Ecological Momentary Intervention for Post-Stroke Anomia

NCT07739875 | Recruiting

• 1 other identifier: 1R21DC022448
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

Anomia (i.e., impaired word retrieval) is one of the most common and debilitating deficits experienced by stroke survivors with aphasia, an acquired disorder characterized by impaired language. Although many anomia treatments exist, treatment response is modest and inconsistent across studies, and the extent of generalization to everyday contexts-the therapy gold standard-is largely unknown. The critical gap between actual outcomes and the therapeutic potential of naming therapy is tied to problems with current treatment delivery practices (i.e., low/unknown dosage, massed practice delivery, and decontextualized training). In this research, we aim to demonstrate that a novel smartwatch-based ecological momentary intervention (EMI) that delivers high-dosage semantic feature training throughout daily life has the potential for overcoming these issues. Every day for six weeks, 20 PWA will complete 24 trials of semantic feature EMI distributed over the day (from 10am-8pm) and delivered by a smartwatch. The EMI trial flow will include five steps: 1) a prompt alert and audiovisual "Ready to name a picture?" cue, 2) a first naming attempt after a YES response, 3) the repetition of an auditory model, 4) semantic feature verification via yes/no questions, and 5) a second naming attempt. To contextualize training further, trained items will be clustered into location categories (e.g., home, pharmacy), and we will use the mobile device's location detection to match PWA's location and item category for \~50% of trials. In Aim #1, we will establish preliminary efficacy of this EMI by determining the extent to which semantic feature EMI improves naming of trained items and generalizes to untrained, related contexts. We predict that the EMI will significantly improve 1) naming of trained items and semantically related, untrained items relative to semantically unrelated items and 2) subjective and objective measures of functional communication effectiveness. Given the novelty of our EMI, the second two aims will focus on identifying key factors of semantic feature EMI user experience (Aim #2) and trends between therapy response and the treatment delivery factors of dosage, trial spacing, and item-location congruence (Aim #3). The proposed research is innovative because of the novel use of EMI for aphasia, our combined application of distributed practice and context-dependent training, and the future promise of extending our system to other types of evidence-based treatment and to other clinical populations, as well as to in-situ "just-in-time" interventions that can intervene in real time during the moment of communication breakdown. The significance of this research lies in its ability to provide technology that automatically tracks dosage metrics; its potential for increasing knowledge regarding which therapy delivery factors impact outcomes; and its promise for providing PWA alternative paths to receive therapy. Successful completion of this research will lead to an R01 application aimed at establishing the efficacy of this novel therapy compared to gold-standard, clinician-provided treatment and determining which active treatment ingredients contribute to outcomes.

Conditions

Post-Stroke Chronic Aphasia

Keywords

Anomia; Semantic Feature Analysis; Ecological Momentary Intervention

Outcome Measures

Primary Outcomes (1)

• Accuracy on Trained Items

  Each participant will receive semantic feature intervention for 24 trained words. Accuracy will be assessed via naming probes administered before, during (at the end of each week), and after therapy. Accuracy will be coded as 0 for incorrect and 1 for correct on each naming probe. Improvement in accuracy on trained items will be compared to change over time on a set of 24 untrained words that are not semantically related to the trained items.

  7 weeks (from before the intervention to the one-week follow-up)

Secondary Outcomes (2)

• Accuracy on Semantically Related, Untrained Items

  7 weeks (from before the intervention to the one-week follow-up)

• Change in Functional Communication

  7 weeks (from before the intervention to the one-week follow-up)

Study Arms (1)

Semantic Feature Ecological Momentary Intervention

EXPERIMENTAL

Participants will wear a smartwatch every day for 6 weeks. Between 10am and 8pm, prompts will be delivered from the watch that correspond to a semantic feature training trial. This intervention is similar to semantic feature verification treatment but delivered via the watch through the day rather than by a clinician in a single session.

Behavioral: Semantic Feature Ecological Momentary Intervention

Interventions

Semantic Feature Ecological Momentary Intervention BEHAVIORAL

If answered, each prompt will correspond to a single picture naming training trial. The trial flow will include five steps: (1) an initial vibration/chime prompt and audiovisual "Ready to name a picture?" question, (2) a first naming attempt upon a button YES response to the "Ready?" question, (3) an audiovisual model of the target word, (4) an audiovisual cue of "Get ready to answer some questions!" followed by a series of six yes/no semantic feature questions, and (5) a second and final naming attempt upon a YES response to the audiovisual "Ready to name a picture?" question. If the participant taps NO to any "Ready?" question or ignores the prompt, the trial flow will end, and they will be re-prompted once more 10 minutes later. If they ignore or respond NO to the re-prompt, that trial will be skipped. PWA will have 10 seconds to respond to Steps #2, #3, and #5.

Semantic Feature Ecological Momentary Intervention

Eligibility Criteria

• Age: 18 Years - 89 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Current/pre-stroke English proficiency
• Normal/corrected-to-normal vision and hearing
• Medical stability
• History of left hemisphere stroke at least six months prior to enrollment.
• Upon enrollment, additional testing will be required to determine eligibility for receiving the therapy, including 1) presence of aphasia as determined by scores on language tests and the study team's clinical judgment (spearheaded by PI Meier) and 2) at least 48 items eligible for training based on the baseline naming probe, a necessity to ensure PWA who do not require training on the targeted word list are not unnecessarily included in the treatment group.

You may not qualify if:

• Diagnosis of neurological disease affecting the brain (besides stroke)
• Major psychiatric disorders
• Recent history of falls within six months of enrollment

Sponsors & Collaborators

• Northeastern University: lead

Study Sites (1)

Northeastern University

Boston, Massachusetts, 02115, United States

RECRUITING

MeSH Terms

Conditions

Anomia

Condition Hierarchy (Ancestors)

Language Disorders; Communication Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Erin L Meier, PhD

  Northeastern University

  PRINCIPAL INVESTIGATOR

• Stephen S. Intille, PhD

  Northeastern University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Erin L Meier, PhD

CONTACT

617-373-7438; e.meier@northeastern.edu

The Aphasia Network Lab

CONTACT

857-342-9694; tanlab.northeastern@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 28, 2026
• First Posted: July 31, 2026
• Study Start: May 19, 2026
• Primary Completion (Estimated): August 1, 2027
• Study Completion (Estimated): August 1, 2027
• Last Updated: July 31, 2026

Record last verified: 2026-05

Locations

US (1)