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.