Criterion-learning Naming Treatment For Addressing Comprehension Deficits in Aphasia

Word Retrieval in Aphasia

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.

Study Overview

• Status: Enrolling by invitation
• Conditions: Aphasia
• Intervention / Treatment: Behavioral: Criterion-learning practice

Detailed Description

This study examines a retrieval practice-based naming treatment termed criterion learning. In criterion learning, each item's assigned criterion level dictates the number of times that item is correctly retrieved before it is dropped from further training within a session. Criterion learning optimally incorporates potent learning experiences, including spaced retrieval practice with emphasis on correct retrievals during training. The present study will provide critical observations for optimizing criterion learning for treating word processing deficits in people with aphasia. This study will recruit 20 community-dwelling individuals with aphasia, who will undergo comprehensive neuropsychological characterization. Subsequently, participants will engage in an experimental treatment designed to promote improvements in word processing deficits.

This study will examine transfer from two types of naming treatment to word comprehension performance. Each PWA will perform naming treatment in one session at different dosages with a test of comprehension performance administered approximately one week and one month following treatment. Main outcomes of interest will be degree of transfer of each type of naming treatment to comprehension performance.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Elkins Park, Pennsylvania, United States, 19027
      • Jefferson Moss Rehabilitation Research Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• English as a native or primary language
• Adults with stroke who are at least 6 months post-onset
• Exhibit semantic comprehension deficit, defined as a minimum of 80 errors on word-picture verification pre-test

Exclusion Criteria:

• History of comorbid neurological diagnoses, such as Multiple Sclerosis or Parkinson's Disease
• History of a learning disability that significantly impacted language development, such as developmental language disorder
• Insufficient stamina to participate in the protocol

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Criterion-learning practice; This is a single-arm study

Behavioral: Criterion-learning practice; The experiments will be presented on a computer. On each criterion-learning trial, a picture is presented and the participant is asked to try to produce the name for the object with or without a cue. Correct-answer feedback is provided. Criterion learning involves presenting a block of items in fixed order, and on each trial, the experimenter or a voice-recognition component will code the response during the trial as correct/incorrect. When the item reaches its assigned criterion level, it is dropped from further training in a session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Trained comprehension items	Word-picture verification task	approximately one-week and one-month following treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Trained naming items	Confrontation naming task that involves trained items	a single session held during a single day, scheduled at the participant's convenience but typically held within two weeks following pre-treatment assessment
Trained comprehension items	Word-picture verification task	pre-treatment
Untrained comprehension items	Word-picture verification task	pre-treatment, approximately one-week and one-month post-treatment

Collaborators and Investigators

• Sponsor: Albert Einstein Healthcare Network
• Collaborators: Thomas Jefferson University; National Institute on Deafness and Other Communication Disorders (NIDCD)
• Investigators: Principal Investigator: Erica L Middleton, PhD, Albert Einstein Healthcare Network

Study record dates

Study Major Dates

• Study Start (Actual): June 24, 2024
• Primary Completion (Estimated): August 1, 2028
• Study Completion (Estimated): August 1, 2028

Study Registration Dates

• First Submitted: August 25, 2025
• First Submitted That Met QC Criteria: September 15, 2025
• First Posted (Estimated): September 17, 2025

Study Record Updates

• Last Update Posted (Estimated): October 7, 2025
• Last Update Submitted That Met QC Criteria: October 2, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: anomia; communication disorder; retrieval practice; word-finding problem; naming impairment; word comprehension impairment
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Mental Disorders; Neurobehavioral Manifestations; Neurodevelopmental Disorders; Language Disorders; Speech Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Aphasia; Communication Disorders; Anomia
• Other Study ID Numbers: 4526.4; R01DC015516 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymized data and analysis code will be accessible on the Open Science Framework (OSF).
• IPD Sharing Time Frame: 6 months following publication
• IPD Sharing Access Criteria: Anonymized data and analysis code will be accessible on the Open Science Framework (OSF).
• IPD Sharing Supporting Information Type: ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No