LANGUAGE IN INDIA

Strength for Today and Bright Hope for Tomorrow

Volume 11 : 9 September 2011
ISSN 1930-2940

Managing Editor: M. S. Thirumalai, Ph.D.
Editors: B. Mallikarjun, Ph.D.
         Sam Mohanlal, Ph.D.
         B. A. Sharada, Ph.D.
         A. R. Fatihi, Ph.D.
         Lakhan Gusain, Ph.D.
         Jennifer Marie Bayer, Ph.D.
         S. M. Ravichandran, Ph.D.
         G. Baskaran, Ph.D.
         L. Ramamoorthy, Ph.D.

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Cueing Hierarchy as an Effective Treatment Approach in the Treatment of Anomic Aphasia

Sudhin Karuppali, M.Sc. (SLP), Buddhima Samaraweera, M.Sc. (SLP), B. S. Premalatha, MASLP, Ph.D.

Introduction

One of the most common devastating features of aphasia is impairment in the ability to retrieve words (Davis, 2000), whether it involves naming seen objects, or producing nouns, verbs and other words conveying meaning in spontaneous propositional speech (Goodglass, 1993). The clinical literature comprises of many reports of therapeutic approaches which have successfully been employed in reducing the word retrieval difficulties of aphasic patients (Keenan, 1966; Croskey and Adams, 1969), as well as reports of strategies which these patients employ spontaneously in their efforts to retrieve a desired word (Marshall, 1976).

One of the principles that formed the foundation of the development of the word-retrieval program follows the notion that, the elicitation of a response is a major concept of aphasia rehabilitation. This suggests the fact that by eliciting the desired response with minimal cue helps in the recovery process. Hence to achieve utmost benefit from stimulus presentation, the patients are expected to retrieve the desired word with minimum external facilitation than required; leading to the concept of “stimulus power” (Bollinger and Stout, 1976). During the development of the research reported here, cues were drawn from different communication areas such as gestural, phonologic, semantic, orthographic - and were hierarchically arranged according to stimulus power. Various factors were considered before the implementation of the stimulus power – number of repetitions of the cue, number of input modalities, contextual constraints, and the form in which they were provided (descriptive statement; sentence completion; closed-end questions, etc.).

However, the stimulus power varies with respect to each individual patient; hence the cueing hierarchy that is appropriate for one patient may not be appropriate for another. Thus it is essential that the stimulus power for a wide variety of cues be assessed for each patient, and subsequently a cueing hierarchy be individually structured.

Importance and Relevance of Cuing

Rosenbek, LaPointe and Wertz (1989) consider cueing to be the heart of aphasia treatment. According to them, the cue which has the lowest stimulus power should be presented first, followed by increasingly powerful cues until the desired response is elicited. Hence the objective is to elicit the desired response with the least powerful cue. A study conducted by Wiegel-Crump & Koenigsknecht (1973) used cueing as a primary treatment approach for word retrieval problem and concluded that the naming deficit exhibited by their patients was indicative of an access problem or an underling loss of efficiency in retrieval words from the lexical store.

This is only the beginning part of the article. PLEASE CLICK HERE TO READ THE ARTICLE IN PRINTER-FRIENDLY VERSION.

Sudhin Karuppali, M.Sc (Speech Language Pathology)
Corresponding Author
Lecturer
Department of Audiology & Speech Language Pathology
Kasturba Medical College
Manipal University
Mangalore – 575 001
Karnataka, India
sudhin.karuppali@manipal.edu

Buddhima Prasangika Samaraweera, M.Sc (Speech Language Pathology)
Senior Speech Language Pathologist
Ratmalana Audiology Centre
Galle Road
Ratmalana
Sri Lanka
buddhima09@gmail.com

B. S. Premalatha, Ph.D. Speech and Hearing
Professor & HOD of Speech Language Pathology
Dr. S. R. Chandrasekhar Institute of Speech and Hearing
Bangalore – 560084
Karnataka, India
dr_premalatha@rediffmail.com
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