I recently shared a post outlining tips to manage difficulty with attention, in which I enumerated the many domains of cognitive-communication SLPs address when working with the adult neurogenic population. Word finding difficulty is one such domain, and is a common complaint of many who have suffered a stroke or brain injury. Word finding difficulty is a hallmark symptom of aphasia, which the National Aphasia Association defines as “an impairment of language, affecting the production or comprehension of speech and the ability to read or write”. Though aphasia can impact all domains of language, today we are addressing word finding.
Impairments with word finding can range in severity from mild (think “tip of the tongue” phenomenon) to severe (unable to produce any meaningful words). Just as we would take both restorative and compensatory approaches to difficulty with attention (as detailed in my previous post), treatment of word finding difficulty follows a similar trajectory. Katherine and I use many evidenced-based approaches to improve verbal expression, and while doing so, we work concurrently on teaching compensatory strategies to manage the client’s present difficulty.
While all treatment should be designed to meet the individual needs of each client, here are some general strategies to assist with word finding difficulty:
- Breathe. Not being able to express yourself clearly and efficiently can be unimaginably frustrating. As you become more frustrated while trying to think of words, your body tenses up, and oftentimes you start holding your breath without even realizing it. Taking a full breath in and releasing it helps to reset your body and mind and helps keep the oxygen flowing. Developing a mindfulness practice can help build your awareness of your breath, and improve your ability to tap into it when you are struggling to express yourself.
- Stop and start again. When stuck thinking about the word you want to say, the tendency is to keep pushing until you get there. However, our brain doesn’t respond well to force. I often use the analogy of running up against a wall – no matter how hard you push, you can’t break through that wall. Instead, stop, take a breath and start again more slowly. These steps help you to get some space from the wall and find a path around it.
- Describe it. Our natural response when we can’t think of a word is to continue thinking, all the while saying things like, “Oh what is the word….hmmm….I can’t think of it”. What can be more helpful is to talk around the key word, which is also known as circumlocution. As a simple example, if the word you are looking for is apple, you could say, “It’s a fruit…it’s red or green… you can bake a pie with it”. These phrases provide your brain with clues that can act as stepping stones for you to get to that word. Even if you are still stuck, chances are your communication partner will know what you mean and be able to help provide the word and keep the communication moving.
- Use a synonym. Substituting a different word for the one that escapes you is a simple and direct method to get your point across. Examples include “couch” instead of “sofa” and “dish” instead of “plate”.
- Gesture. Non-verbal communication can go a long way to convey meaning. Try to think of a simple gesture to communicate your idea. Luckily there are many gestures that are universally known!
Next time you find yourself stuck searching for a word, try one of the strategies outlined above. If you’d like to learn more about speech therapy services for word finding difficulty, please reach out.