Sometimes a person can understand certain words but have trouble thinking of and using the word themselves. A speech pathologist can help diagnose if a child has problems with this. They can then help a child in several ways, depending on how old the child is, how severe the problem is and any other problems the child may have.                 

What is it?

A 'word retrieval difficulty' or 'word finding problem' is when a person knows and understands a particular word, but has difficulty retrieving it and using it in their speech. This is similar to when we feel that a word (for example a name) is on the tip of our tongue. Children may not be able to find the word at all, they might retrieve a word that sounds similar to the one they want or they might produce nonsense words (neologisms) .

In the classroom, a child with a word finding problem may have difficulty expressing their knowledge. They may appear not to know the answers when asked questions that need retrieval of specific facts. For instance, they may have difficulty relating character or people's names, locations, dates or other specific facts. Their conversation may be brief or include word repetitions, substitutions, empty words, time fillers and delays.

For some people with an acquired brain injury, word retrieval difficulties can be a significant problem, making it very difficult to communicate clearly and competently. A child with an acquired brain injury will also have greater problems with finding the right word when they are tired or stressed.

Symptoms

A child may:

• have a good understanding of words but a poor expressive vocabulary
• talk around the word or explain the word they cannot find, for example 'You know, the thing I brush my hair with'
• use non-specific words such as thing, there, that one, him, stuff.  They may over-use general words, such as good, big
• over-use words such as um or ah
• substitute words with a close meaning, for example they might say spoon instead of fork. Or may use words that sound the same, for example they might say hair instead of share
• use obvious word searching behaviors such as using um a lot, for example 'ball, book, um, um, um bike'
• have lots of pauses in their speech and may take a long time to answer a question
• rarely use 'content' words. For example, instead of saying 'I got the book from her' they may say 'I got it from her'

Diagnosis

A speech pathologist can assess if a child has specific word retrieval or other difficulties with their language development.

Treatment

There are several ways to help a child with word finding difficulties. These generally depend on:

• how severe the problem is
• how old the child is
• if the child is very aware of the problem
• other underlying cognitive and communication disorders

A speech pathologist can recommend the best ways to help each individual child. Some general techniques are outlined below:

• support the child's efforts in everyday interactions
• provide help online as necessary
• encourage them to search for the specific word, rather than talk in a roundabout way and skirt around it
• encourage them to think of the sound the word starts with
• if they are unable to think of the sound, help their retrieval by offering the first sound in the word, for example 'b' for ball. Or offer the initial syllable for the word for example, 'bir' for bird
• give the child clues. For example, 'It looks like', 'It's used to do'
• encourage description of the object. For example, 'What does it look like?', 'What do we do with it?
• offer a gesture. For example, drinking movement for milk
• use a sentence completion strategy, for example, 'Grass is...'

Key points to remember

• A 'word retrieval difficulty' or 'word finding problem' is when a person knows and understands a particular word, but has difficulty retrieving it and using it in their speech.
• A speech pathologist can assess if a child has specific word retrieval difficulties or is possibly having other difficulties with their language development.
• There are several ways to help, depending on the age of the child and how severe the problem is.

For more information

• The Royal Children's Hospital
  Paediatric Rehabilitation Service
  T: (03) 9345 9300
  E: rehab.service@rch.org.au
• The Children's Hospital at Westmead Brain injury Service
• Kids Health Info series of fact sheets listed under 'Brain injury'

Developed by The Royal Children's Hospital Paediatric Rehabilitation Service based on information from the Brain Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH consumers and carers.

Reviewed September 2020.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.