Aphasia Speech Therapy: Confrontation Naming Old School


The Teaching of Talkiing; a book for therapists, family members and caregivers by Mark A. Ittleman, M.S., CCC/

The Teaching of Talkiing;  by Mark A. Ittleman, M.S., CCC/

“Aphasia Speech Therapy Confrontation Naming Old School "What is this?" "Say Apple!" What is this? Say lettuce. (yawn)

Aphasia Speech Therapy Confrontation Naming Old School
“What is this?” “Say Apple!”
What is this? Say lettuce.

People with difficulty speaking typically do better in speaking tasks when engaged in interesting topics of conversation.

People with difficulty speaking typically do better in speaking tasks when engaged in interesting topics of conversation.








APHASIA SPEECH THERAPY:  Confrontation Naming Old School

Speech Therapy 


Mark A. Ittleman, M.S., CCC/SLP

Serving People with Difficulty Speaking for over 40 years

Aphasia Speech Therapy Confrontation Naming Old School?

Confrontational naming old school speech therapy is a term I coined.  In addition the person with the speaking difficulty repeats or “names” words that are often stimulated from flash cards. The words are practiced with printed words, pictures, or both.

Aphasia Speech Therapy Confrontation Naming Old School  does not have a positive connotation.  Within that term is a root word: to confront.  Being confronted does not conjure up positive thoughts. 

Being confronted is often unexpected. In addition it’s usually an uncomfortable experience.

What the dictionary says about ‘to confront’

The dictionary defines the word confront: to meet (someone) face to face with hostile or argumentative intent.  It’s like being blamed for something we did not do, or were incapable of doing.  Additionally, it’s not fun!

We’re taught the theory but rarely if ever the way to do the therapy

As a speech language pathology student, I could never get the gist of language therapy, because there was no expert there who knew how to do language therapy in a fun and easy way.  The majority of the professors would frequently tell us the therapy methods would be covered “later in the course,” but that rarely, if ever happened.  Therefore fun and easy methods of speech and language techniques for children who were not talking were never covered.  Likewise this “We’ll get to that later phenomenon” also occurred for the adult populations with aphasia.  .  .  We’re taught the theory, but the methods are often minimized or lacking.

What’s it like having to fend for yourself?

Therefore as a student I had to fend for myself.  I found empty boxes and filled them with bathroom items, and kitchen utensils, and found photographs of people doing things.  Specific picures of people in the professions, and food item were used.   I then went about taking large flash cards and asking the patient:  “Now what is this__________?  or What is that______?”  “Now say This is _______.”  (Makes me sleepy even thinking about it!)

It’s no fun having frustration whether you are a therapist or client/patient

Patients with aphasia and children who do not talk often have difficulty with confrontational naming tasks.   They frustrate therapists, caregivers, and anyone else in the process! Those wih aphasia or childhood speech and language delay often needs cues.  They often struggle since the the task is too difficult and they are not at an approiate level to do tasks of immediate or short term memory.  That process needs to be built slowly by a competent therapist who understands simple principles of speech and language stimulation.

Am I really doing this patient any good?

I would often scratch my head and wonder: “Am I really doing this person any good with confrontational therapy?”

It’s dissapointing to realize you’re not doing any good for the patient

Sadly, my clients were not talking any better!

There must be a better way!

(I figured there must be something out there that would be better than what I was doing!)

My observations of what other therapists were doing

Through the years I had the opportunity to watch other speech language pathologists do therapy.  It was surprising many had similar training, or lack of it.   I watched many of them do the confrontational naming tasks.  One can be very entrenched in a method without realizing that it has minimal efficacy in the real speaking world.

At last, Eureka!

With experience and great dissatisfaction with confrontational naming tasks and hand-out sheets I finally used (shhhhhh…don’t tell anyone) common sense  and fun techniques.

Realistically  I could stimulate speech and language while talking with the person, especially about interests (discourse), rather than boring and redundant tasks of identifying single word pictures that often had no functional use for normal, everyday conversation.

Trying to correct or improve speaking with confrontational techniques is just NOT FUN! (yawn) for anyone concerned! (It’s like doing oral motor exercises with no attention to speaking, or practicing the sounds of speech by themselves and not within words.)  Believe me I know!

