When the Words Are On the ‘Tip of Your Tongue’

This post was written by Maria Crotty Palumbo, MA, CCC-SLP, a speech pathologist at Abington-Jefferson Health. May is Stroke Month.  A sudden onset of word-finding problems, especially when accompanied by other symptoms of stroke, such as slurred speech, headache, muscle weakness, trouble walking, seeing or swallowing is a medical emergency and requires immediate medical attention.

“The words just collapsed around me.” He stared at me intently, bright blue eyes wide with confusion, as he tried to describe how, for a few long minutes just the night before, he had been unable to find any words at all.  Long-familiar words, words that he has taken for granted, that he has used, effortlessly, since before he could remember, were just gone, all at once, and in an instant.  He described his fear at not being able to communicate, to tell anyone what was happening. He was one of the lucky ones, though: the words came back quickly, and on their own.

Word-Finding: It is the ability to call to mind, automatically, seamlessly and with lightning speed, exactly the right words to express all of our infinite thoughts.  It is an amazing, universal, but not fully-understood process.  It is taken for granted; until of course, it doesn’t work. And it doesn’t work all the time, even in the best of circumstances.  That feeling that there is a word, just beyond grasp, on the “tip of the tongue,” is an example of an error in word-finding.  For most people, it is an annoying, but once-in-a-while, not-terribly-disruptive glitch in the system.  But for some people, especially those who have had a stroke, it is a constant problem. And it can be debilitating.

I’d heard his story before; I hear similar stories almost every day.  As a speech pathologist at Abington-Jefferson Health, I evaluate the language skills of people of all ages, and with a wide range of diagnoses.  Diagnoses such as stroke, post-concussion syndrome, multiple sclerosis, primary progressive aphasia and dementia can all affect a person’s ability to find the right words.  Word-finding is a skill that can be delayed in children, causing them just as much frustration as it causes in adults.  Evaluation includes not just identifying the source of the problem, if possible, but also the severity level. The last part of the evaluation process is determining what to do about it.

There is help. After the evaluation, the patient and speech pathologist will have enough information to devise a treatment program. Treatment can involve using evidence-based therapy programs to strengthen the word-finding “muscles.”  It can also include teaching compensatory strategies, devised to help someone get the point across, even if the words don’t come.  For the most severe cases of word-finding problems, there are high-tech solutions: electronic devices that can help to find, and even to speak, the missing words.

If you are experiencing word-finding problems, or if someone you love is, call 1-800-JEFF-NOW to appointment with a Jefferson physician who can refer you to the appropriate professional, including a speech pathologist.

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