Acquisition and Generalization Responses in Aphasia Naming Treatment: A Meta-Analysis of Semantic Feature Analysis Outcomes
Abstract
Purpose: This meta-analysis synthesizes results from published studies that used semantic feature analysis (SFA) treatment to improve naming for people with aphasia. It examines how both person- and treatment-related variables affected the likelihood of correct naming responses in individual probe sessions for both acquisition (treated) and generalization (untreated) stimuli. Method: The meta-analysis compiled data from 12 studies analyzing a total of 35 participants with aphasia. It used mixed-effects models as a novel statistical tool to examine the effects of 2 sets of variables on naming performance: treatment-related variables, including treatment phase (baseline vs. treatment), dosage (number of treatment sessions), and stimulus type (treated vs. untreated, semantically related vs. unrelated items), and person-specific variables, including degree of language impairment and demographic variables (age, time poststroke). Results: Results of the meta-analysis revealed that SFA intervention promoted increased naming accuracy during naming probes when comparing baseline and treatment phases. In addition, increased dosages of SFA were associated with increased naming accuracy, and treatment-related gains were larger for acquisition (treated) than generalization (untreated) stimuli, likewise for related versus unrelated generalization stimuli. Furthermore, a subset of person-specific variables was predictive of SFA-related gains: Language impairment variables were related to treatment-related changes in naming performance, but demographic variables were not. Conclusion: These results provide group-level evidence for the efficacy of SFA as well as preliminary estimates of how much naming performance benefit is engendered by varying dosages of SFA. The results also provide promising and previously unobserved evidence of potential person-level predictors of SFA treatment response.
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Aphasia severity influences inter-individual variability in treated language improvement in post-stroke aphasia.
“It is well established that inter-individual variability in TLI in post-stroke aphasia is influenced by an array of factors, including, but not limited to, age12–15, education16–19, aphasia severity11,14,15,20,21, baseline cognitive abilities13,22,23, and, specific to bPWA, bilingual language experience and language of treatment (e.g., whether therapy is delivered in L1 or L2)24,25.”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
Various approaches, including cognitive-based, cognate-based, and semantic-feature-based treatments, have shown efficacy in producing treated language improvement.
“Various approaches, including cognitive-based4, cognate-based4,5, and semantic-featured-based treatments (SFT)6–11 have shown efficacy in producing treated language improvement (TLI).”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
Some studies have shown improvements in naming in the untreated language (cross-language generalization) after treatment.
“Some studies have further shown improvements in naming in the untreated language (hereafter cross-language generalization; CLG)8–11.”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
In semantic feature therapy (SFT), greater language system integrity may facilitate the spread of activation to related semantic nodes, promoting generalization to untreated items and cross-language transfer.
“In SFT, greater language system integrity may facilitate the spread of activation to related semantic nodes, promoting generalization to untreated items and cross-language transfer7,11.”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
In individuals with milder aphasia, the language system is more preserved and responsive, providing the necessary resources to support the re-learning of previously acquired but inconsistently accessible word forms and the re-establishment of connections between disrupted and available representations.
“Expanding on the role of aphasia severity and TLI, a meta-analysis of SFT in monolingual aphasia proposed that in individuals with milder aphasia, the language system is more preserved and responsive, providing the necessary resources to support the re-learning of previously acquired but inconsistently accessible word forms and the re-establishment of connections between disrupted and available”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
WLG is a well-studied aspect of aphasia rehabilitation in monolingual populations.
“While WLG is a well-studied aspect of aphasia rehabilitation in monolingual populations11, we chose to focus on CLG due to the lack of sufficient statistical power in a previous bilingual meta-analytic study to identify its predictors61, and because, specific to bilingual aphasia, understanding factors that promote benefits across both languages is crucial when treatment is often delivered in only”
From Machine Learning Predictions of Recovery in Bilingual Poststroke Aphasia: Aligning Insights With Clinical Evidence (2025) · cites this paper as [11]
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“outcomes specifically (40), we predict that milder aphasia will correlate with better AbSANT outcomes.”
