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.

 

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