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Do Word- and Sentence-Level Treatments Generalize to Dialogue? A Systematic Review and Synthesis of the Evidence in Poststroke Aphasia Interventions.

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Title: Do Word- and Sentence-Level Treatments Generalize to Dialogue? A Systematic Review and Synthesis of the Evidence in Poststroke Aphasia Interventions.
Authors: Schultz, Kristina1,2, Larkman, Chelsea1,2, Rose, Miranda L.1,2 M.Rose@latrobe.edu.au, Togher, Leanne2,3, Carragher, Marcella1,2
Source: American Journal of Speech-Language Pathology. May2026, Vol. 35 Issue 3, p1274-1303. 30p.
Subject Terms: *Aphasia, *Communication, *Language acquisition, *Speech therapy, Medical information storage & retrieval systems, CINAHL database, Systematic reviews, MEDLINE, Stroke, Psychology information storage & retrieval systems, Disease complications
Abstract: Purpose: This systematic review aimed to synthesize evidence related to the effects of word- and/or sentence-level poststroke aphasia interventions on dialogue. Method: Six electronic databases were searched up to September 13, 2023. A total of 2,906 studies were identified, 33 of which met inclusion criteria. Risk of bias assessment was completed using appraisal tools according to study design. The studies were not sufficiently homogeneous for meta-analysis; therefore, descriptive synthesis was completed. Results: Treatment targeted the word level (55%), sentence level (21%), and mixed word and sentence levels (24%). Few studies (27%) explicitly reported treatment ingredients hypothesized to facilitate generalization. Methodological quality was variable. There was considerable variability in the range of methods used for the collection and analysis of dialogue data. A total of 111 different dialogue measures were identified, with lexical measures being the most common (38%), followed by structural (17%), informativeness (18%), and interaction (21%). Psychometric data for the dialogue measures were rarely reported. Generalization to dialogue was more likely demonstrated by structural or informativeness measures. Conclusions: Generalization from word- and sentence-level interventions to dialogue is evident, but infrequent. This may reflect underspecification of treatment ingredients to facilitate generalization, low treatment dose, poor sensitivity of dialogue measures to generalization, or lack of psychometrically sound dialogue measures. Although lexical measures of dialogue were most prevalent, structural or informativeness measures may be more sensitive to change in dialogue following word- and/or sentence-level aphasia interventions. Implications for supporting generalization to dialogue are discussed. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Do Word- and Sentence-Level Treatments Generalize to Dialogue? A Systematic Review and Synthesis of the Evidence in Poststroke Aphasia Interventions.
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  Data: <searchLink fieldCode="AR" term="%22Schultz%2C+Kristina%22">Schultz, Kristina</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Larkman%2C+Chelsea%22">Larkman, Chelsea</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Rose%2C+Miranda+L%2E%22">Rose, Miranda L.</searchLink><relatesTo>1,2</relatesTo><i> M.Rose@latrobe.edu.au</i><br /><searchLink fieldCode="AR" term="%22Togher%2C+Leanne%22">Togher, Leanne</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Carragher%2C+Marcella%22">Carragher, Marcella</searchLink><relatesTo>1,2</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Speech-Language+Pathology%22">American Journal of Speech-Language Pathology</searchLink>. May2026, Vol. 35 Issue 3, p1274-1303. 30p.
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  Data: *<searchLink fieldCode="DE" term="%22Aphasia%22">Aphasia</searchLink><br />*<searchLink fieldCode="DE" term="%22Communication%22">Communication</searchLink><br />*<searchLink fieldCode="DE" term="%22Language+acquisition%22">Language acquisition</searchLink><br />*<searchLink fieldCode="DE" term="%22Speech+therapy%22">Speech therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+information+storage+%26+retrieval+systems%22">Medical information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22CINAHL+database%22">CINAHL database</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+information+storage+%26+retrieval+systems%22">Psychology information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Purpose: This systematic review aimed to synthesize evidence related to the effects of word- and/or sentence-level poststroke aphasia interventions on dialogue. Method: Six electronic databases were searched up to September 13, 2023. A total of 2,906 studies were identified, 33 of which met inclusion criteria. Risk of bias assessment was completed using appraisal tools according to study design. The studies were not sufficiently homogeneous for meta-analysis; therefore, descriptive synthesis was completed. Results: Treatment targeted the word level (55%), sentence level (21%), and mixed word and sentence levels (24%). Few studies (27%) explicitly reported treatment ingredients hypothesized to facilitate generalization. Methodological quality was variable. There was considerable variability in the range of methods used for the collection and analysis of dialogue data. A total of 111 different dialogue measures were identified, with lexical measures being the most common (38%), followed by structural (17%), informativeness (18%), and interaction (21%). Psychometric data for the dialogue measures were rarely reported. Generalization to dialogue was more likely demonstrated by structural or informativeness measures. Conclusions: Generalization from word- and sentence-level interventions to dialogue is evident, but infrequent. This may reflect underspecification of treatment ingredients to facilitate generalization, low treatment dose, poor sensitivity of dialogue measures to generalization, or lack of psychometrically sound dialogue measures. Although lexical measures of dialogue were most prevalent, structural or informativeness measures may be more sensitive to change in dialogue following word- and/or sentence-level aphasia interventions. Implications for supporting generalization to dialogue are discussed. [ABSTRACT FROM AUTHOR]
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  Group: Ab
  Data: <i>Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1044/2025_AJSLP-25-00285
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        Text: English
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        PageCount: 30
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      – SubjectFull: Communication
        Type: general
      – SubjectFull: Language acquisition
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              Text: May2026
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              Y: 2026
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