InfluentialSelf-citationThe “I” in ICAPs: examining treatment intensity under the microscope
Griffin-Musick, J. R., Harvey, S., Pierce, J. E., Fahey, D., & Off, C. A. (2024) · Aphasiology · doi:10.1080/02687038.2024.2317920 · Cited by 8 · see citing works
“There is currently no consensus on what constitutes an active ingredient of aphasia treatment, although researchers have begun to shed light on this issue (e.g., Cherney et al., 2022; Gravier et al., 2018; Quique et al., 2019; Evans et al., 2021).”
Behavioral interventions for poststroke aphasia
Cherney, L. R., & Carpenter, J. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-12-823384-9.00010-4 · Cited by 9 · see citing works
Determinants of Multilevel Discourse Outcomes in Anomia Treatment for Aphasia
Cavanaugh, R., Dickey, M. W., Hula, W. D., Fromm, D., Golovin, J., Wambaugh, J. L., Fergadiotis, G., & Evans, W. S. (2024) · Journal of Speech Language and Hearing Research · doi:10.1044/2024_jslhr-24-00030 · Cited by 7 · see citing works
Self-citationFranco, J., Glize, B., & Laganaro, M. (2025) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2025.109069 · Cited by 7 · see citing works
“…use of phonological or semantic approaches to facilitate access to mental representations has been shown to be effective (Efstratiadou et al., 2018; Quique et al., 2019; Pierce et al., 2019; Sze et al., 2021; Wisenburn and Mahoney, 2009), all people who suffer from aphasia do not respond…”
Tratamientos para la afasia en hispanohablantes
Forero, L. V., Castilla, M. P. B., Mejía, Ó. M. A., & Quique, Y. M. (2023) · Revista de Investigación en Logopedia · doi:10.5209/rlog.81535 · Cited by 7 · see citing works
Self-citationBontemps, M., Servières-Bordes, M., & Moritz‐Gasser, S. (2024) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2023.2289351 · Cited by 7 · see citing works
“In the same vein, Quique et al. (2019) performed a meta-analysis of SFA treatment outcomes and analysed data from 12 studies, including a total of 35 PWA, by using mixed-effects models to examine the effects of SFA treatment-related and person-specific variables on both acquisition and…”
Peñaloza, C., Marte, M., Billot, A., & Kiran, S. (2025) · Cortex; a journal devoted to the study of the nervous system and behavior · doi:10.1016/j.cortex.2025.05.017 · Cited by 6 · see citing works
“Semantic-based interventions are assumed to stimulate the conceptual properties of treated words in the semantic system to increase their activation (and that of untreated words with shared semantic features) at post-semantic levels to facilitate their lexical retrieval (Quique et al., 2019).”
Effectiveness of sensorimotor therapy on action naming in post-stroke aphasia: a systematic review
Spigarelli, M., & Macoir, J. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2439015 · Cited by 5 · see citing works
“Studies have shown the effectiveness of SFA in recovering treated nouns, with some reporting generalization effects to untreated nouns [24].”
Outcomes of semantic feature analysis treatment for aphasia with and without apraxia of speech
Scholl, D. I., McCabe, P., Nickels, L., & Ballard, K. J. (2021) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12597 · Cited by 5 · see citing works
Lammers, B., Sydnor, M. J., Cust, S., Kim, J. H., Yenokyan, G., Hillis, A. E., & Sebastian, R. (2024) · PLoS ONE · doi:10.1371/journal.pone.0298991 · Cited by 5 · see citing works
Sorting the “mixed bag” of semantic tasks in aphasia therapy: a scoping review
Shenoy, R., Harvey, S., Krishnan, G., & Nickels, L. (2024) · Aphasiology · doi:10.1080/02687038.2024.2401421 · Cited by 5 · see citing works
“The rise in the use of the semantic feature generation protocol is also reflected in several reviews focusing on this protocol (e.g., Efstratiadou et al., 2018; Maddy et al., 2014; Murray, 2020; Quique et al., 2019).”