Aphasia Speech Therapy Old School Confrontation Naming What the research shows us

There is some research that addresses the use of confrontational naming in the speech pathology literature.  There are some enlightened investigators who find that those with aphasia tend to speak more readily when they are spoken to in discourse (talking) in a way that stimulates interesting language that is at an appropriate level of difficulty.   The results are much more complimentary in comparison to those who are asked to do confrontational naming tasks.

My 2 cents worth

To me confrontational naming is not stimulating speech and language and has nothing to do with talking or discourse.  It is confrontational and typically sets up increased stress, anxiousness and frustration.  Not only that but it also has a tendency to set up “performance anxiety,” in people who cannot and should not be confronted to recall when they have not had enough opportunity for repetition of the word or phrase.  That is a very difficult task for those who have severe anomia and aphasia.

That’s how and why the Teaching of Talking was developed

The Teaching of Talking, an approach to speech and language stimulation is the result of over 40 years of my life’s work with children and adult neuro-patients and those who have difficulty speaking.  It is a relaxed and fun way to stimulate speech in discourse or conversation.  It gives the person with a speaking difficulty and their loved one or caregiver a better chance for speech recovery.  It’s simple and the work is done at the individuals’ level of speaking.   It can be at the single word level or longer.

Yeah……And so?

 If the person with the speaking difficulty can imitate or mimic words, phrases or sentences, they can be included in conversations with one or more people!

It is a way to get the person with the speaking difficulty talking, even if it is cued.  One can be comical, serious or fun-loving in the approach.

It is natural, and involves speaking, without the use of digital or augmentative devices.  It is a method, however which requires a loved one or caregiver, to provide the words necessary in the moment.  Request or answer to simple questions are stimulated.  The person with the speaking difficulty must be able to repeat or mimic a syllable, word or phrase.  With daily repetition in the context of the speaking situation, spontaneous speech and language have a better chance to re-emerge.  

How do I find out more?

To find out more about the Teaching of Talking, kindly go to our website at http://www.teachingoftalking.com or contact me to find out about our Free Talk Again Success Kit that answers the questions that so many caregivers parents and family members ask.

We answer the 3 questions that almost every caregiver asks.

  •  You will learn if your loved one or client is a good candidate for The Teaching of Talking,

  • You will find out what to expect when dealing with the subject of how rapidly will I see better results in speaking?

  • In addition we answer the question for caregivers:   “Can I really help my loved one whether adult or child with aphasia or sigificant speech and language difficulty talk better at home?

    I will also be providing a free gift called the Talk Again Success Kit that includes free videos documents you can download to start your own Kit.

Caregivers and therapists who are learning fun and easy ways to help people talk are becoming EMPOWERED.

If you would like to receive our Free Talk Again Success Kit please click here.  Or you can click on the kit icon which is on the right side of this page if you are on our website.  You will then receive a confirmation e mail that you will confirm in order to receive your kit.  

THE TALK AGAIN SUCCESS KIT WILL BE AVAILABLE after DECEMBER 27, 2016.  WE WILL E MAIL IT TO YOU THEN.  Please remember to click on the Icon for the Kit and join our community.

We also mentor people individually, should you wish to become proficient with the Teaching of Talking Method.

Mark A. Ittleman, M.S., CCC/SLP

Speech Language Pathologist-Author

Life Member American Speech Language and Hearing Association

Author and Developer of The Teaching of Talking Method and Systems

E Mail: markittleman@teachingoftalking.com

Website:  http://www.teachingoftalking.com









About Mark Ittleman

Mark Ittleman is a Senior Speech Language Pathologist and serves those with moderate to profound speaking difficulties. He consults with many of the best rehabilitation hospitals and now travels the country with his wife, and lectures at Universities, Hospitals, and Aphasia Organizations. He also consults with people all over the world with speaking difficulties and their families.
This entry was posted in Aphasia Speech Therapy, Apraxia Speech Therapy, Dysarthria Speech Therapy, Speech Therapy at Home, Stroke Rehabilitation, tot and tagged , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

Leave a Reply