Despite agreement that dysnomia affects virtually every aphasic patient, there is no consensus about the purpose and effectiveness of techniques to treat it. Semantic feature analysis (SFA), a treatment technique designed to improve retrieval of conceptual information by accessing semantic networks, was used to treat aphasic dysnomia in a 57-year-old male who exhibited Broca's aphasia secondary to a left frontoparietal ischemic infarction. SFA was effective for improving confrontation naming and for generalized improvement to untreated pictures. However, no generalization to connected speech was seen on the measures of mean words per minute, mean correct information units per minute, or the percentage of all words that were correct information units.

A systematic review of studies that focused on the executive functions of problem solving, planning, organising and multitasking by adults with traumatic brain injury (TBI) was performed through 2004. Qualitative and quantitative methods were used to evaluate the 15 studies that met inclusion criteria. Demographic variables, design and intervention features, and impairment and activity/participation outcomes (ICF) (World Health Organization, 2001) were documented. Five randomised control treatment (RCT) studies used step-by-step, metacognitive strategy instruction (MSI) and outcomes were evaluated in a meta-analysis. Effect sizes (ESs) from immediate impairment outcomes after MSI and "control" intervention were similar to each other, and both were significantly larger than chance. ESs from immediate activity/participation outcomes after MSI were significantly larger than the ESs from control intervention, and both were significantly larger than chance. These results, along with positive outcomes from the other group, single-subject design and single case studies, provided sufficient evidence to make the clinical recommendation that MSI should be used with young to middle-aged adults with TBI, when improvement in everyday, functional problems is the goal (Level A) (American Academy of Neurology, 2004). Although maintenance effects were generally positive, there was insufficient data quantitatively to evaluate this. Furthermore, there was insufficient evidence to make clinical recommendations for children or older adults. Intervention that trained verbal reasoning and multi-tasking was promising, although the evidence is insufficient to make clinical recommendations at this time. Additional research needs were highlighted.

Semantic Feature Analysis (SFA) is a treatment technique designed to improve lexical retrieval by increasing the level of activation within a semantic network. The purpose of this study was to replicate the Boyle and Coelho (1995) study in which SFA was applied with a mild non-¯uent aphasic individual resulting in improved confrontation naming of trained and untrained items but no generalization to connected speech. The present study investigated whether a comparable treatment eåect could be demonstrated, and to what extent severity and type aphasia might impact overall outcome. SFA was applied to an individual with a moderate¯uent aphasia secondary to a closed head injury. Gains in confrontation naming of both trained and untrained stimulus pictures were noted as well as measures of connected speech. Potential explanations for these ®ndings are discussed.

Nonstandardized assessment procedures serve a variety of purposes, including determining competencies in domains for which there are no standardized tests, describing performance in the context of real-world settings and activities, and exploring the effects of systematic changes in communication and cognitive demands and partner supports. This article reviews evidence on the use of nonstandardized procedures for the assessment of individuals with traumatic brain injury and offers recommendations for the use of the procedures that are supported by the available evidence.

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