InfluentialIs Aphasia Treatment Beneficial for the Elderly? A Review of Recent Evidence
Fabian, R., Bunker, L. D., & Hillis, A. E. (2020) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-020-00287-z · Cited by 5 · see citing works
Babiak, M. C., Hula, W. D., Autenreith, A., Nader, M. M., Hula, S. N. A., Swiderski, A. M., Cavanaugh, R., Nunn, K., Johnson, J. P., & Dickey, M. W. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2025_ajslp-24-00331 · Cited by 4 · see citing works
Self-citationCognitive Functions Supporting Learning Over Time in Naming Treatment for Aphasia
Goldberg, E. B., Hula, W. D., Cavanaugh, R., Swiderski, A. M., Autenreith, A., & Dickey, M. W. (2025) · Journal of Speech Language and Hearing Research · doi:10.1044/2025_jslhr-25-00101 · Cited by 4 · see citing works
Self-citationLi, R., Chen, S., & Kiran, S. (2024) · Journal of Speech Language and Hearing Research · doi:10.1044/2024_jslhr-23-00705 · Cited by 4 · see citing works
A systematic review of Phonological Components Analysis therapy studies for aphasia
Python, G., Durand, E. D., & Masson‐Trottier, M. (2025) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2025.111269 · Cited by 5 · see citing works
“The proportion of participants showing improvements post-PCA (i.e., at least a small effect size) is quite similar to the proportions reported by Efstratiadou et al. (2018) post-SFA, despite having a larger number participants in this review: PCA therapy was efficient in improving the naming accuracy of treated items…”
InfluentialFocusing on the locus of the breakdown for treatment of anomia: a pilot study
Shekari, E., Mehrpour, M., Joghataei, M. T., Zadeh, A. M., Valinejad, V., Adineh, H. A., Seyfi, M., & Goudarzi, S. (2023) · Clinical Linguistics & Phonetics · doi:10.1080/02699206.2023.2221374 · Cited by 3 · see citing works
“The rationale for the number of sessions was that higher dosages of provided treatments result in a higher degree of naming success (Efstratiadou et al., 2018; Quique et al., 2019).”
Russell-Meill, M., Carpenter, E., Marte, M. J., Scimeca, M., Peñaloza, C., & Kiran, S. (2025) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2025.2522196 · Cited by 3 · see citing works
“This prediction is anchored in spreading activation theory (Collins & Loftus, 1975; Dell, 1986) and consistent with previous findings (Goral et al., 2023; Lee & Faroqi-Shah, 2024; Quique et al., 2019).”
InfluentialThe evolution of word retrieval errors during semantic feature-based therapy in bilingual aphasia
Scimeca, M., Peñaloza, C., Carpenter, E., Marte, M. J., Russell-Meill, M., & Kiran, S. (2025) · Bilingualism Language and Cognition · doi:10.1017/s1366728925100370 · Cited by 3 · see citing works
“This finding is consistent with recent work demonstrating that baseline language abilities are informative predictors of response to treatment in chronic aphasia (Braun & Kiran, 2022; Quique et al., 2019; Scimeca et al., 2024).”
Murray, L. L. (2020) · Evidence-Based Communication Assessment and Intervention · doi:10.1080/17489539.2020.1834724 · Cited by 4 · see citing works
Lyalka, O., Nickels, L., Morris, J., & Howard, D. (2022) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2022.2110278 · Cited by 3 · see citing works
Boukrina, O. V., Madden, E. B., Giordano, N., Karim, D. O., Staples, R., & Graves, W. W. (2024) · American Journal of Speech-Language Pathology · doi:10.1044/2024_ajslp-23-00364 · Cited by 3 · see citing works
Bihovsky, A., Ben‐Shachar, M., & Meir, N. (2024) · Folia Phoniatrica et Logopaedica · doi:10.1159/000542477 · Cited by 3 · see citing works
“…activating the conceptual/semantic network associated with a speci fi c word meaning, SFA facilitates the activation of related meanings, potentially leading to within-language generalization, i.e., improvements in naming semantically related words in the treated language [23, 26 – 29].”
Kim, E. S., Laird, L., Wilson, C., Stewart, S., Mildner, P., Möller, S., Schatz, R., Spang, R. P., Voigt-Antons, J.-N., & Rochon, E. (2025) · JMIR mHealth and uHealth · doi:10.2196/67711 · Cited by 2 · see citing works
“These results extend the literature base on the efficacy of SFA and PCA for improving naming [48,49], as well as the growing number of studies reporting positive outcomes from app-based instantiations of these therapy protocols [15,18,23].”
