Word Retrieval Difficulties

Almost all people have experienced a “tip of the tongue” moment when coming up with a
desired word was extremely difficult or maybe even impossible at the very moment the
word was needed. In the most classic sense, a word retrieval problem represents
temporary difficulty gaining access to and retrieving a known and understood word.
Word retrieval difficulties, also referred to as word finding difficulties or dysnomia,
occur not only in adults but also in children. When the frequency of the problem is more
than that of the occasional “tip of the tongue” moment, the ability to fully and coherently
express one’s thoughts can be diminished.

A child with word retrieval difficulties may display some of the following tendencies:
substitutions for a targeted word that may be similar in regards to word class or sound
structure (e.g. fruit for apple, water for juice, hammer for tool, pellet for pelican),
circumlocutions whereby the child “talks around the word,” descriptions of the target
word (e.g. “you eat soup with it” for spoon), use of time fillers (e.g. “um” and “well,
uh”), vague words or pronouns (e.g. stuff, thing), self-corrections (e.g. “ . . . a spoon . . I
mean a fork), the use of gestures to replace a target word or to supplement vague
language (e.g. the thing where you go like this [gesture]), and extra verbalizations (e.g.
“oh, I know that . . . hold on . . . it’s a . . .). These are some of the most common
characteristics seen with word retrieval difficulties.

These difficulties are thought to be associated with storage, retrieval, or a combination of
storage and retrieval of words. Difficulties with storage can be related to storage of the
word meaning or storage of the phonological representation (i.e. syllable and sound
structure) of the word. Likewise, difficulties with retrieval can be related to retrieval of
the word meaning or retrieval of the phonological representation of the word. Thus,
German (1994) delineates three basic groups of students who demonstrate word finding
errors: children who fit the classic definition of word retrieval difficulties due to
sufficiently stored knowledge of both word meaning and phonological representation of
words, yet they cannot access one or both of these components; children who have
difficulty storing word meanings or phonological representations in a sufficiently
comprehensive manner which may be linked to overall comprehension difficulties; and,
children who present with both storage and retrieval difficulties. The first group would
benefit the most from learning word retrieval strategies, the second group would likely
require work with underlying vocabulary and phonological deficits, and the third group
would need a combination of intervention techniques.

Several remediation strategies exist and choice of intervention techniques is based not
only on the subtype of the child as described above, but also on other characteristics such
as speed and accuracy of retrieval. For instance, a child who is a fast but inaccurate
retriever of words might receive instruction in reflective pausing techniques whereas a
child who is slow and inaccurate may receive more instruction in cueing strategies or
synonym substitutions. A comprehensive intervention program addresses not only
remediation techniques but also self-advocacy and compensatory modifications. For
example, a child must develop self-awareness of their vulnerabilities in order to advocate
for themselves (e.g. ask the teacher to provide the first sound in the targeted word when
called upon in class). Modifications must be made in the classroom (e.g. provide a word
bank for a fill-in-the-blank quiz or provide a multiple choice format instead) to
accommodate the difficulty so that a child has other opportunities to demonstrate their

Assessment of a child for word retrieval difficulties would include both formal and
informal assessment procedures. A child’s ability to retrieve words may be differentially
affected by the context of a task (e.g. can label a picture of an object without difficulty
but cannot retrieve the name of the object in conversation) and even by settings which a
child perceives to be more or less stressful. Observation of the child and caregiver and/or
teacher interview would supplement any standardized testing. Diagnosis of word
retrieval difficulties is typically made by a certified speech-language-pathologist or a
psychologist, neuropsychologist, or a neurologist as part of a more comprehensive exam.
Word retrieval difficulties can be extremely frustrating for a child as it can affect overall
expression of ideas, demonstration of their true knowledge, and even fluency of speech.
Learning word retrieval strategies and consistent practice in retrieving accurately and
efficiently can improve word retrieval abilities. Please contact a certified speechlanguage-pathologist
with any concerns regarding word retrieval skills or other areas of
speech and language abilities.