Authors: Sze WP, Hameau S, Warren J, Best W
Title: Identifying the components of a successful spoken naming therapy: a meta-analysis of word-finding interventions for adults with aphasia
Source: Aphasiology 2021 35(1): 33-72
Year: 2021
Research Design: Systematic Review

Background: Spoken word retrieval therapy forms an integral part of aphasia therapy. Due to the range of therapy options and variations, drawing clear-cut conclusions from the evidence base can be challenging. Aim(s): This paper consolidates recent findings (2008-2018), pertinent to spoken word-finding interventions. Specifically, we are interested in aphasia interventions: (1) that target single-word spoken naming; (2) whose participants are adults with acquired naming impairments after a stroke; and (3) whose treatment approach focusses on the use of language forms (i.e., semantics, phonology, and orthography). The over-arching objective is to determine the important therapy components underpinning successful single-word naming treatments. Methods and Procedures: A systematic literature search was conducted. This led to the compilation of a large-scale dataset (n=222 participants from 32 papers), with the heterogenous interventions dissected into their "active" therapy components. A detailed framework ("RITA": (1) Regimen; (2) Item(s); (3) Technique(s); and (4) Application of technique(s) with their Adjuncts) was designed to organise these "active therapy ingredients". Using random forest, we identified the crucial components responsible for the successful naming of treated and untreated items, respectively, at short-term and maintenance periods. Outcomes and Results: The role of the written form as therapeutic cues, presented either as a whole word or part-word, emerged to be a consistent and robust predictor, across the outcomes. Semantic tasks were useful in the successful naming of untreated items. Conclusion(s): Clinicians should consider using written prompts as part of spoken naming therapy. It is possible that the use of orthography underlies the success of multi-component techniques. Other clinical implications (e.g., homework, treatment intensity) are also discussed. In addition, we propose a comprehensive "RITA" framework, which summarises the "active" therapy components. "RITA" (available as a template in Appendix 3) is useful for clinicians and researchers as a guide to unpack language interventions. Furthermore, the paper highlights the strengths of a well-established method, random forest, as a valuable statistical tool to move aphasia research forward. Overall, the study refines our understanding of spoken naming treatment for those with aphasia, specifically individuals with word-finding deficits. Importantly, through the use of a robust statistical approach and an original framework designed to lay out language therapy components, the paper adds new clarity to the evidence base.

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