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.