scholarly journals Convergent and Construct Validity of a Conversation Difficulties Outcome Measure in Primary Progressive Aphasia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1037-1037
Author(s):  
Haylie Santos ◽  
Angela Roberts ◽  
Nathan Gill ◽  
Elizabeth Salley ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Construct Validity ◽  
Convergent Validity ◽  
Primary Progressive Aphasia ◽  
Communication Effectiveness ◽  
Functional Communication ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Communication Impairments ◽  
Effectiveness Index

Abstract Cognition and language changes, and their impacts on functional communication, are central to many dementias. Thus, functional communication, including conversation difficulties, is an important endpoint for clinical trials. To develop robust outcomes in primary progressive aphasia (PPA), a dementia characterized by communication impairments, we examined the convergent and construct validity of the Perception of Conversation Difficulties-Dementia Alzheimer’s Type (PCI-DAT; Orange et al., 2009). The PCI-DAT is a care partner reported measure of conversation difficulties. Eighty-two care partners with a mean age of 64.8 years (SD=10.61; 85% spouses, 5% adult children, 10% friends/siblings) whose mean relationship duration to the person with PPA was 39.1 (SD=15.1) years completed the study. Pearson’s correlation indicated a significant, modest correlation (r=-0.54, p<0.0001) between the PCI-DAT Perception of Conversation Difficulties subscale and the Communication Effectiveness Index (Lomas et al., 1989) suggesting strong convergent validity. A Rasch analysis conducted on the same PCI-DAT subscale showed high person (0.92) and item (0.95) reliability indicating a robust overall scale structure that adequately evaluates various levels of conversation difficulty severity in PPA. Six items (27%) had minor ‘fit’ issues (defined by Wright and Linacre, 1994 as having infit statistics < 0.6 or > 1.4) relative to the underlying construct. Results suggest strong convergent and construct validity of the PCI-DAT in PPA and indicate items that will benefit from further development. Overall, our results suggest that the PCI-DAT holds promise for use as a functional communication endpoint in PPA clinical trials. Data for all five PCI-DAT subscales will be presented.

scholarly journals Breakdowns in Informativeness of Naturalistic Speech Production in Primary Progressive Aphasia

2021 ◽  
Vol 11 (2) ◽  
pp. 130
Author(s):  
Jeanne Gallée ◽  
Claire Cordella ◽  
Evelina Fedorenko ◽  
Daisy Hochberg ◽  
Alexandra Touroutoglou ◽  
...  
Keyword(s):  
Primary Progressive Aphasia ◽  
Speech Analysis ◽  
Clinical Settings ◽  
Functional Communication ◽  
Or Efficiency ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Communication Impairment ◽  
Semantic Variant ◽  
Lower Production

“Functional communication” refers to an individual’s ability to communicate effectively in his or her everyday environment, and thus is a paramount skill to monitor and target therapeutically in people with aphasia. However, traditional controlled-paradigm assessments commonly used in both research and clinical settings often fail to adequately capture this ability. In the current study, facets of functional communication were measured from picture-elicited speech samples from 70 individuals with mild primary progressive aphasia (PPA), including the three variants, and 31 age-matched controls. Building upon methods recently used by Berube et al. (2019), we measured the informativeness of speech by quantifying the content of each patient’s description that was relevant to a picture relative to the total amount of speech they produced. Importantly, form-based errors, such as mispronunciations of words, unusual word choices, or grammatical mistakes are not penalized in this approach. We found that the relative informativeness, or efficiency, of speech was preserved in non-fluent variant PPA patients as compared with controls, whereas the logopenic and semantic variant PPA patients produced significantly less informative output. Furthermore, reduced informativeness in the semantic variant is attributable to a lower production of content units and a propensity for self-referential tangents, whereas for the logopenic variant, a lower production of content units and relatively ”empty” speech and false starts contribute to this reduction. These findings demonstrate that functional communication impairment does not uniformly affect all the PPA variants and highlight the utility of naturalistic speech analysis for measuring the breakdown of functional communication in PPA.

scholarly journals A Window Into Functional Communication: Leveraging Naturalistic Speech Samples in Primary Progressive Aphasia

2021 ◽  
pp. 1-10
Author(s):  
Jeanne Gallée ◽  
Anna Volkmer
Keyword(s):  
Primary Progressive Aphasia ◽  
Functional Communication ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Communication Difficulties ◽  
Treatment Plans ◽  
Strengths And Difficulties ◽  
Disordered Speech ◽  
Everyday Communication ◽  
Diagnose Monitor

Purpose Naturalistic speech samples should be routinely collected in the assessment of individuals with communication difficulties. However, even when these samples are collected, they are often underutilized. We propose that the analysis of naturalistic speech samples can greatly enhance our understanding and evaluation of the functional impact of primary progressive aphasia (PPA) on communication. First, we review the current practices of evaluating PPA. Second, we provide a framework to optimize the collection, analysis, and interpretation of speech samples to accomplish this goal. In particular, we demonstrate how speech samples can be evaluated for measures of informativeness, the presence of atypical patterns of speech, articulatory rate, and pausing, all of which are helpful metrics in characterizing disordered speech. These factors can be leveraged to identify both the strengths and difficulties an individual may face in everyday communication. Conclusion The collection of naturalistic speech in both clinical and naturalistic settings with typical communication partners is highly recommended to best diagnose, monitor, and inform treatment plans for individuals with PPA.

scholarly journals FEASIBILITY OF AN INTENSIVE SPEECHLANGUAGE THERAPY PROGRAM FOR PRIMARY PROGRESSIVE APHASIA

2021 ◽  
Author(s):  
Maria Isabel Freitas ◽  
Ricardo Nitrini
Keyword(s):  
Speech Intelligibility ◽  
Intensive Therapy ◽  
Primary Progressive Aphasia ◽  
Functional Communication ◽  
Progressive Aphasia ◽  
Face To Face ◽  
Primary Progressive ◽  
Therapy Program ◽  
General Desire ◽  
Language Areas

Background: Primary progressive aphasia (PPA) is caused by selective neurodegeneration of the specific language areas in the brain. Until recently, this area had been dominated by impairment-focused interventions, more specifically, word-retrieval therapies. The compensatory-based approach targets everyday use of conversation between a people with PPA (pwPPA) and the family member or carer, and is underpinned by an assessment of those strategies which facilitate communication and those that act as a barrier. Objective: To analyze the feasibility of an intensive SLT program for pwPPA. Methods: Three patients with PPA (1 with PPA-S, 1 PPA-NF and 1 PPA-L) received the treatment (2 by face-to-face format and one by videoconference/telerehabilitation). The program comprised an initial evaluation of 2 hours (day 1), five 1-hour treatment sessions on consecutive days (days 2 to 6), followed by a post-treatment evaluation (day 7) to determine the results of the intensive therapy. Results: The treatment provided a greater load of cognitive-linguistic stimuli, which promoted some gains in speech intelligibility, functional communication improving general desire to engage in communicative exchanges relative to baseline. Conclusions: The intensive program was feasible and that some gains in functional communication can be made after five consecutive sessions in the same week.

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