I often wonder how it is that our guy looses words. He talks about the "toast making machine" for "toaster" and even "the car driving place" for "road." Today his band-new SLP pointed to a picture and asked what it was.
"A cloth" he said.
"And do you see one of those in my office?"
"And what is it called."
"A window cloth. ... A curtain."
It makes me wonder. It's a word we use at home all the time, as it's his job to open and close the curtains. The SLP's first question was astute, because it showed her whether he knew the concept of curtain. By identifying another object it the same class, he showed that he did. His second answer, "window cloth" also shows that he knows what defines it. His third answer of "curtain" shows that the word was in fact stored in memory. But for some reason it was unaccessible for production as speech (it have no idea whether or not it would have been accessible if the conversation had been happening in text).
We ended up not choosing the SLP who was into Michelle Garcia Winner, but that was not because of my opinion of MGW's attitude. The thing that made us want to work with the second SLP that we interviewed was her use of the techniques of Naci Bell and Reuven Feuerstein, neither of whom I had heard of before. They both start from the idea that processing can be made more flexible and successful by a combination of cognitive training and learned meta-cognitive habits. It's an interesting idea. I have no idea whether it will work for our guy, but the literature shows that it does sometimes appear to work, which is about the highest acclaim that can be given to any form of therapy for communicative speech to date. It certainly can't be much less effective than all the speech therapy he has had in the past.
The new SLP's idea is to teach him to use his visual processing for language processing tasks. If I understand her correctly, her tests showed that our guy has more visual processing capacity than auditory processing capacity (no big surprise there), so she will attempt to rewire his brain to use some of that left-over visual processing capacity to supplement auditory processing tasks. It's ambitious, but there is plenty of evidence that the brain is quite happy to remap resources -- consider the gains in one sense when another sense is lost. It will be months before we have any inkling as to whether it is useful, but the guy enjoyed today's session and it feels good to be doing something .