Phonological therapy for word-finding difficulties: A re-evaluation

Using Phonemic Cueing of Spontaneous Naming to Predict Item Responsiveness to Therapy for Anomia in Aphasia

“…In other words, the elusive finding of generalized improvement in word retrieval skills, for example, as indicated by greater accuracy scores on treated and untreated sets of target words, has been the exception rather than the rule in published studies. 26 This has led to several studies in which the primary goal has been improved reliability of production for purposefully trained items, for example, usually vocabulary items, which are agreed to be communicatively relevant to an individual participant, 5,[27][28][29] where generalized improvement in word retrieval skills was taken to be a possible but not a probable therapy outcome. Such studies have negotiated target words for training on the basis of likely everyday use in conversation or general interaction; proper names of family members and friends are one example.…”

“…Participants hear a series of beeps at random time intervals (representing floors in a lift). They are asked to count the number of beeps (range, [3][4][5][6][7][8][9][10][11][12][13][14] as if they were listening to an elevator lift climbing to a specific floor and then specify at which floor the lift had arrived. A table of written numbers was provided to enable responses from participants with number-naming difficulties.…”

“…6 Responsiveness to cues in picture naming assessment might provide a positive prognostic indicator for treatment. 7 Hickin et al, 5 in a case-series study of 8 participants with aphasia undergoing naming therapy using phonologic and orthographic cues, found a significant correlation between the effect of cue facilitation and overall therapy outcome for the group as a whole. Referring to the initial degree of responsiveness to cueing as facilitation, participants were presented with the picture of an object representing a short word (consisting of a consonantvowel-consonant only, eg, pen) to name, and if unable to do so were given 1 of 3 types of cues.…”

“…4 Initially, treatment using semantic/word meaning cues (eg, word definitions, word-to-picture matching, semantic judgements, categorizing according to meaning) was thought to be more effective than treatment using phonologic/word sound cues. 5 However, the current consensus has been that the outcome of picture naming therapies based on semantic or phonologic cues are indistinguishable, given that word phonology is activated in semantic tasks and semantics is activated in phonologic tasks, especially given that the target picture will tend to activate the target semantics. 6 Responsiveness to cues in picture naming assessment might provide a positive prognostic indicator for treatment.…”

“…First, cueing has been used as a therapy technique, whereby repeated application can generate lasting improvements in later spontaneous naming. 5,7 Second, cueing has been used as an indicator of current levels of word knowledge in participants with aphasia, whereby words which can be cued are closer to their activation threshold for accurate naming than those which are not. 8,9 The present study combined both of these themes by investigating the process through which repeated and systematic cueing, as a therapy, improves word retrieval by tracing changes in response to cueing throughout therapy on a session-by-session basis.…”