Making the Research on Verbal Fluency Clinically Usable

Objective. The purpose of this project is to produce a clinical decision-making model and literature review to help clinicians use the extensive literature on phonemic and semantic fluency. Background. Measures of phonemic and semantic fluency assess cognitive and linguistic function, are extremely sensitive, and quick to measure (less than 5 minutes). Because verbal fluency requires both cognitive and linguistic functions and relies extensively on different areas of the brain, it is sensitive to a number of different neurological conditions, and each condition may have its own profile or pattern of characteristic responses to the task. Indeed, phonemic verbal fluency is more sensitive than the Wisconsin Card Sort for detecting brain injury (Henry & Crawford, 2002). Although the literature on verbal fluency is extensive, it may be difficult for most clinicians to access. Therefore we have compiled an evidence-based guide for clinicians. Methods. After a comprehensive review of the literature, we summarized a clinical decision-making model that can help link clinical performance profiles to diagnoses. WE also summarized the available quantitative and qualitative scoring methods. Results. A clinical decision-making model for semantic and phonemic fluency has been created and is currently under peer review. Conclusion. Considering how quickly verbal fluency tests can be administered, and how sensitive it can be to cognitive-linguistic functions, we recommend using the Semantic (Animal Naming) and Phonemic (F-A-S) tests for many clinical situations. Our clinically-oriented summary of the evidence can help clinicians implement this useful tool in practice.