Treatment for Anomia in Bilingual Speakers with Progressive Aphasia

Anomia is an early and prominent feature of primary progressive aphasia (PPA) and other neurodegenerative disorders. Research investigating treatment for lexical retrieval impairment in individuals with progressive anomia has focused primarily on monolingual speakers, and treatment in bilingual speakers is relatively unexplored. In this series of single-case experiments, 10 bilingual speakers with progressive anomia received lexical retrieval treatment designed to engage relatively spared cognitive-linguistic abilities and promote word retrieval. Treatment was administered in two phases, with one language targeted per phase. Cross-linguistic cognates (e.g., rose and rosa) were included as treatment targets to investigate their potential to facilitate cross-linguistic transfer. Performance on trained and untrained stimuli was evaluated before, during, and after each phase of treatment, and at 3, 6, and 12 months post-treatment. Participants demonstrated a significant treatment effect in each of their treated languages, with maintenance up to one year post-treatment for the majority of participants. Most participants showed a significant cross-linguistic transfer effect for trained cognates in both the dominant and nondominant language, with fewer than half of participants showing a significant translation effect for noncognates. A gradual diminution of translation and generalization effects was observed during the follow-up period. Findings support the implementation of dual-language intervention approaches for bilingual speakers with progressive anomia, irrespective of language dominance.

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Treating lexical retrieval using letter fluency and tDCS in primary progressive aphasia: a single-case study

Aphasiology ◽

10.1080/02687038.2021.1881432 ◽

2021 ◽

pp. 1-27

Author(s):

Vânia de Aguiar ◽

Adrià Rofes ◽

Haley Wendt ◽

Bronte N. Ficek ◽

Kimberly Webster ◽

...

Keyword(s):

Single Case ◽

Primary Progressive Aphasia ◽

Lexical Retrieval ◽

Single Case Study ◽

Progressive Aphasia ◽

Primary Progressive

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Embedding Aphasia-Modified Cognitive Behavioral Therapy in Script Training for Primary Progressive Aphasia: A Single-Case Pilot Study

American Journal of Speech-Language Pathology ◽

10.1044/2021_ajslp-20-00361 ◽

2021 ◽

pp. 1-16

Author(s):

Kristin M. Schaffer ◽

William S. Evans ◽

Christina D. Dutcher ◽

Christina Philburn ◽

Maya L. Henry

Keyword(s):

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Single Case ◽

Primary Progressive Aphasia ◽

Phenomenological Analysis ◽

Post Treatment ◽

Cognitive Behavioral ◽

Progressive Aphasia ◽

Primary Progressive ◽

Script Training

Purpose This study sought to determine the initial feasibility and benefit of a novel intervention that combines speech-language treatment with counseling treatment for an individual with the nonfluent/agrammatic variant of primary progressive aphasia (PPA). Method Using a single-case experimental design, we evaluated the utility of modified script training paired with aphasia-modified cognitive behavioral therapy. The study employed a multiple baseline design across scripts for the primary linguistic outcome measure and a mixed methods approach for analyzing counseling outcomes. Psychosocial and communicative functioning scales were administered in conjunction with a phenomenological analysis of semi-structured interviews. Results The participant completed all study phases and participated in all treatment components. She met the criterion of 90% correct, intelligible scripted words on all trained scripts through 12 months post-treatment. Treatment outcomes were comparable to a comparison cohort that received script training without counseling ( Henry et al., 2018 ). At post-treatment, the participant demonstrated stability or improvement on all measures of psychosocial and communicative functioning, with stability documented on seven out of 11 scales at follow-ups through 12 months post-treatment. A phenomenological analysis revealed pervasive themes of loss and resilience at both time points, and emerging themes of positive self-perception, sense of agency, and emotional attunement following treatment. Conclusions Results indicate that script training with aphasia-modified cognitive behavioral therapy is a feasible treatment for an individual with the nonfluent/agrammatic variant of PPA, with immediate and lasting benefits to speech-language production and psychosocial functioning. These findings are the first to support the integration of personal adjustment counseling techniques within a speech-language treatment paradigm for PPA. Supplemental Material https://doi.org/10.23641/asha.14925330

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Exploring generalisation processes following lexical retrieval intervention in primary progressive aphasia

International Journal of Speech-Language Pathology ◽

10.3109/17549507.2016.1151936 ◽

2016 ◽

Vol 18 (3) ◽

pp. 299-314 ◽

Cited By ~ 16

Author(s):

Ashleigh Beales ◽

Jade Cartwright ◽

Anne Whitworth ◽

Peter K. Panegyres

Keyword(s):

Primary Progressive Aphasia ◽

Lexical Retrieval ◽

Progressive Aphasia ◽

Primary Progressive

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The Effect of Word Retrieval Therapy in Primary Progressive Aphasia: A Single-Case Study

Archives of Neuroscience ◽

10.5812/ans.67577 ◽

2018 ◽

Vol In Press (In Press) ◽

Cited By ~ 1

Author(s):

Salime Jafari ◽

Ahmad Reza Khatoonabadi ◽

Maryam Noroozian ◽

Azar Mehri ◽

Hassan Ashayeri ◽

...

