About this trial
Aphasia is a language disorder caused by stroke and other acquired brain injuries that affects over two million people in the United States and which interferes with life participation and quality of life. Anomia (i.e., word- finding difficulty) is a primary frustration for people with aphasia. Picture-based naming treatments for anomia are widely used in aphasia rehabilitation, but current treatment approaches do not address the long-term retention of naming abilities and do not focus on using these naming abilities in daily life. The current research aims to evaluate novel anomia treatment approaches to improve long-term retention and generalization to everyday life.
This study is one of two that are part of a larger grant. This record is for sub-study 1, which will adaptively balance effort and accuracy using speeded naming deadlines.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Existing diagnosis of chronic (>6 months) aphasia subsequent to left hemisphere ischemic or hemorrhagic stroke.
Impaired performance on 2/8 sections of the Comprehensive Aphasia Test.
Disqualifiers
History of other acquired or progressive neurological disease.
Significant language comprehension impairments
Unmanaged drug / alcohol dependence.
Severe diagnosed mood or behavioral disorders that require specialize mental health interventions.
Trial design
Crossover
Treatments tested in this trial
Accuracy-maximized condition
BehavioralNaming treatment condition in which the target will be immediately provided for repetition at picture onset.
Effort-maximized condition
BehavioralNaming treatment condition in which participants will have up to 10 seconds to respond before the target is provided for repetition.
Effort-accuracy balanced condition
BehavioralNaming treatment condition in which naming deadlines will be determined based on the balanced effort-to-accuracy benefit ratio formalized above, calculated on clinician-provided accuracy and response time ratings. Deadlines will be recalculated session-by-session to adjust to participant-specific treatment gains over time.
Treatment groups
6
Treatment groupsSee each treatment group below.
Trial outcomes
Primary outcomes
Change in correct responses in Confrontation Naming of Treated Pictured Objects
Confrontation naming accuracy of pictures targeted in each training condition will serve as a primary outcome. Individualized lists for each participant will be selected from a corpus of pictured objects. Performance will be evaluated twice at each timepoint. Change in performance from initial assessment to the 3-month follow-up timepoint on the treated items will serve as the primary outcome measure.
Secondary outcomes
Change in correct responses in Confrontation Naming of Untreated Pictured Objects
Confrontation naming accuracy of pictured untreated items (matched for linguistic difficulty to treated items in the primary outcome) for each training condition will serve as a secondary outcome control condition.
Change in correct responses in Context Generalization of Treated and Untreated Pictured Objects
Production of trained words on the context generalization complex scene description task for each training condition and corresponding untreated items will serve as a secondary outcome. Words from complex scenes and wordless picture books will be chosen for each participant. These words will consist of a subset of those selected for confrontation naming. Performance will be evaluated twice at each timepoint. Change in performance from initial assessment to the 3-month follow-up timepoint on the treated and untreated items will serve as a secondary outcome measure.
Change in core lexicon analysis on the Aphasia Bank Discourse Protocol
The Aphasia Bank Discourse Protocol is a brief, but thorough set of language tasks which will characterize participants' language at the discourse level. The protocol requires participants to generate discourse samples within the contexts of free speech, a picture description, a story narrative, and procedural discourse. Change in performance in core lexicon analysis on discourse samples from initial assessment to each post-treatment follow up timepoint will serve as a secondary outcome measure.
Change in mean scores on the Aphasia Communication Outcome Measure Short-Form
The Aphasia Communication Outcome Measure (ACOM) is a measure of patient-reported "communication functioning," defined as the ability to effectively convey and receive personally relevant messages in natural environments. Results are provided in T scores (sample mean of 50 with a standard deviations of 10), with higher scores indicating better communication functioning.
Sponsors and contacts
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University of Pittsburgh
Lead sponsor
University of Massachusetts, Amherst
Collaborator
National Institute on Deafness and Other Communication Disorders (NIDCD)
Collaborator