Naming Treatment for Aphasia

Overseen By Kelly Horel, CCC SLP

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Albert Einstein Healthcare Network

Disqualifiers: Multiple sclerosis, Parkinson's, others

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

Compensation: Varies

Number of Visits: 5

Duration: 5 weeks

90 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

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.

What data supports the effectiveness of the Criterion-learning Based Naming Treatment for aphasia?

Research shows that semantic-based treatments, which focus on understanding the meaning of words, are generally more effective for improving naming abilities in people with aphasia compared to phonological treatments, which focus on the sounds of words. This suggests that treatments like Criterion-learning Based Naming Treatment, which may include semantic elements, could be beneficial for naming difficulties in aphasia. ^{1 2 3 4 5}

Is the Naming Treatment for Aphasia safe for humans?

The research does not provide specific safety data for the Naming Treatment for Aphasia, but it focuses on changes in brain activation and improvements in language processing, suggesting it is generally safe for use in humans. ^{2 3 5 6 7}

How does Criterion-learning Based Naming Treatment for aphasia differ from other treatments?

Criterion-learning Based Naming Treatment is unique because it focuses on specific learning mechanisms to improve naming abilities in aphasia, potentially incorporating elements like errorless learning, errorful learning, and retrieval practice to maximize treatment gains. This approach is distinct from other treatments that may focus solely on semantic or phonological cues. ^{2 3 4 8 9}

What is the purpose of this trial?

Aphasia is a disorder of spoken and written language, most commonly following a stroke. It is estimated that between 2.5 and 4 million Americans are living with aphasia today. A common problem in aphasia involves difficulty retrieving known words in the course of language production and comprehension. The overarching goal of this project is to develop and test early efficacy, efficiency, and the tolerability of a lexical treatment for aphasia in multiple-session regimens that are comprised of retrieval practice, distributed practice, and training dedicated to the elicitation of correct retrievals. The aim of this work is to add to and refine the evidence base for the implementation and optimization of these elements in the treatment of production and comprehension deficits in aphasia, and make important steps towards an ultimate goal of self-administered lexical treatment grounded in retrieval practice principles (RPP) to supplement traditional speech-language therapy that is appropriate for People with Aphasia (PWA) from a broad level of severity of lexical processing deficit in naming and/or comprehension. This project cumulatively builds on prior work to develop a theory of learning for lexical processing impairment in aphasia that aims to ultimately explain why and for whom familiar lexical treatments work, and how to maximize the benefits they confer.

Research Team

Erica L Middleton, PhD

Principal Investigator

Albert Einstein Healthcare Network

Eligibility Criteria

This trial is for adults who have had a stroke at least 6 months ago and primarily speak English. It's designed to help those with aphasia, which is a language disorder affecting speech and comprehension.

Inclusion Criteria

English is my first language.

I had a stroke more than 6 months ago.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a multi-session naming treatment study with criterion-learning practice, involving five training sessions generally separated by one week.

5 weeks

5 visits (in-person or virtual)

Retention Test

A retention test of naming performance is administered approximately one week following the final training session to assess naming mastery.

1 week

Follow-up

Participants are monitored for safety and effectiveness after treatment, with additional retention tests approximately one week and one month post-treatment.

4 weeks

Treatment Details

Interventions

• Criterion-learning Based Naming Treatment

Trial Overview The study tests a treatment called 'Criterion-learning practice' aimed at improving word retrieval in people with aphasia. The treatment involves exercises that focus on correct word usage, spread out over multiple sessions.

Participant Groups

Group I: Criterion-learning practice Experimental Treatment 1 Intervention

This is a single-arm study.

Who Is Running the Clinical Trial?

Albert Einstein Healthcare Network

Lead Sponsor

Trials

65

Recruited

869,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Thomas Jefferson University

Collaborator

Trials

475

Recruited

189,000+

Findings from Research

In a study of 104 individuals with chronic post-stroke aphasia, semantically focused treatment was found to be more effective than phonologically focused treatment for improving naming performance, regardless of treatment order.

