From a SLT angle, I tend to look for patterns of listening and patterns of words that are less-easily recalled for speech (or writing). We see a learner who may recall a word, but gets stuck with it ‘on the tip of their tongue’, or who uses words from a semantic group interchangeably, or who says most words clearly but with a small group of them in a rather mumbled or blurred way. Perhaps the word wasn’t ‘specified’ clearly by the student when learned, so was not distinctive enough for recall: this could be due to perception of the sounds within the word, the sensations of making the sounds, or being sufficiently clear about the meaning of the word. So I look for patterns: is there a group of words affected? Nouns? Verbs? (you could go mad and look for verb types…or verb semantics…) Perhaps they are people’s names: OK, so what are the circumstances where the learner is told the (e.g. names) – there are loads of mnemonic strategies here to make the information richer.

Maybe the learner relies more than most on the social demands being low for them to grab new information: so meeting new people is a particularly demanding time for them, or learning in group discussion, or while in the middle of a shared activity. Or the reverse might be true. Maybe this learner benefits more than most from written support. Similarly, if the words are from one subject area, it’s possible that they are sitting in a noisy part of the class, or the subject-teacher tends to be particularly pacey, or there is a just a general need for more repetition for that learner with word-finding difficulties. Also, it’s possible that they ‘switch off’, anticipating failure with vocabulary learning in one or two subject-areas as a result of previous experiences, attributing their performance to the subject, rather than to a particular, less-helpful, way of presenting the material that they came across in the past, probably when teaching staff weren’t aware of their liability to
word-finding difficulties.

The other pattern I look for is what type of input makes the most difference to secure word-finding. I make a list of low-frequency words (looking for words new to them, so the list varies) and teach some with the emphasis on repetition, others emphasising written support, others heightening visual sense of the word, perhaps using a cartoon or diagram, others presenting the word in its different morphological forms, or its syllable structure, or its sounding closely (dangerously) similar to other words, others in several sentences, and some with attention to the physical making of the word in the mouth. Actually, it’s usually pretty obvious that some of these can be discounted straight away, and just home in on a couple of approaches.

Then note the words that can be recalled after a week or two, or even longer if you both have the endurance and time, and match to the input method. The learner then knows what they can most effectively do to learn words for recall. Is it 100% and done in the twinking of an eye – no. This is why 6 sessions of SLT turns out to be insufficient – but that’s another story. Of course, this sort of thing isn’t the exclusive domain of SLTs, either!

Other SLT approaches make use of the initial phoneme of the targeted word, or increasing use of gesture, or making more use of ‘thing’, ‘that thing you use to…’ or similar descriptions of function or distinguishing features. My experience is that students don’t like having to do these things, but actually do them in practice quite a lot, so may have benefited not so much from the suggestion as from its ‘endorsement’.

In adult dysphasia and aphasia, there are all sorts of patterns, some of them amazingly precise in the types of words affected…in a young person, word-finding difficulties will often signal a language disorder of some kind and it will clearly have an impact on learning and using language as well as participating in rich language activities. An adult might have a discrete ‘dysnomia’, though the terminology probably varies depending on the professionals involved and their clinical interests