scholarly journals Counseling and Care Partner Training in Primary Progressive Aphasia

2021 ◽  
pp. 1-11
Author(s):  
Kristin M. Schaffer ◽  
Maya L. Henry
Keyword(s):  
Primary Progressive Aphasia ◽  
Additional Treatment ◽  
Future Research ◽  
Psychosocial Effects ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Counseling Interventions ◽  
Treatment Considerations ◽  
Treatment Paradigm ◽  
Narrative Literature Review

Purpose Individuals with primary progressive aphasia (PPA) experience loss of communication abilities in the context of neurodegenerative disease. Consequently, many individuals with PPA endorse negative psychosocial effects, including social isolation, reduced communication confidence, and depression. Incorporating communication-centered counseling early and often within the speech-language pathology treatment framework is a vital component in holistically addressing the multifaceted ramifications of living with this devastating disorder. Additionally, care partners are key stakeholders in the treatment dynamic. Involving these individuals in the treatment paradigm through care partner training is crucial for facilitating optimal communication in daily life. The purpose of this narrative literature review is to discuss existing research regarding counseling and care partner training in PPA and to outline additional treatment considerations and future research needs in this understudied area. Conclusions Relative to studies that delineate restitutive speech-language interventions for PPA, the literature pertaining to counseling and care partner training is limited. Available evidence supports the utility of these approaches, which serve as complementary components to restitutive and compensatory speech-language intervention. Additional research is warranted to support generalizability and long-term benefit of these interventions, and to address facets of counseling and care partner training that have not been explored in PPA (e.g., counseling interventions drawing from specific psychotherapeutic traditions; multicultural counseling) or have only been explored to a limited degree (e.g., interventions that jointly provide counseling and partner training).

scholarly journals Speech Metrics and Samples That Differentiate Between Nonfluent/Agrammatic and Logopenic Variants of Primary Progressive Aphasia

2021 ◽  
pp. 1-22
Author(s):  
Katarina L. Haley ◽  
Adam Jacks ◽  
Jordan Jarrett ◽  
Taylor Ray ◽  
Kevin T. Cunningham ◽  
...  
Keyword(s):  
Large Scale ◽  
Primary Progressive Aphasia ◽  
Diagnostic Tools ◽  
Future Research ◽  
Apraxia Of Speech ◽  
Connected Speech ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Syllable Duration ◽  
Semantic Variant

Purpose Of the three currently recognized variants of primary progressive aphasia, behavioral differentiation between the nonfluent/agrammatic (nfvPPA) and logopenic (lvPPA) variants is particularly difficult. The challenge includes uncertainty regarding diagnosis of apraxia of speech, which is subsumed within criteria for variant classification. The purpose of this study was to determine the extent to which a variety of speech articulation and prosody metrics for apraxia of speech differentiate between nfvPPA and lvPPA across diverse speech samples. Method The study involved 25 participants with progressive aphasia (10 with nfvPPA, 10 with lvPPA, and five with the semantic variant). Speech samples included a word repetition task, a picture description task, and a story narrative task. We completed acoustic analyses of temporal prosody and quantitative perceptual analyses based on narrow phonetic transcription and then evaluated the degree of differentiation between nfvPPA and lvPPA participants (with the semantic variant serving as a reference point for minimal speech production impairment). Results Most, but not all, articulatory and prosodic metrics differentiated statistically between the nfvPPA and lvPPA groups. Measures of distortion frequency, syllable duration, syllable scanning, and—to a limited extent—syllable stress and phonemic accuracy showed greater impairment in the nfvPPA group. Contrary to expectations, classification was most accurate in connected speech samples. A customized connected speech metric—the narrative syllable duration—yielded excellent to perfect classification accuracy. Discussion Measures of average syllable duration in multisyllabic utterances are useful diagnostic tools for differentiating between nfvPPA and lvPPA, particularly when based on connected speech samples. As such, they are suitable candidates for automatization, large-scale study, and application to clinical practice. The observation that both speech rate and distortion frequency differentiated more effectively in connected speech than on a motor speech examination suggests that it will be important to evaluate interactions between speech and discourse production in future research.

scholarly journals Semantic Variant Primary Progressive Aphasia: Practical Recommendations for Treatment from 20 Years of Behavioural Research

2021 ◽  
Vol 11 (12) ◽  
pp. 1552
Author(s):  
Aida Suárez-González ◽  
Sharon A. Savage ◽  
Nathalie Bier ◽  
Maya L. Henry ◽  
Regina Jokel ◽  
...  
Keyword(s):  
Best Practice ◽  
Current Knowledge ◽  
Primary Progressive Aphasia ◽  
Memory Systems ◽  
Semantic Knowledge ◽  
Future Research ◽  
Long Term Memory ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Semantic Variant

People with semantic variant primary progressive aphasia (svPPA) present with a characteristic progressive breakdown of semantic knowledge. There are currently no pharmacological interventions to cure or slow svPPA, but promising behavioural approaches are increasingly reported. This article offers an overview of the last two decades of research into interventions to support language in people with svPPA including recommendations for clinical practice and future research based on the best available evidence. We offer a lay summary in English, Spanish and French for education and dissemination purposes. This paper discusses the implications of right- versus left-predominant atrophy in svPPA, which naming therapies offer the best outcomes and how to capitalise on preserved long-term memory systems. Current knowledge regarding the maintenance and generalisation of language therapy gains is described in detail along with the development of compensatory approaches and educational and support group programmes. It is concluded that there is evidence to support an integrative framework of treatment and care as best practice for svPPA. Such an approach should combine rehabilitation interventions addressing the language impairment, compensatory approaches to support activities of daily living and provision of education and support within the context of dementia.

