Semantic Feature Analysis + Metacognitive Strategy Training for Acquired Aphasia

Overseen By Victoria Tilton-Bolowsky, Ph.D. CCC-SLP

Age: 18+

Sex: Any

Trial Phase: Phase 2

Sponsor: Teachers College, Columbia University

Disqualifiers: Neurodegenerative disease, Mental illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 34

Duration: 8 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two types of speech therapy for adults with speaking difficulties due to conditions like a stroke. The study compares traditional Semantic Feature Analysis (SFA), which involves naming and describing objects, with a new method that adds Metacognitive Strategy Training (SFA+MST) to help participants reflect on their thinking and strategies. Researchers aim to determine which approach better improves naming and speaking. Suitable candidates for this trial are English-speaking adults who have experienced aphasia for at least six months following a stroke or brain injury, without other serious conditions affecting their brain or speech capabilities. Participants will attend several therapy sessions and assessments to track their progress. As a Phase 2 trial, this research measures the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to important advancements in speech therapy.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Semantic Feature Analysis (SFA) is generally safe for people with aphasia. A review of studies on SFA found no major safety concerns, indicating it is a safe option for participants. This treatment involves naming objects and describing their features, a common therapy method without known serious side effects.

Previous trials have also shown the combination of Semantic Feature Analysis with Metacognitive Strategy Training (SFA+MST) to be safe. This approach includes metacognitive strategy training, which involves thinking about and improving cognitive processes. Early trials with SFA+MST reported no significant negative effects, indicating it is well-tolerated.

Both treatments have been tested in clinical settings, and neither has raised major safety issues. These findings reassure participants about the safety of these approaches. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for acquired aphasia because they offer a fresh approach to improving language skills. The traditional Semantic Feature Analysis helps patients by having them name objects, describe their features, and form sentences, which strengthens their language retrieval skills. The addition of Metacognitive Strategy Training in the experimental treatment enhances this approach by teaching patients to think about their thinking, allowing them to reflect on their performance and strategize for real-world use. This combination could lead to more significant and lasting improvements in communication abilities compared to standard therapies that don't incorporate metacognitive elements.

What evidence suggests that this trial's treatments could be effective for acquired aphasia?

Studies have shown that Semantic Feature Analysis (SFA) helps people with acquired aphasia improve their ability to find the right words. This method focuses on the features of objects, such as their category and physical characteristics. In this trial, one group of participants will receive traditional SFA treatment, while another group will receive SFA combined with Metacognitive Strategy Training (MST). Research suggests that MST can enhance the benefits of SFA by encouraging patients to think about their own thinking, helping them apply new strategies in everyday life. Initial findings indicate that using SFA with MST can lead to better accuracy in naming objects and more natural speech. ^{3 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adults with acquired aphasia, a condition affecting language abilities. Participants should be able to attend multiple assessment and treatment sessions over several months. Specific types of aphasia like Broca's or mixed may be included, but the full eligibility criteria are not provided.

Inclusion Criteria

I do not have any major brain-related health issues affecting my thinking, speech, or memory.

It has been over 6 months since my aphasia started.

I have aphasia from a one-time event like a stroke.

Exclusion Criteria

My hearing and vision have not been corrected.

I am over the age of 89.

I am under 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-treatment Assessment

Participants complete 5-7 sessions involving picture naming, storytelling, and questionnaires

1-2 weeks

5-7 visits (in-person)

Treatment

Participants receive 3 sessions per week of either SFA or SFA+MST for 8 weeks

8 weeks

24 visits (in-person)

Post-treatment Assessment

Participants complete 3 sessions of the same assessments as pre-treatment

1 week

3 visits (in-person)

Follow-up

Participants complete 2 retention assessment sessions at 30 and 60 days post-treatment

2 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Semantic Feature Analysis
• Semantic Feature Analysis + Metacognitive Strategy Training

Trial Overview The study compares traditional Semantic Feature Analysis (SFA) therapy with an enhanced version that includes Metacognitive Strategy Training (SFA+MST). It measures how these treatments affect picture naming accuracy and spontaneous speech in people with aphasia over two months.