Keyword(s):

Single Case ◽

Primary Progressive Aphasia ◽

Word Retrieval ◽

Single Case Study ◽

Progressive Aphasia ◽

Primary Progressive

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Making the Right Connections: Maximizing Lexical Generalization in Lexical Impairments in Primary Progressive Aphasia and Alzheimer's Disease

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-20-00019 ◽

2021 ◽

pp. 1-16

Author(s):

Ashleigh Beales ◽

Anne Whitworth ◽

Jade Cartwright ◽

Peter K. Panegyres ◽

Robert T. Kane

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family Members ◽

Primary Progressive Aphasia ◽

Lexical Retrieval ◽

Connected Speech ◽

Progressive Aphasia ◽

Primary Progressive ◽

Word Classes ◽

The Impact

Purpose Positive intervention effects following lexical retrieval interventions are increasingly reported with people with progressive language impairments; however, generalization of therapy gains are less frequently evident and less well understood. This study sought to explore the impact of specific therapy ingredients on generalization outcomes. Method Twelve participants with progressive lexical retrieval deficits (four each with semantic variant primary progressive aphasia, logopenic variant primary progressive aphasia, and Alzheimer's disease, amnestic presentation) and their family members participated in a 6-week intervention that aimed to increase access to different word classes (nouns, verbs, and adjectives) through a strategic self-cueing approach. Generalization was actively facilitated through strategy practice in connected speech. Repeated baselines of picture naming and connected speech were conducted prior to intervention and repeated immediately post and at 6 weeks following intervention. Results All three diagnostic groups showed significant improvements in naming performance post-intervention for all word classes and for both treated and untreated items, demonstrating consistent treatment effectiveness and generalization at the word level. No changes in the informativeness or efficiency of connected speech were found. Conclusions Despite heterogeneity across participants, widespread evidence of both treatment effects and generalization to untreated items was found for all diagnostic groups and word classes. The consistent within-level generalization across all groups is explored here in relation to optimization of strategy use through incorporation of cognitive scaffolds, strategic practice at the connected speech level, and the inclusion of family members. The absence of across-level generalization to connected speech is also explored. Supplemental Material https://doi.org/10.23641/asha.14219771

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Lost for words: Perspectives and experiences of people with primary progressive aphasia and Alzheimer’s disease and their families of participation in a lexical retrieval intervention

International Journal of Speech-Language Pathology ◽

10.1080/17549507.2019.1625439 ◽

2019 ◽

Vol 21 (5) ◽

pp. 483-492 ◽

Cited By ~ 1

Author(s):

Ashleigh Beales ◽

Kristyn Bates ◽

Jade Cartwright ◽

Anne Whitworth

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Primary Progressive Aphasia ◽

Lexical Retrieval ◽

Progressive Aphasia ◽

Primary Progressive

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Treatment for Lexical Retrieval Impairments in Primary Progressive Aphasia: A Research Update with Implications for Clinical Practice

Seminars in Speech and Language ◽

10.1055/s-0038-1660783 ◽

2018 ◽

Vol 39 (03) ◽

pp. 242-256 ◽

Cited By ~ 8

Author(s):

Karen Croot

Keyword(s):

Clinical Practice ◽

Clinical Decision Making ◽

Primary Progressive Aphasia ◽

Clinical Decision ◽

Lexical Retrieval ◽

Progressive Aphasia ◽

Primary Progressive ◽

Behavioral Studies ◽

Long Term Treatment

AbstractLexical retrieval impairments (also known as anomia or word-finding deficits) are an early and prominent symptom in primary progressive aphasia (PPA), causing distress and frustration to individuals with PPA and their communication partners, and prompting research on lexical retrieval treatment. This paper reviews the research on lexical retrieval treatment in PPA from the earliest reports in the 1990s to early 2018 and considers the implications of this research for clinical practice. The number of published studies has increased markedly over the past decade, consisting primarily of behavioral studies, with rapid recent growth in noninvasive brain stimulation studies. Five general treatment techniques were identified in the behavioral studies, described here as standard naming treatment, Look, Listen, Repeat treatment, cueing hierarchies, semantically focused treatments, and lexical retrieval in context. Across techniques, behavioral studies targeting difficult-to-retrieve items typically report immediate gains, and there is evidence these gains can be maintained over months to years by some participants who continue with long-term treatment. There is also evidence that prophylactic treatment supports retrieval of treated items compared with untreated items. There is limited evidence for generalization of treatment to untreated items, suggesting the primary aim of lexical retrieval treatment in this population is to maintain retrieval of a core vocabulary for as long as possible. Language and cognitive assessment and piloting of the intended treatment can inform decisions about treatment selection and participant suitability for long-term lexical retrieval treatment. The paper concludes with some questions to guide clinical decision making about whether to implement or continue with a behavioral lexical retrieval treatment.

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