Applying Adaptive Distributed Practice to Self-Managed Computer-Based Anomia Treatment - A Single-Case Experimental Design

Aug 29, 2026

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Need for more effective, long-term, evidence-based computer-based aphasia treatments drives this single-case experimental study. Two post-stroke aphasia participants completed a 12-week adaptive distributed practice naming intervention. Stimuli variability was tested across high versus low exemplar variability and a verbal description prompt balanced across 120 trained words. Outcomes were evaluated at 1 week, 1 month, and 3 months using Bayesian generalized mixed-effects models.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages31

Reading Time1 h 18 min

AccessFree to download

Introduction

Need for improved computer-based aphasia treatment

Methods

Participants and 12-week intervention

Stimuli variability conditions

Outcome measures and analysis

Results

Acquisition, generalization, retention effects

Conclusions

Clinical feasibility and future trials

Applying adaptive distributed practice to self-managed computer-based anomia treatment: a single-case experimental design Yina M. Quique 1, Robert Cavanaugh2, Erica Lescht2, William S. Evans2 1Center for Education in Health Sciences, Northwestern University, Chicago, IL, USA. 2Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA. Corresponding author: Yina M. Quique [yinaquique@northwestern.edu](yinaquique@northwestern.edu) Center for Education in Health Sciences 633 N. Saint Clair St. 20th Floor Chicago, IL 60611 Keywords: aphasia, anomia, adaptive distributed practice, self-managed treatment Funding and acknowledgments: Research reported in this publication was supported by the UPMC Competitive Medical Research Fund (CMRF) awarded to William Evans. Our sincere gratitude to Brandon Nguy and Gillian Reed for their assistance in finding the picture exemplarsand Joshua Peckman for his assistance in scoring. Declaration of Interest statement: The authors report no declarations of interest. This is the author version of the accepted manuscript which is published in the Journal of Communication Disorders, available here: [https://doi.org/10.1016/j.jcomdis.2022.106249](https://doi.org/10.1016/j.jcomdis.2022.106249). Licensed under the Creative Commons CC BY-NC-ND. Abstract Introduction: There is a pressing need to improve computer-based treatments for aphasia to increase access to long-term effective evidence-based interventions. The current single case design incorporated two learning principles, adaptive distributed practice and stimuli variability, to promote acquisition, retention, and generalization of words in a self-managed computer-based anomia treatment. Methods: Two participants with post-stroke aphasia completed a 12-week adaptive distributed practice naming intervention in a single-case experimental design. Stimuli variability was manipulated in three experimental conditions: high exemplar variability, low exemplar variability, and verbal description prompt balanced across 120 trained words. Outcomes were assessed at 1-week, 1-month, and 3-months post-treatment. Statistical comparisons and effect sizes measured in the number of words acquired, generalized, and retained were estimated using Bayesian generalized mixed-effect models. Results: Participants showed large and robust acquisition, generalization, and retention effects. Out of 120 trained words, participant 1 acquired ~77 words (trained picture exemplars) and ~ 63 generalization words (untrained picture exemplars of treated words) . Similarly, participant 2 acquired ~ 57 trained words and ~48 generalization words. There was no reliable change in untrained control words for either participant. Stimuli variability did not show practically meaningful effects. Conclusions: These case studies suggest that adaptive distributed practice is an effective method for re-training more words than typically targeted in anomia treatment research (~47 words on average per Snell et al., 2010) . Generalization across experimental conditions provided evidence for improved lexical access beyond what could be attributed to simple stimulusresponse mapping. These effects were obtained using free, open-source flashcard software in a clinically feasible, asynchronous format, thereby minimizing clinical implementation barriers. Larger-scale clinical trials are required to replicate and extend these effects. 1 1. Introduction Approximately one-third of stroke survivors are diagnosed with aphasia, and more than two million people with aphasia are currently living in the United States (Simmons-Mackie & Cherney, 2018) . Aphasia negatively affects communication ability, life participation, and longterm quality of life (Cruice et al., 2006; Dalemans et al., 2010) . Although people with aphasia continue to improve their communication abilities in response to long-term speech and language pathology services (All

FAQs

What intervention was used in the study for self-managed anomia treatment?

Participants completed a 12-week naming intervention using adaptive distributed practice delivered through a self-managed computer-based format.

How were stimuli variability conditions implemented?

Stimuli variability was manipulated using high exemplar variability, low exemplar variability, and a verbal description prompt balanced across 120 trained words.

What outcomes were measured and when were they assessed?

Word acquisition, generalization, and retention were assessed at 1 week, 1 month, and 3 months post-treatment using Bayesian generalized mixed-effects models.

Aug 29, 2026

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