Word Finding Program by Daniel J. Carlson

1
Word Finding Program by Daniel J. Carlson

• Dawn Levy
• Carin White
• Candy Tsim
• Maggie Heller
• November 17th, 2004

2
Introduction

• Treatment program to improve word-finding ability
  in aphasic individuals
• Anomia is a common symptom in all types of
  aphasias.
• Can be administered by clinicians or
  caregivers/family members. No training is
  required. (instructions in manual)
• The purpose of the treatment is not to re-teach
  language, but to stimulate disrupted language
  processes during rehabilitation

3
Theoretical Basis/Rationale

• Basso et al. (1979)
• Automatic-voluntary dissociation
• A common symptom of aphasics is the inability to
  voluntarily produce an intended response.
• Stimuli of the treatment range to elicit
  responses from automatic to voluntary
  (automatic-voluntary dissociation)
• Schuell et al. (1964)
• Stimuli should be strong enough to elicit the
  desired response.
• Phonetic, semantic, gestural, and written cues
• Gradual withdrawal of support increases
  independence

4
Overview of Program

• Picture-object identification
• Black and white line drawings of objects
• Succession of cueing on back of cards includes
  phonological cues as well as semantic
  associations.
• Exercise 1 Name the pictures
• Cueing Hierarchy- E.g., Iron
• Phonemic cue (Press clothes with an i_____)
• Sentence completion (This is an _____)
• Function cue (What is used to press clothes?)
• Confrontation naming (Whats this?)

5

• Exercise 2 Name the function
• What do you do with this?
• Exercise 3 Name related words
• Tell me what this is. Tell me another word that
  is similar.
• Exercise 4 Use the words in a sentence
• Tell me what this is. Use the word in a
  sentence.
• Exercise 5 Communication of Ideas
• Client provides clues for clinician to guess word
  
• Function, description, attributes, synonyms,
  gesturing, and writing

6

• Sentence Completion
• Press clothes with an _____ (iron)
• Theme Yard work. Mow the _____ (lawn)
• The Phantom of the _____ (opera)
• Variety of questions
• What do you check out of a library? (book)
• Who delivers the newspaper? (any logical
  answer)
• Whats a wallet for? (any logical answer)

7

• Naming Opposites
• Correct and _____ (incorrect)
• Borrow and _____ (lend)
• Autumn and _____ (spring)
• Naming Similar Items
• Name 3 things you
• Read _____ _____ _____ (newspaper, magazine,
  book)
• Noun-Verb Association
• Name some things you can do with
• A ball _____ _____ _____ (throw, catch, roll)

8

• Category Naming
• Tell me what these are.
• Cow, Pig, Horse, Chicken _____ (animals)
• Naming Items within a Category
• Give me 3 examples of
• Colors _____ _____ _____
• Synonyms
• Tell me a word that means the same or almost the
  same.
• Autumn _____ (fall)
• Begin _____ (start)
• Hasty _____ (quick)

9
Efficacy

• There is no efficacy data confirming the
  effectiveness of Carlsons program.
• According to Froud (2004), the program is used by
  many clinicians despite no efficacy studies (i.e.
  Its just a feeling they have about it.)
• Evidence-based practice has been defined as a
  conscientious, explicit, and judicious use of
  current best evidence in making decisions about
  the care of individual patientsby integrating
  individual clinical expertise with the best
  available external clinical evidence from
  systematic research (Sackett et al., 1996).
• ASHA is a strong supporter of evidence-based
  practice

10
Potential Problems with Intervention Exercises

• Brocas aphasic
• Sentence completion exercise
• Functions/ categorization exercise
• Wernickes aphasic
• Fluent aphasic and phonemic paraphasias,
  neologisms
• Phonemic cueing ineffective
• Sentence completion. paragrammatic speech
• Fluent aphasic with semantic paraphasias
• Unable to discriminate target word within the
  semantic category
• Transcortical sensory aphasia
• acoustic-to-phonological conversion
• Conduction aphasia
• conduit dapproche

11
Our Opinion

• Positives
• Program is simple and straightforward
• Does not require training
• Logical sequence of cueing to help patient
  achieve more independent word finding
• Client feels a sense of accomplishment early on
  in treatment.
• Target items are common words to promote
  generalization

12
Our Opinion Cont.

• Negatives
• Lack of guidelines for progressing through
  program
• No clear indication for when to transition to
  next level. The decision is subjective.
• No specification of which activities are
  appropriate for different types of aphasia.
  Carlson categorizes aphasia as one general
  disorder.
• Pictures are not separated by visual complexity.
• Vision impairment could hinder performance
  throughout.
• Generalization is limited
• No recommendations for how to integrate
  strategies into real life experiences

13
References

• ASHA Web site EBP http//www.asha.org/member/s
  lp
• Basso, A. Vignolo, L. (1979). Influence of
  rehabilitation on language skills in aphasic
  patients. Archives of Neurology, 36, 190-196.
• Carlson, D. J. (1990). Word Finding A Language
  Rehabilitation Manual for Aphasic Adults (rev.
  ed.). Bisbee, AZ Imaginary International, Inc.
• Sackett, D. L., Rosenberg, W. M. C., Muir Gray,
  J. A., Haynes, R. B., Richardson, W. S. (1996).
  Evidence based medicine what it is and what it
  isn't. British Medical Journal, 312, 71-72.
• Schuell, H., Jenkins, J., Jimenez-Pabon, E.
  (1964). Aphasia in adults. New York, NY Harper
  Row.