Measurement of cross-language and cross-domain generalization following semantic feature-based anomia treatment in bilingual aphasia.

Abstract

Semantic feature-based treatment (SFT), which engages the semantic network by repeatedly targeting retrieval of conceptual features to improve lexical-semantic access, has shown promise for facilitating generalization in aphasia rehabilitation. However, its capacity to drive broad improvement across cognitive-linguistic domains in bilinguals with aphasia (BWA) remains unclear. This study examined generalization effects (i.e., direct transfer, near transfer, and far transfer) following SFT in 48 Spanish-English BWA who took part in a randomized controlled trial. Participants received 40 h of SFT targeting word retrieval, with generalization assessed across three domains: naming of untrained items (direct transfer), semantic processing (near transfer), as well as global language ability and nonverbal abstract reasoning (far transfer). Results showed (i) robust improvements for trained and untrained naming targets, demonstrating direct transfer, (ii) near transfer effects for select semantic processing tasks, and (iii) far transfer limited to overall language function, with no gains in domain-general cognition. Notably, treatment benefits extended across languages, demonstrating cross-language generalization to multiple domains of language processing. Findings highlight SFT's capacity to drive comprehensive language recovery in BWA, revealing broad generalization effects across languages and linguistic domains. Such effects underscore the importance of systematically examining generalization patterns to optimize rehabilitation outcomes.Trial registration: ClinicalTrials.gov identifier: NCT02916524.