Examples of Verbal Feedback in Therapy

Examples of excellent (positive) verbal feedback: "That's right," "You're right," "Yep, that's right," "Great. That's a great answer," "Exactly," with specific information provided such as, "Good job; I like how you corrected yourself. That's what we want you to do."

Examples of good verbal feedback: "You're close; that's close," with an explanation of incorrect or missing information. "There you go," "You're doing great," and "Good job."

Examples of poor verbal feedback: "Hmm-mmm," "Okay," or silence.

A Few Treatment Tips

Once you've asked a question such as "What month is it?" and you receive an answer that is incorrect such as "It's November" when it is actually October; then cue the individual with, "No that's not right. It's not November; it's the month before it. The month before November is ____________." Hopefully, this will enable the person to recall the correct month.

Give succinct introductions to new tasks. Don't go into great detail; sometimes it may be of benefit to give an example.

Always reinforce and praise requests for repetitions from your 'patient' or 'client.' So, if the person says, "Say that again." you should say, "I like the way you asked me to say that again. That's a great self-cue."

Don't be embarrassed by your questions. If they are too difficult (or too easy!) for your patient or client, adjust them.

Verbal Feedback in Testing and in Treatment

When testing, the idea is not to give verbal feedback that indicates whether the individual was correct or incorrect. The VF you give should be more of an encouraging kind: "You're doing well." "Just do your best."

During treatment, however, your verbal feedback is therapy. Without your verbal feedback, the individual you are treating does not know whether his or her responses are correct or incorrect. If you do not indicate incorrectness, then the person does not have an opportunity to learn the best response. If you do not indicate correctness, the individual also does not receive reinforcement for that correct response. In other words, no treatment is occurring.

Keep this in mind as you approach evaluation and therapy.

Therapy: Verbal Feedback, Cueing, Etc.

Verbal feedback in therapy: Telling the patient "that's right," "you got it," or "that's correct" is great verbal feedback. Perfect feedback is: "That's right; it is a zebra!"

Rewording the stimulus is a helpful cue: Asking "if wood burns, what melts?" assists a patient to complete the verbal analogy "Burn is to wood as melt is to _________."

During a verbal fluency task, remain quiet while the patient is listing exemplars unless they pause, or deny ability to think of any more items.

During word retrieval tasks such as confrontational naming, should give a letter cue or phonemic cue prior to giving model.

Hierarchy of Cues and Verbal Feedback

In general, during a confrontational naming task, cues are as follows:

1. Extra time (about 15 seconds)
   
2. Function, location, property cues (i.e. semantic feature analysis)
   
3. Cloze condition cueing such as "You sleep in a _________."
4. Initial letter cue or
   
5. Phonemic cue

Verbal feedback should consist of:

"That's right." or "That's correct."
"That's wrong." or "That's not correct."

Additionally, verbal feedback can provide the person with information about what he or she is doing correctly, such as: "That's right. You allowed yourself extra time to think before you answered."

Or, conversely, what he or she is doing incorrectly, as in: "That's not correct. Try to wait before you answer. Give yourself extra time to find the word."

Cues and Timing

Timing of cues is important. Of value is allowing time for the person to process the task; however, too much latency between the stimulus presentation and the person's first response can lead to even greater failure.

So, do allow approximately 15 seconds for a response. If 15 seconds goes by and you have not elicited any kind of verbal or gestural response, then give a cue or prompt.

Allow approximately 10 to 15 seconds to check effectiveness of the cue, then give the next type of cue.

If this final cue does not work, then model the target response.

Give verbal feedback for each response you elicit.

Verbal Feedback

During treatment (not evaluation), verbal feedback of some kind needs to come after each response elicited.

This verbal feedback can be "that's right" vs. "that's wrong" or "that's not right" followed by a cue of some sort. Most semantic cues can be drawn from semantic feature analysis with questions such as:

"where is this found?"
"what do you do with this?"
"what does this item do?"
"to which group does this item belong"
"what does this look like, feel like, taste like, smell like...etc?"

If the question does not elicit a correct response, then providing the information in statement form, such as "you use this to open cans" may assist the person. If not, the first letter of the target word sometimes triggers word retrieval. Finally, the phonemic cue may be given. Often it helps to remind the person to attend to your face with "watch me, listen to me, do what I do."

The verbal feedback that you gave today re: sustaining attention via eye contact, etc. was very appropriate.

Keep up the good work.