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Differential Diagnosis in Word Finding

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I spent the last 3 days at the Illinois Speech-Language-Hearing Association convention, and attended some energizing sessions. The most relevant to this blog was Dr. Diane German’s presentation entitled, “Word Finding: Picture Naming is Not Enough to Identify Semantic and Phonological Word-Finding Errors.”  Dr. German’s passion for the study of word finding is contagious.  I left there determined to be more precise in my therapy for my word finders.

Dr. German stressed how important it is to match our goals with specific error patterns. I admit to getting lazy sometimes in my therapy with word retrieval clients:  I start to treat them all with the same strategies.  So for the next 3 posts, I’m going to write about the differences among 3 types of word finders.  Each type will benefit from different interventions.  We have to start with the assumption that the “evasive word” is one that is in the child’s repertoire:  given the word, he knows its meaning.  That is why his difficulties are word retrieval, not vocabulary.

“Type 1” word finders fit the error pattern that Dr. German calls “slip of the tongue.”  Error pattern 1 are kids who make semantic, lemma-related errors.  What is a “lemma-related error”?  This is a disruption in accessing the semantic features of a word.  How do we recognize these kids?  These are the kids who are fast but inaccurate.  They make a lot of revisions and substitutions of words that are in the same category or somehow related to the target word.  They may say “basketball, I mean baseball,” or  “I want a hammer, I mean a nail.”  We typically do not see secondary characteristics in these children (eyes to the corner of the room, fist to the thigh, palm hitting one’s forehead in frustration).

The errors we find with  Type 1 more often occur on frequently occurring words. They are more typically familiar and shorter words and occur in “dense neighborhoods.”  Dense neighborhoods are groups of words that are phonologically similar (red, bed, head or head, hid, had). These kids sometimes make mistakes retrieving compound words.   When they read aloud, they make errors in familiar words.  So when they see “dog,” they may say “puppy.”  Obviously, they read the word correctly if they substituted “puppy” for “dog.”  It was an error in retrieval, not a reading error.

Type 1 word finders might regularize irregular verbs:  he runded, she eated.  In naming categories, they might name examplars within the category instead of giving the category name (instead of “vegetable,” he might name “broccoli”).  They realize they were inaccurate, and correct themselves (“broccoli, I mean vegetable.” ).  The reason for this is that the words are competing within the child’s lexical system.  He names a word quickly and immediately recognizes his error.

These students benefit from slowing down.  Some of the strategies I use for children who stutter are effective with these rapid, inaccurate namers:  model a calm, steady pace and allow a slight pause before responding.   I play games in which the children must pause before responding in order to advance on a game board.  I remind them that it is more important to be accurate than to be fast.  I remind them to use “thinking time” to check their own answers.

That’s my understanding of “type 1” word finding errors.  Any mistakes are my own, and not due to Dr. German’s presentation! Please go to her website http://wordfinding.com/ for more info.

 

 

 

Last Chance for Valentine’s Day Word Retrieval Cues!

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Last chance to review word finding cues for Valentine’s Day!

cupid    – “cute/stupid”   This little guy is cute but stupid.  I have found some parents teach their kids that “stupid” is a naughty

word, so be careful with this one.

florist –  “flowers on the floor”

valentine –  the kids don’t need a cue for this word, but I like to teach them “tiny tines” on a fork because so many of them say

“valentime”.

exchange – a big X on a pile of change.  I like to use real coins and have the kids draw a big paper X to cover them.

Hopefully, you reinforced Valentine’s Day vocabulary a couple of weeks ago.  Remember to present the cues BEFORE your students need them!

Heading for ISHA

This is the week of the Illinois Speech-Language-Hearing Association (ISHA) convention.  I’m looking forward to hearing about new ideas in speech pathology and reconnecting with colleagues.   I am especially interested in a study that examined the impact on naming ability (i.e., word retrieval)  of a computer-assisted treatment advertised to increased executive function skills and Dr. Diane German’s “Picture Naming is not Enough…”

I hope to come back energized and ready to share ideas!   Be sure to visit wordfindingforkids Facebook page for easy access to old posts.  More importantly, email me  or comment on a post and share your ideas!

 

Word finding or reading difficulty?

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How can you distinguish between a child with a word retrieval problem and a child who has a reading difficulty? You hear a child reading orally.  He makes repeated errors and substitutions.  But is he truly experiencing difficulty decoding the words or is he experiencing word finding difficulties?

The quick and dirty way to differentiate the two difficulties is to ask the child to “show me the word,” or “underline the answer.” If you ask the child to “tell me” or “read it to me,” his errors could be rooted in a retrieval problem.  The difference was highlighted in a 2008 article published in Advanceweb.com, volume 18, issue 2, page 6.  In the article, Dr. Diane German of National-Louis University and Dr. Rochelle Newman of the University of Maryland warned that  children with oral language difficulties are sometimes misplaced into remedial reading classrooms because oral reading tests “misread” children with word-finding difficulties.  The researchers suggested using silent reading tests instead of oral ones.  A discrepancy between oral reading scores and silent reading scores is the first indication  that a weakness is in retrieval, not in decoding.

