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A cueing aid which turns letters to sounds to aid word retrieval
Background
Keyphone provides an evidence based intervention for use with adults with anomia as part of their aphasia and with children (age 6+) with word-finding difficulties which can occur as part of specific language impairment.
How to use Keyphone
How to use Keyphone items
Select a set of items on which the child or adult wishes to work. This may be for example, words required often, family members, words related to work or hobbies for adults or curriculum-based words for children.
At first the words should all begin with a limited set of initial sounds (e.g. 9). The words should be known to the person (e.g. in the child's receptive vocabulary). The number of items could vary between 10-50 depending on age, motivation etc. The idea is to cycle through these items in a set of treatment sessions. It is advisable not to select sets of items that are very close in meaning (e.g. lion and tiger) or in sound (e.g. transparent and transport) to work on at the same time.
Agree a picture to represent each item. In the case of verbs or adjectives this could involve discussion. In those with good comprehension a definition of the item may be used rather than a picture.
Step by step instructions for helping people produce target words using Keyphone
Once you have accessed keyphone on the web choose whether the person prefers upper or lower case letters. Drag the required set of letters so only these show. Ask the person to name the items (in response to pictures or definitions) one at a time.
Cueing Hierarchy
a) In the first 2 sessions ask the person to press the correct initial letter and listen to the cue (even if they know the item) before saying the word. This will familiarize them with the aid
b) If the person selects the wrong letter, limit the choice to 3 (the correct letter and 2 distractors)
c) If they are unable to name the item with 3 letters available, show them the correct letter to select
d) If they are still unable to produce the word, say it for them to repeat
In this way each target item is produced at least once per session. In subsequent sessions use the same cueing hierarchy but do not require use of keyphone for words that are returned without help.
Intervention may be developed by;
- Using different items
- Using items starting with a larger set of letters
- Using keyphone to cue word finding in connected speech
Research
The concept of keyphone was invented by Dr Carolyn Bruce who noticed that adults with aphasia could sometimes select the correct initial letter for a word they were trying to find and were helped by initial sound cues, but did not make the link between letter and sound (Bruce & Howard, 1987).
The approach was used with a further set of people with aphasia, resulting in improvement in naming x/y participants (Best et al., 1997; Best, 1997). More recently keyphone was used in therapy with children with word-finding difficulties. Word-finding improved and for some children there was evidence of generalization to connected speech (Best, 2005).
Register to use Keyphone
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Glossary
Aphasia: Difficulty with language processing, often after a stroke - may affect understanding, speaking, reading and writing.
Anomia: Difficulty finding specific words (often nouns and verbs). The majority of adults with aphasia have anomia as one of their symptoms.
Specific Language Impairment: A developmental difficulty with learning language in the context of...
Word-finding difficulties: A specific difficulty in retrieving words that are understood. This can happen to all of us from time-to-time (particularly when trying to retrieve names) but in some children it occurs frequently and impacts on conversation and education.