous speech (word finding in “discourse”) even if they are able to name individual words efficiently.

Maybe a more practical use of these checklists is AWARENESS. I have encountered parents who were totally unaware of their child’s word finding difficulties come to IEP meetings and say, “It never occurred to me that these things could be due to ‘word finding’”. I’ve also had teachers come back to me with the checklist and say, “these behaviors describe my student exactly.”   I feel like they open up a discussion about what the child is experiencing when he has trouble expressing himself. It is especially interesting to see how a teacher’s observations correlates (or doesn’t correlate) with a parent’s.

I have posted the “Classroom Teacher’s Observations of Word Finding Behaviors” and the “Parent’s Observations of Word Finding Behaviors” in the materials/resources page of this blog. Please feel free to use them. I would very much like your data if you do choose to use them. Eventually, I would love to develop norms for the responses. Let me know if you find them to be helpful.

Sources:

German, D. J. (2015). Test of Word Finding, Third Edition  (TWF-3). Austin, Texas: Pro-ed.

Observation checklists adapted from German, D.J. & German, A. E. (1993) Word Finding Referral Checklist (WFRC), Long Grove, IL: Word Finding Materials, Inc.