Word Retrieval in the Wild: The Feasibility of an Audio-Based Ecological Momentary Naming Protocol Completed by Adults With and Without Poststroke Aphasia

PURPOSE: Ecological momentary assessment (EMA) involves collecting data regarding behaviors or states of interest repeatedly in individuals' natural environments, typically from a smart device. The feasibility of EMA protocols with people with aphasia (PWA) remains relatively unexplored, particularly for objective assessments of language ability. We assessed the feasibility of a novel, smartwatch-delivered, audio-based ecological momentary naming protocol. METHOD: Fourteen PWA and 13 healthy controls completed a 3-week EMA protocol in which they attempted to name pictured objects delivered via smartwatch prompts while going about daily routines. Participants were pseudorandomly assigned to either a single-item (36 prompts per day, one image each) or nine-item (four prompts per day, nine images each) condition. Feasibility metrics were compliance (number of naming attempts/number of scheduled prompts), completion (number of naming attempts/number of delivered prompts), and perceived ease and burden of completing EMAs (captured via weekly surveys). RESULTS: Average compliance for both PWA and controls was 77%, with completion at 83% and 84% for controls and PWA, respectively. Participants in the one-item condition trended toward higher compliance (at 83.3%) than individuals in the nine-item condition (at 71.9%). Perceptions of EMA ease and burden did not change over time or vary by group or EMA condition. Higher compliance was associated with temporal variables (day of protocol, time of day, day of week), older age, and better inhibitory control. Higher completion was associated with being unemployed and higher perceived burden. Qualitative analysis of exit interviews indicated that 89% of participants had a generally positive impression of the protocol. CONCLUSIONS: This novel EMA was feasible for adults with and without aphasia. Although EMA research with PWA is still in its infancy, mobile health methodologies provide several promising avenues for improving the accuracy of long-term, in situ surveillance of aphasia symptoms.