scholarly journals Multidimensional Apathy in Behavioral Variant Frontotemporal Dementia, Primary Progressive Aphasia, and Alzheimer Disease

2020 ◽  
pp. 089198872092471
Author(s):  
Ratko Radakovic ◽  
Shuna Colville ◽  
Denise Cranley ◽  
John M. Starr ◽  
Suvankar Pal ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Frontotemporal Dementia ◽  
Primary Progressive Aphasia ◽  
Future Research ◽  
Self Awareness ◽  
Behavioral Variant Frontotemporal Dementia ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Patient Groups ◽  
Rating Discrepancy

Apathy is prevalent in dementia, such as behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and Alzheimer disease (AD). As a multidimensional construct, it can be assessed and subsumed under a Dimensional Apathy Framework. A consistent apathy profile in bvFTD and PPA has yet to be established. The aim was to explore apathy profiles and awareness in bvFTD, PPA, and AD. A total of 12 patients with bvFTD, 12 patients with PPA, 28 patients with AD, and 20 matched controls, as well as their informants/carers, were recruited. All participants completed the Dimensional Apathy Scale (DAS), assessing executive, emotional, and initiation apathy subtypes, a 1-dimensional apathy measure, depression measure, and functional and cognitive screens. Apathy subtype awareness was determined through DAS informant/carer and self-rating discrepancy. Apathy profile comparison showed patients with bvFTD had significantly higher emotional apathy than patients with AD ( P < .01) and significantly higher apathy over all subtypes than patients with PPA ( Ps < .05). Additionally, patients with bvFTD had significantly lower awareness for emotional apathy ( P < .01) when compared to patients with AD and PPA. All patient groups had significant global apathy over all subtypes compared to controls. The emergent apathy profile for bvFTD seems to be emotional apathy (indifference or emotional/affective neutrality), with lower self-awareness in this subtype. Further, lower self-awareness for executive apathy (lack of motivation for planning, organization, or attention) differentiates bvFTD from PPA. Future research should investigate the cognitive and neural correlates as well as the practical impact of apathy subtypes.

scholarly journals Describing Phonological Paraphasias in Three Variants of Primary Progressive Aphasia

2018 ◽  
Vol 27 (1S) ◽  
pp. 336-349 ◽  
Author(s):  
Sarah Grace Hudspeth Dalton ◽  
Christine Shultz ◽  
Maya L. Henry ◽  
Argye E. Hillis ◽  
Jessica D. Richardson
Keyword(s):  
Target Word ◽  
Phonological Processing ◽  
Speech Rate ◽  
Primary Progressive Aphasia ◽  
Future Research ◽  
Word Target ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Sequencing Errors ◽  
Part Of Speech

Purpose The purpose of this study was to describe the linguistic environment of phonological paraphasias in 3 variants of primary progressive aphasia (semantic, logopenic, and nonfluent) and to describe the profiles of paraphasia production for each of these variants. Method Discourse samples of 26 individuals diagnosed with primary progressive aphasia were investigated for phonological paraphasias using the criteria established for the Philadelphia Naming Test (Moss Rehabilitation Research Institute, 2013). Phonological paraphasias were coded for paraphasia type, part of speech of the target word, target word frequency, type of segment in error, word position of consonant errors, type of error, and degree of change in consonant errors. Results Eighteen individuals across the 3 variants produced phonological paraphasias. Most paraphasias were nonword, followed by formal, and then mixed, with errors primarily occurring on nouns and verbs, with relatively few on function words. Most errors were substitutions, followed by addition and deletion errors, and few sequencing errors. Errors were evenly distributed across vowels, consonant singletons, and clusters, with more errors occurring in initial and medial positions of words than in the final position of words. Most consonant errors consisted of only a single-feature change, with few 2- or 3-feature changes. Importantly, paraphasia productions by variant differed from these aggregate results, with unique production patterns for each variant. Conclusions These results suggest that a system where paraphasias are coded as present versus absent may be insufficient to adequately distinguish between the 3 subtypes of PPA. The 3 variants demonstrate patterns that may be used to improve phenotyping and diagnostic sensitivity. These results should be integrated with recent findings on phonological processing and speech rate. Future research should attempt to replicate these results in a larger sample of participants with longer speech samples and varied elicitation tasks. Supplemental Materials https://doi.org/10.23641/asha.5558107

scholarly journals Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: A systematic review of the literature

2013 ◽  
Vol 7 (1) ◽  
pp. 122-131 ◽  
Author(s):  
Maria Teresa Carthery-Goulart ◽  
Amanda da Costa da Silveira ◽  
Thais Helena Machado ◽  
Leticia Lessa Mansur ◽  
Maria Alice de Mattos Pimenta Parente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Rehabilitation ◽  
Primary Progressive Aphasia ◽  
Future Research ◽  
Single Subject ◽  
Evidence Based ◽  
Research Committee ◽  
Level Of Evidence ◽  
Progressive Aphasia ◽  
Primary Progressive

ABSTRACT This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. Methods: A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. Results: Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. Conclusion: Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.

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