Charting the Course of Aphasia Recovery: Factors, Trajectories, and Outcomes
Marte, M. J., Russell-Meill, M., Carvalho, N., & Kiran, S. (2024) · Annual Review of Linguistics · doi:10.1146/annurev-linguistics-011724-121245 · Cited by 5 · see citing works
Blackett, D. S., Kristinsson, S., Walker, G. M., Sayers, S., Gibson, M., Wilmskoetter, J., den Ouden, D., Fridriksson, J., & Bonilha, L. (2025) · Journal of Speech Language and Hearing Research · doi:10.1044/2024_jslhr-24-00304 · Cited by 2 · see citing works
Hashimoto, N. (2023) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2023.106384 · Cited by 2 · see citing works
Kim, J. E., & Sung, J. (2024) · Communication Sciences & Disorders · doi:10.12963/csd.240003 · Cited by 3 · see citing works
“Kiran 과 Thompson (2003) (Maddy, Capilouto, & McComas, 2014; Oh, Eom, Park, & Sung, 2016; Quique, Evans, & Dickey, 2019).”
Gorshkov, G., Buivolova, O. V., Gavrilova, E., & Dragoy, O. (2025) · Neurorehabilitation · doi:10.1177/10538135241296737 · Cited by 3 · see citing works
“Another concern involves de fi ning effectiveness: although correct responses to the trained items and tasks are signi fi cant, the central aim of speech-language therapy has been generalization (Goral et al., 2023; Quique et al., 2019).”
Boukrina, O. V., Madden, E. B., Sandroff, B. M., Cui, X., Yamin, M. A., Kong, Y., & Graves, W. W. (2025) · PLoS ONE · doi:10.1371/journal.pone.0317210 · Cited by 2 · see citing works
Semantic Software Traceability Using Property Listing Task: Pilot Study
Ahmadiyah, A. S., Rochimah, S., & Siahaan, D. (2022) · International Electronics Symposium (IES) · doi:10.1109/ies55876.2022.9888365 · Cited by 2 · see citing works
“[19] and [20] reported that SFA leads to positive results using different treatment procedures, dosage, duration, and variations to the traditional SFA protocol.”
BackgroundA Novel Morphology-Based Naming Therapy for People with Aphasia
Truzman, T., Biran, M., Soroker, N., Levy, T., & Bitan, T. (2023) · Aphasiology · doi:10.1080/02687038.2023.2257354 · Cited by 1 · see citing works
“While some studies found no significant association between demographic variables and treatment-related naming improvements (Quique et al., 2018), others reported that pre-treatment language performance severity and psycho-linguistic abilities, including pre-treatment naming, were predictive of…”
BackgroundResultLi, R., Gilmore, N., O'Connell, M., & Kiran, S. (2024) · Aphasiology · doi:10.1080/02687038.2024.2377325 · Cited by 1 · see citing works
“However, generalization effects after SFA treatment have been mixed (Kiran & Bassetto, 2008; Quique et al., 2019) with some studies observing gains in untrained items (Boyle & Coelho, 1995; Coelho et al., 2000) and others not finding evidence of such transfer (Wambaugh et al., 2013).”
Choi, S., & Sung, J. E. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2025_ajslp-24-00397 · Cited by 1 · see citing works
Sharma, S., Jebahi, F., Bloss, J., & Rothermich, K. (2026) · Aphasiology · doi:10.1080/02687038.2026.2632691 · Cited by 1 · see citing works
Godecke, E., Brogan, E., Palmer, R., Brady, M., Becker, F., Breitenstein, C., Brownsett, S. L. E., Fridriksson, J., Hilari, K., Hillis, A. E., et al. (2026) · Aphasiology · doi:10.1080/02687038.2026.2693093 · Cited by 1 · see citing works
Hula, W. D., Dickey, M. W., Autenreith, A., Swiderski, A. M., Babiak, M. C., Nunn, K., Johnson, J. P., Nader, M. M., Tessmer, R., Hula, S. N. A., et al. (2026) · Journal of Speech Language and Hearing Research · doi:10.1044/2026_jslhr-26-00097 · Cited by 1 · see citing works
Self-citationOutcomes from a pilot dose comparison study of naming therapy in aphasia
Harvey, S., Carragher, M., Dickey, M. W., & Rose, M. L. (2022) · Aphasiology · doi:10.1080/02687038.2022.2144112 · Cited by 1 · see citing works
“A number of mechanisms and factors that favour generalisation in picture naming treatments have been proposed including typicality of stimuli (e.g., Kiran, 2008), semantic relatedness of stimuli (e.g., Quique et al., 2019), and lexical-semantic processing (e.g., Best et al., 2013).”
