Stuck trying to retrieve a word? Try drawing it!

Remember all those years you spent honing your drawing skills so you could beat your folks at Pictionary? Turns out that may just be handy when you or your client with aphasia are stuck trying to get a word out.

This study by Hung & Ostergren suggests that if you’re working with persons with aphasia (PWA) on naming, you may see more success if they draw the item instead of write it.

In the study, 15 PWA, ranging in age from 44 to 81 years, were given the same set of 30 black and white pictured items to name on three different days under three different conditions:

  • naming the picture without strategies (confrontation naming; CN)  

  • naming the picture with a drawing strategy (DN)

  • naming the picture with a writing strategy (WN)

The authors found that regardless of the type of aphasia, the quality of the drawing, or one’s ability to recognize the item, a PWA was more likely to name an item when they were drawing its image versus writing its name. So even a participant with non-fluent aphasia produced target words more accurately when they were drawing it.

But there are some caveats: Not surprisingly, the authors found that the severity of aphasia affected one’s ability to name an item. Compared to persons with mild aphasia, persons with moderate or severe aphasia were more likely to benefit from this strategy of drawing as a facilitative technique for retrieving a word. For persons with mild aphasia with preserved or relatively strong writing skills, writing was as much a strength as drawing when it came to word retrieval.

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Why is drawing a more effective route to word retrieval compared to writing? The authors speculate that the act of drawing promotes deeper semantic processing of the key features of the item. Drawing therefore activates the semantic network more strongly compared to writing. Unlike drawing, writing heavily relies on the left hemisphere and linguistic systems. Writing also increases the cognitive–linguistic demands for word-retrieval. There is a growing body of evidence that supports the use of drawing as a more effective solution to word retrieval compared to writing. In fact, Hung & Ostergren (2019) replicated the findings of Farias and colleagues who used fMRI data to explore the neural effects of drawing, (2006).

Another rationale proposed by the authors is that drawing activates cerebral hemispheres bilaterally, thereby stimulating the semantic network more strongly for retrieval. The authors “draw” upon previous research to support their hypothesis that drawing activates both hemispheres to facilitate recall of key visual features and mental images associated with the item.

What does this mean for clinical practice? Perhaps we need to start incorporating assessment of drawing skills as part of our evaluation routine. One such tool under study is the Drawing Assessment Protocol. In terms of intervention, consider including drawing in your semantic feature analysis routine. Looking for stimuli ideas? Hung and Ostergren (2019) used line drawings from the Reading Comprehension Battery for Aphasia– 2nd Edition.

Hung P., & Ostergren J. (2019). A comparison of drawing and writing on facilitating word retrieval in individuals with aphasia. Aphasiology. doi: 10.1080/02687038.2019.1602861.