Are sound cues easier than meaning cues and can online assessments be used as a productivity tool?




Journal Title

Journal ISSN



Volume Title




Peer reviewed




• WHY THE STUDY WAS UNDERTAKEN This work was undertaken as part of an undergraduate programme of study. People with aphasia (PWA) experience word finding difficulties (WFD). Therapy may be provided to help PWA find words more easily (Royal College of Speech and Language Therapists, 2005). It is thought that the cueing hierarchy therapy technique (Rochford and Williams, 1962) may help PWA to access words more easily. Linebaugh and Lehner (1997) suggest that some cues are harder than others and that these cues should be used first, giving PWA the opportunity to access the word with little external help. Easier cues should then be presented in descending order of difficulty until PWA are able to find the word. Proponents of this therapy technique such as Thompson et al (2006), suggest that PWA are able to respond to sound cues more easily than they can respond to meaning based cues. This research project was designed to investigate whether people without aphasia have an inherent ability to use sound cues more readily than those based on meaning. A secondary objective was to assess the ease of designing and administering online assessments as an alternative to traditional methods.

• HOW THE STUDY WAS DONE 40 people agreed to participate in this research and were randomly allocated to either a meaning cue assessment condition or sound cue assessment condition. Software was developed to enable standardised assessments over the phone. Using the online application, volunteers were asked to name 107 images of low frequency words. 57 of these images were objects or living things and the remaining 50 were corporate logos. After saying the word, the volunteer was asked to press the space bar to enable the next image to appear. If the volunteer was unable to find a word, cues were provided. In the meaning condition, a highly associated word was provided as a cue and in the sound condition, the first sound of a word was provided. These cues were given to try and stimulate word finding. If the participant was entirely unable to access the word, they were asked to identify the target word from a choice of three written words.

• A SUMMARY OF MAIN RESULTS Results suggested that when participants were asked to find words for objects and living things, sound cues were more effective than meaning cues. Statistical analysis using Levene’s test of equivalence (p0.618) and subsequent t-test (p 0.00014) revealed a significant difference between the two conditions. This significant difference was not evident when participants were asked to name corporate logos. For this type of vocabulary, meaning cues showed a slight advantage over sound cues. Online assessments can have beneficial effects on the consistency of administration and shorten the time required to assess participants.

• IMPLICATIONS FOR FUTURE POLICY AND PRACTICE The results of this research suggest that cueing hierarchies are dependent, not only on the client, but also on the concept selected as the target for therapy. Low frequency words and abstract concepts do not respond to cueing in the same way as frequent and imageable words. This has implications for the way in which therapists provide cueing therapy for PWA. This project also provides support and direction for the use of technology in the assessment and remediation of word finding difficulties for people with aphasia.

• REFERENCES Linebaugh, C.W. and Lehner, L.H. (1997) Cueing hierarchies and word retrieval: A therapy program. In R.H. Brookshire (Ed.) Clinical Aphasiology Conference Proceedings. Minneapolis: BRK Publishers. Rochford, G. and Williams, M. (1962). Studies in the development and breakdown in the use of names. Journal of Neurology, Neurosurgery and Psychiatry, 25, 222-227. Royal College Of Speech And Language Therapists (2005) Clinical Guidelines. Bicester: Speechmark. Thompson, C.K., Kearns, K.P., Edmonds, L.A. (2006) An experimental analysis of acquisition, generalisation and maintenance of naming behaviour in a patient with anomia. Aphasiology, 20, 12, 1226-1244.


Conference presentation


aphasia, cueing, technology


Naylor, S. AND Bixley, M. (2014) Are sound cues easier than meaning cues and can online assessments be used as a productivity tool? British Aphasiology Therapy Symposium Book of Abstacts.


Research Institute

Institute for Allied Health Sciences Research