How Is the Trial Designed?

Group I: Semantic Feature Analysis + Metacognitive Strategy Training Experimental Treatment 1 Intervention

A portion of the study participants will participate in traditional Semantic Feature Analysis treatment, as described in Tilton-Bolowsky, V. E., Brock, L., Nunn, K., Evans, W. S., \& Vallila-Rohter, S. (2023). Incorporating metacognitive strategy training into semantic treatment promotes restitutive and substitutive gains in naming: A single-subject investigation. American journal of speech-language pathology, 32(5), 1979-2020. https://doi.org/10.1044/2023\_AJSLP-22-00230. Briefly, this treatment involves metacognitive teaching and practice, naming pictures of objects, describing the objects' features (e.g., category membership, physical attributes, etc), creating sentences using the objects' names, debriefing on overall performance, and discussing recent and future opportunities for strategy implementation in real life.

Group II: Traditional Semantic Feature Analysis Active Control 1 Intervention

A portion of the study participants will participate in traditional Semantic Feature Analysis treatment, as described in Gravier, M. L., Dickey, M. W., Hula, W. D., Evans, W. S., Owens, R. L., Winans-Mitrik, R. L., \& Doyle, P. J. (2018). What matters in semantic feature analysis: Practice-related predictors of treatment response in aphasia. American Journal of Speech-Language Pathology, 27(1S), 438-453. https://doi.org/10.1044/2017\_AJSLP-16-0196. Briefly, this treatment involves naming pictures of objects, describing the objects' features (e.g., category membership, physical attributes, etc.), and creating sentences using the objects' names.

Who Is Running the Clinical Trial?

Teachers College, Columbia University

Lead Sponsor

Trials

27

Recruited

6,100+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7731677/

Effectiveness of Semantic-based Treatment in Persons with ... Semantic-based treatment is the salient approach used to remediate word retrieval deficits in persons with aphasia (PWAs).

2. apps.asha.org apps.asha.org/EvidenceMaps/Articles/ArticleSummary/68f09949-63e1-4827-af5b-f808453c410c

The Effectiveness of Semantic Feature Analysis Results indicated semantic feature analysis is an effective treatment for confrontational naming impairment in adults with acquired aphasia.

3. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/abs/10.1111/1460-6984.12597

Outcomes of semantic feature analysis treatment for ... This study compares the effects of SFA in a group of individuals with aphasia alone and a group with similar severity of aphasia but with concomitant AOS.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT07036406?term=AREA%5BConditionSearch%5D(%22Aphasia%22)&rank=3

Comparing Traditional Semantic Feature Analysis (tSFA) ... The goal of this clinical trial is to compare the effectiveness of traditional Semantic Feature Analysis (SFA) treatment to a modified SFA protocol that ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0021992411000207

The use of a modified semantic features analysis approach ... Several studies have reported improved naming using the semantic feature analysis (SFA) approach in individuals with aphasia.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10886986/

High-Frequency Language Therapy with Semantic Feature ... The goal of this study was to investigate whether the combination of semantic feature analysis (SFA) and transcranial direct current stimulation (tDCS) is ...

7. lrcl.pitt.edu lrcl.pitt.edu/sites/default/files/study3.pdf

What Matters in Semantic Feature Analysis A T-score of 50 reflects mean performance for the CAT normative sample of individuals with aphasia, with a standard deviation of 10. Thus, a score of < 70 ...

8. researchgate.net researchgate.net/publication/324629937_A_Systematic_Review_of_Semantic_Feature_Analysis_Therapy_Studies_for_Aphasia

(PDF) A Systematic Review of Semantic Feature Analysis ... The purpose of this study was to review treatment studies of semantic feature analysis (SFA) for persons with aphasia.

9. frontiersin.org frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1401240/full

AI-assisted assessment and treatment of aphasia: a review Crucially, the implementation of AI algorithms enables the integration of data obtained from image analysis with other forms of clinical data.