Cueing hierarchies and word retrieval: A therapy program

Background: Lexical retrieval impairments are pervasive among persons with aphasia, and a great deal of effort has been expended to develop effective treatments for these impairments. Aims: The purpose of this study was to develop a new treatment approach in which cues of increasing stimulus power were presented sequentially, contingent upon participant responses and to provide preliminary evidence regarding the effectiveness of the cueing hierarchy approach. Methods & Procedures: Five single-subject experiments were conducted in which persons with a significant lexical retrieval impairment participated in a treatment regimen involving the systematic use of a cueing hierarchy comprised of both semantic and phonological cues. Participants' performances were measured on both trained and untrained stimuli. Outcomes & Results: Four of the five participants achieved improved naming performance on trained stimuli and three also showed generalization to untrained stimuli. Conclusions: Although the interpretation of the results is limited by what are now recognized as significant flaws in the experimental design, the results were sufficiently robust and promising to provoke many other investigators to examine the effectiveness of the cueing hierarchy approach. Through the efforts of these investigators, cueing hierarchies employing a variety of cues have been demonstrated to be an effective intervention for a number of different aphasic lexical retrieval impairments.