Participants with milder speech impairments and fluent speech were more likely to respond positively to semantic treatment, while those with more severe impairments and apraxia of speech benefited more from phonological treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individualized response to semantic versus phonological aphasia therapies in stroke. Kristinsson, S., Basilakos, A., Elm, J., et al.[2022]

A semantic-based treatment for picture naming was effective for 2 out of 4 individuals with Broca's aphasia, leading to improved naming of both trained and untrained nouns.

For the other 2 participants, improvements in naming only occurred after additional treatment focused on phonological information, highlighting the importance of tailoring therapy to individual needs in lexical processing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Model-based semantic treatment for naming deficits in aphasia. Drew, RL., Thompson, CK.[2019]

This systematic review analyzed 19 studies on three learning-based approaches (errorless learning, errorful learning, and retrieval practice) for improving naming in aphasia, highlighting the importance of understanding mechanisms of action (MoAs) to enhance treatment effectiveness.

Key proposed MoAs included Hebbian learning and effortful retrieval, but significant knowledge gaps remain regarding which specific ingredients influence these mechanisms and how individual patient characteristics affect treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Errorless, Errorful, and Retrieval Practice for Naming Treatment in Aphasia: A Scoping Review of Learning Mechanisms and Treatment Ingredients. Nunn, K., Vallila-Rohter, S., Middleton, EL.[2023]

In a study involving 12 adult patients with chronic acquired aphasia, both semantic and phonological treatments led to significant improvements in picture naming abilities after 4 or 8 treatment sessions.

The semantic treatment showed a small but significant advantage over phonological treatment, particularly in generalizing improvements to untreated items, indicating its effectiveness in enhancing word retrieval skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of word retrieval deficits in aphasia. A comparison of two therapy methods. Howard, D., Patterson, K., Franklin, S., et al.[2006]

In a study involving 72 participants with stroke aphasia, using a distance measure that accounts for item difficulty and response types revealed more significant treatment effects on naming ability compared to standard accuracy measures.

The results suggest that naming ability is made up of different subabilities, indicating that more nuanced measures can better capture the effectiveness of therapies for anomia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Beyond Percent Correct: Measuring Change in Individual Picture Naming Ability. Walker, GM., Basilakos, A., Fridriksson, J., et al.[2022]

Semantic feature analysis is an effective intervention for improving naming abilities in individuals with aphasia, as shown by a review of 11 studies that utilized single subject research designs.

While most participants showed a small effect size using Cohen's d, a large treatment effect was observed when calculating the percent of non-overlapping data, indicating significant improvements in confrontational naming for many individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of semantic feature analysis: an evidence-based systematic review. Maddy, KM., Capilouto, GJ., McComas, KL.[2018]

In a study involving 10 individuals with aphasia, phonological cues were found to be more effective than semantic cues for improving picture naming accuracy, particularly for items with low visual complexity.

The results suggest that phonological cues aid in the initial categorization of pictures rather than directly mapping to phonological processes, which has important implications for developing more effective rehabilitation therapies for naming impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What Does a Cue Do? Comparing Phonological and Semantic Cues for Picture Naming in Aphasia. Meteyard, L., Bose, A.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Individualized response to semantic versus phonological aphasia therapies in stroke. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Model-based semantic treatment for naming deficits in aphasia. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Errorless, Errorful, and Retrieval Practice for Naming Treatment in Aphasia: A Scoping Review of Learning Mechanisms and Treatment Ingredients. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Treatment of word retrieval deficits in aphasia. A comparison of two therapy methods. [2006]

5. United States pubmed.ncbi.nlm.nih.gov

Learning to fail in aphasia: an investigation of error learning in naming. [2021]

6. Italy pubmed.ncbi.nlm.nih.gov

Treatment-related changes in neural activation vary according to treatment response and extent of spared tissue in patients with chronic aphasia. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Beyond Percent Correct: Measuring Change in Individual Picture Naming Ability. [2022]

8. Netherlands pubmed.ncbi.nlm.nih.gov

The effectiveness of semantic feature analysis: an evidence-based systematic review. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

What Does a Cue Do? Comparing Phonological and Semantic Cues for Picture Naming in Aphasia. [2019]