Reconstructing Meaning: Approaches to Lexical-Semantic Therapy in Aphasia

Abstract

Word-finding difficulties are a hallmark of aphasia, often resulting from a breakdown in lexical-semantic processing. This disruption can make words difficult to retrieve due to issues with storage or accessibility. Impairments may occur at different levels of lexical processing—such as the lemma level, leading to verbal paraphasias, or at the phonological level, resulting in phonemic paraphasias. Cueing strategies are commonly employed to bridge these lexical-semantic gaps and support communication. Among the most widely used therapeutic approaches are Semantic Feature Analysis (SFA) and Phonological Components Analysis (PCA); however, these techniques are often applied without sufficient consideration of their appropriateness for individual profiles of impairment. The present study aimed to identify the locus of lexical-semantic breakdown in individuals with anomic aphasia and to determine the most effective therapy accordingly. Twelve participants with anomic aphasia were initially recruited. All underwent tasks involving phoneme judgment and semantic judgment to assess their specific language deficits. Two participants withdrew from the study. Of the remaining ten, four showed greater difficulty with phonological tasks (Group 1), and six with semantic tasks (Group 2). Group 1 received PCA-based therapy, while Group 2 received SFA-based training . Post-therapy assessments were conducted using the Boston Naming Test and the Action Naming Test. Results demonstrated significant improvement in naming performance and lexical retrieval accuracy in both groups, suggesting that therapy tailored to the underlying level of breakdown—semantic or phonological—can effectively enhance word retrieval in individuals with anomic aphasia.