BackgroundSelf-citationAphasia: Acquired Language and Speech Disorder
Mirman, D. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-819641-0.00031-1 · Cited by 1 · see citing works
Nguyen, K. L. (2020) · doi:10.15760/honors.962
“Moreover, researchers have used these CNTs to verify the efficacy of different treatment approaches (Kendall et al., 2015; Quique et al., 2019) and the cortical reorganization after anomia treatment (Fridriksson et al., 2006).”
MethodGrötzbach, H., & Spitzer, L. (2023) · Springer eBooks · doi:10.1007/978-3-662-66413-1_4
Catania, V., D’Angelo, G., Panerai, S., Lanuzza, B., & Ferri, R. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1407399
Acquired dyslexia: Cognitive components, neural underpinnings, and treatment approaches
Graves, W. W., Boukrina, O. V., & Madden, E. B. (2024) · Elsevier eBooks · doi:10.1016/b978-0-12-820480-1.00202-3
Approaches to Word-Finding Difficulties by Using Language Networks
Ishii, Y. (2024) · The Japan Journal of Logopedics and Phoniatrics · doi:10.5112/jjlp.65.217
Devane, N., Mazzoleni, S., Behn, N., Marshall, J., Wilson, S., & Hilari, K. (2025) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.70054
“High dose (e.g., 15 sessions) has a positive impact on outcomes, for both treated and untreated items (Quique et al. 2019).”
Bailey, D. J., & Wilkes, E. B. (2025) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.70109
Treating anomia in aphasia: findings from a modified SFA-Working memory approach
Hashimoto, N. (2025) · Aphasiology · doi:10.1080/02687038.2025.2570802
Zhang, J.-W., DeDe, G., Magee, W., & Shoemark, H. (2026) · Aphasiology · doi:10.1080/02687038.2026.2647138
Rééducation de l'anomie et chirurgie de l'épilepsie temporale pharmaco-résistante
Sabadell, V. (2023) · theses.fr (ABES) · doi:10.70675/55829b57z7815z44fdz92c5zdb4bf81fdf42
Inside Semantic Feature Analysis: A Within-Trial Analysis of Feature Quantity and Quality
Cavanaugh, R., Swiderski, A. M., Goldberg, E. B., Hula, W. D., Evans, W. S., & Dickey, M. W. (2026) · American Journal of Speech-Language Pathology · doi:10.1044/2026_ajslp-25-00515
Self-citationvan der Stelt, C. M., Cavanaugh, R., Hula, W. D., Starns, J. J., Kelly, A. N., Goodman, M. L., Terhorst, L. A., Hassany, M., Brusilovsky, P. L., & Evans, W. S. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-116172
Self-citationSelf-Reported Inner Speech Reflects Improvement From Language Therapy
Stark, B. C., Alexander, J. M., Stockrahm, E., Taylor, R., Nielsen, P., & Barron, B. (2026) · American Journal of Speech-Language Pathology · doi:10.1044/2026_ajslp-25-00363
Sandberg, C., Gray, T., Osfoori, P., & Dickey, M. W. (2026) · American Journal of Speech-Language Pathology · doi:10.1044/2026_ajslp-25-00426
Self-citation
- Authors
- Quique, Y. M., Evans, W. S., & Dickey, M. W.
- Affiliations
- University of Pittsburgh (US)
- Venue
- American Journal of Speech-Language Pathology
- Published
- 2019-03-11
- Volume
- 28
- Issue
- 1S
- Pages
- 230-246
- ISSN
- 1058-0360 (ISSN-L)
- 1558-9110
- OpenAlex
- W2890701693
- Cited by
- 81
- References
- 62
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 16 · 2023: 13 · 2022: 8 · 2021: 8 · 2020: 8 · 2019: 2 · 2018: 1
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Speech-Language Pathology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 RX000832)
- Geriatric Research Education and Clinical Center
- VA Pittsburgh Healthcare System
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Keywords
- aphasia, semantic feature analysis, word naming, treatment generalization, treatment dosage, stroke, language impairment
- MeSH terms
- Aphasia, Generalization, Psychological, Humans, Language Tests, Language Therapy, Semantics, Treatment Outcome
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