Contrasting treatments for severe impairments of picture naming

Abstract

Little is known about the treatment of object naming impairments in patients with multiple loci of deficit in the cognitive processes underlying picture naming. We evaluated the outcome of naming treatment in two such patients. We developed two treatments on the basis of a cognitive neuropsychological assessment of naming and contrasted their effectiveness with that of simple verbal rehearsal. In Treatment Programme 1, we targeted presumed impairment at the level of lexical retrieval by attempting to train subjects to use a phonological cueing hierarchy during a name to auditory definition task. In Treatment Programme 2, we targeted presumed impairment of visual-semantic processing by attempting to train subjects to use a visual-semantic cueing hierarchy during an oral picture naming task. Treatment Programme 3 was designed to determine if improvement in oral naming could result from simple rehearsal. All three treatment programmes improved naming abilities of the two subjects to some degree, particularly Treatment Programmes 1 and 2. We discuss various factors that may have contributed to these results. Although this report does not conclusively demonstrate efficacy of naming treatment in subjects with inordinate picture naming impairment due to multiple loci of disruption within the naming process, it suggests that cognitive processes implicated in this disorder are sensitive to these interventions.