A Case Study in Discourse-Based Intervention for Word-Finding Abilities

Abstract

Research indicates that while traditional word finding (WF) therapy techniques such as semantic and phonemic cueing are seen to have some benefits in reducing overt word finding behaviours (OWFB), particularly in isolated and structured communication situations, they do not facilitate the generalisation of skills learned to online communication. This lack of carryover highlights the need for a more naturalistic, dynamic and flexible therapeutic approach to WF. The aim of this study was to evaluate a discourse based intervention approach in reducing OWFBs in a young girl, called LL. A single case study design was conducted involving an 11-year old girl diagnosed with Specific Speech and Language Impairment (SSLI, which was characterised by word finding difficulties (WFDs). The study involved (i) identifying LL’s OWFBs through qualitative analysis of speech samples gained during assessment (ii) providing a discourse-based intervention focusing on picture elicited narrative, story retelling and inferencing activities (iii) evaluating the impact of the intervention on the OWFB profile through assessment at three points during intervention (time A1–pre-therapy, time B- post-therapy, time A2 – 4 month interval post therapy). Results showed that the number of OWFBs decreased from time A1 to time B. Inferencing skills were seen to develop but did not generalise to the unsupported context of retelling stories. A shift was seen in the OWFB profile from time A1 to time A2. It is concluded that a broader approach to WFDs through a discourse-based intervention facilitated word finding in the short term. This single case study highlighted LL’s need for a longer more intensive episode of intervention with a gradual decrease in visual and linguistic supports to allow for generalisation. Further research needs to address whether such intervention can be generalised to other children with varying profiles of SSLI and associated word finding difficulties.