The remediation of word-finding impairments in aphasia

mpairments of word-retrieval and production are a common and distressing feature of aphasia, and much clinical time is devoted to attempts at their remediation. There are now many research papers devoted to case studies examining treatments for word retrieval impairments using a wide range of tasks with individuals with varying levels of impairment. This paper will derive and discuss several main themes from the literature, these will include the contrasts between strategic approaches and facilitative or repair approaches to remediation, semantic and phonological tasks in therapy, generalisation in therapy tasks and the relationship between impairment, therapy task and outcome. Further discussion will be made regarding the relationship between impairment level treatments and measures of disability and handicap, and between therapy research and therapy practice. The paper concludes that there can be no doubt that therapy for word retrieval impairments can be highly successful, resulting in long term improvements which can be of great communicative significance for the individual with aphasia. However, predicting the precise result of a specific treatment task with a specific individual with certainty is still not possible. For clinicians the recommendation is to use analyses of functional impairments to guide the choice of task, but to ensure that efficacy is tested and not assumed. Furthermore, structured multi-modal and multicomponent tasks (e.g., “semantic” or “phonological” cueing hierarchies) may hold the most promise for many individuals. For researchers, there remains a need to further dissect tasks, impairments and their interactions across series of single cases.