So what can we do as SLPs to identify these kids?  Encourage silent reading tasks to follow up oral reading tests.  Ask a child to “show me where the answer is,”  “underline the correct word” or “circle the letter that makes the /b/ sound.”

A second characteristic of  children with word finding problems is that their reading errors are frequently on words that have common phonological patterns.  This is similar to the difficulties they have in oral language.  As SLPs, we can have a significant impact on children by making sure their identification and treatment is targeted to their true needs. Collaborate with teachers and reading specialists – share your expertise!

 

Word retrieval dialog for building a snowman

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With the massive snows that are covering much of the country, this is a good time to republish the dialog I wrote to increase awareness of word finding difficulties:

Word Finding Dialog – Snowman

There are more dialogs on my resources and materials page: https://www.wordfindingforkids.com/resources-and-materials/

Let’s hope we don’t need to use these words for much longer!

 

 

 

 

ASHA Leader cites wordfindingforkids.com!

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I was very excited to see the February, 2015 ASHA Leader!  On page 18, the Blogjam page cites my post of December 11.  Search for bit.ly/tip-tongue.  On a blizzardy Monday morning, with 19″ of snow piling up in the Chicago area, this was a ray of sunshine.  Please subscribe to these posts, and like wordfindingforkids on Facebook.  On Twitter, I am @wordfinding4kdz.  You can always email me with your ideas: jan@wordfindingforkids.com.  I would love to hear from you!

 

Word retrieval cues for Valentine’s Day

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Remember to teach word retrieval cues before your students need them!  How about these to get you

started?

cupid    – “cute/stupid”   This little guy is cute but stupid.  I have found some parents teach their kids that “stupid” is a naughty

word, so be careful with this one.

florist –  “flowers on the floor”

valentine –  the kids don’t need a cue for this word, but I like to teach them “tiny tines” on a fork because so many of them say

“valentime”.

exchange – a big X on a pile of change.  I like to use real coins and have the kids draw a big paper X to cover them.

Don’t forget to check in with your teachers for current curriculum words. Refer to these pages for more ideas:

K-2

3-5

Middle School

High School

Or go to the list of mnemonic cues on the header at the top of this page, arranged by grade level. Happy

Valentine’s Day a bit early!

 

 

 

 

Word Finding Activities for Preschoolers

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Please send me your favorite preschool activity that can be used for word retrieval!  Preschool classrooms are rich with language activities that can reinforce word finding.  Please “comment” or email me with your go-to for expressive language.

We all modify games to suit our goals.  To avoid confusion, I tell the kids that these are “Mrs. Schwanke’s rules” for the speech room; sometimes the rules are different than published.  It’s also important to explain to parents how the game has been modified.

The most important guideline is to say the target words aloud.  Repeat, repeat, repeat!  Make it fun.  I sometimes roll a die to dictate how many times a word must be produced.   Here are some of my favorites:

Richard Scarry’s Busy, Busy Airport

Richard Scarry’s Busytown Eye Found It

Fisher-Price and Playskool toys

The Cat in the Hat “I Can Do That” game

Peaceable Kingdom – Count Your Chickens

Lotto, matching , categorizing of almost any kind

Make the most of trends:   Olaf, Disney Princesses (Frozen is HOT)

What do you use with preschoolers?  Please share!

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.

 

 

 

Focus on LANGUAGE in kindergarten and pre-K

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Should we really worry about reading in kindergarten and pre-K?  I feel so strongly that we need to focus on language at that level…and on social communication skills.  The Alliance for Childhood and Defending the Early Years put out a marvelous call for action that we all should read.  Please refer to. https://deyproject.files.wordpress.com/2015/01/readinginkindergarten_online-1.pdf

Remember Robert Fulghum’s  “all I needed to know I learned in kindergarten”?

1. Share everything.
2. Play fair.
3. Don’t hit people.
4. Put thngs back where you found them.
5. CLEAN UP YOUR OWN MESS…. and so on. If you don’t remember this, you should read the whole list.

Robert Fulghum, All I Really Need to Know I Learned in Kindergarten

Should we really worry about reading about farms and animals and plants and trees when many children have not experienced these things first hand or have the vocabulary with which to express these concepts?

Play-based education is support by years of research.  The Common Core State Standards (CCSS) were developed with no appreciation of developmental readiness. In fact, I was shocked to learn that there were NO early-childhood professionals or K-3 teachers on the committee that developed the CCSS. In preschool and in kindergarten, we need to focus on developing ORAL language as a pre-cursor for written language.  The article also tells us that by the end of third grade, early readers have no advantage over later readers.

In fact, teaching reading too early can result in stress and in dis-engagement from learning. “When children have educational experiences that are not geared to their developmental level or in tune with their learning needs and cultures, it can cause them great harm, including feelings of inadequacy, anxiety and confusion.”

Push back!  Advocate for age-appropriate learning experiences.  I would love to hear from reading professionals about this.  My bias is language development.  Please share your opinion and your expertise!