Effects of functional communication interventions for people with primary progressive aphasia and their caregivers: a systematic review

Volkmer, Anna; Spector, Aimee; Meitanis, Vanessa; Warren, Jason D.; Beeke, Suzanne

doi:10.1080/13607863.2019.1617246

Cited by 59 publications

(42 citation statements)

References 52 publications

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“…In recent years, there has been an increase in research focusing on compensatory, or functional approaches to symptom management for people with PPA [103]. These approaches focus on compensating for the speech and language difficulties through use of strategies, environmental supports, or augmentative alternative communication aids.…”

Section: The Challenge Of Treatment: Optimising Function and Changingmentioning

confidence: 99%

Primary Progressive Aphasia: Toward a Pathophysiological Synthesis

Ruksenaite

Volkmer

Jiang

et al. 2021

Curr Neurol Neurosci Rep

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Purpose of Review The term primary progressive aphasia (PPA) refers to a diverse group of dementias that present with prominent and early problems with speech and language. They present considerable challenges to clinicians and researchers. Recent Findings Here, we review critical issues around diagnosis of the three major PPA variants (semantic variant PPA, nonfluent/agrammatic variant PPA, logopenic variant PPA), as well as considering ‘fragmentary’ syndromes. We next consider issues around assessing disease stage, before discussing physiological phenotyping of proteinopathies across the PPA spectrum. We also review evidence for core central auditory impairments in PPA, outline critical challenges associated with treatment, discuss pathophysiological features of each major PPA variant, and conclude with thoughts on key challenges that remain to be addressed. Summary New findings elucidating the pathophysiology of PPA represent a major step forward in our understanding of these diseases, with implications for diagnosis, care, management, and therapies.

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Section: The Challenge Of Treatment: Optimising Function and Changingmentioning

confidence: 99%

Primary Progressive Aphasia: Toward a Pathophysiological Synthesis

Ruksenaite

Volkmer

Jiang

et al. 2021

Curr Neurol Neurosci Rep

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“…Several studies have demonstrated effectiveness of intervention approaches in improving naming difficulties in PPAs [ 12 , 17 , 22 , 24 , 25 , 55 – 60 ], supporting both crucial roles of early intervention and the possibility of inducing generalization and long-term maintenance of gains [ 21 , 56 , 61 , 62 ].…”

Section: Naming Treatment In Ppamentioning

confidence: 99%

Language training for oral and written naming impairment in primary progressive aphasia: a review

Pagnoni

Gobbi

Premi

et al. 2021

Transl Neurodegener

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Background Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by a gradual, insidious and progressive loss of language abilities, with naming difficulties being an early and persistent impairment common to all three variants. In the absence of effective pharmacological treatments and given the progressive nature of the disorder, in the past few decades, many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life. Main body We review language treatments most commonly used in clinical practice among patients with different variants of PPA, with a focus on the enhancement of spoken and written naming abilities. Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed. Forty-eight studies were included in this literature review, identifying four main types of language treatment: a) lexical retrieval treatment, b) phonological and/or orthographic treatment, c) semantic treatment, and d) a multimodality approach treatment. Overall, language training is able to induce immediate improvements of naming abilities in all variants of PPA. Moreover, despite the large variability among results, generalization and long-term effects can be recorded after the training. The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system. Conclusion The majority of studies have demonstrated improvements of naming abilities following language treatments. Given the progressive nature of PPA, it is essential to apply language treatment in the early stages of the disease.

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“…A systematic review of the effects of functional communication‐focused interventions for people with PPA and their caregivers is currently in preparation by the authors (Volkmer et al . ).…”

Section: Introductionmentioning

confidence: 97%

Speech and language therapy for primary progressive aphasia across the UK: A survey of current practice

Volkmer

Spector

Warren

et al. 2019

Intl J Lang & Comm Disor

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Background: Primary progressive aphasia (PPA) describes a heterogeneous group of language-led dementias. People with this type of dementia are increasingly being referred to speech and language therapy (SLT) services. Yet, there is a paucity of research evidence focusing on PPA interventions and little is known about SLT practice in terms of assessment and provision of intervention. Aims: To survey the practices of SLTs in the areas of assessment and intervention for people with PPA. Methods & Procedures:A 37-item, pilot-tested survey was distributed electronically through the Royal College of Speech and Language Therapists (RCSLT), Clinical Excellence Networks (CENs) and social media networks. Survey items included questions on care pathways, assessment and intervention approaches, and future planning. Analysis was conducted using descriptive statistics and thematic analysis. Outcomes & Results: A total of 105 SLTs completed the survey. Respondents reported more frequently using formal assessment tools designed for stroke-related aphasia than for dementia. Informal interviews were reportedly always used during assessment by almost 80% of respondents. Respondents were significantly more likely to use communication partner training than impairment-focused interventions. Goal attainment was the most commonly used outcome measure. Respondents provided 88 goal examples, which fell into six themes: communication aid; conversation; functional communication; impairment focused; specific strategy; and communication partner. Additionally, respondents reported addressing areas such as future deterioration in communication and cognition, decision-making and mental capacity, and driving. Ten (9.4%) respondents reported the existence of a care pathway for people with PPA within their service. Conclusions & Implications:This survey highlights the range of current PPA assessment and intervention practices in use by the respondents. Communication partner training is commonly used by the surveyed SLTs, despite the lack of research evidence examining its effectiveness for PPA. There is a need to develop evidence-based care pathways for people with PPA in order to advocate for further commissioning of clinical services. What this paper addsWhat is already known on the subject People with PPA present with communication difficulties, yet they find it difficult to access SLT services. Research literature examining the effectiveness of PPA interventions remains sparse and is dominated by impairment-based approaches to word relearning. Little is known about the nature of services delivered by SLTs to people with PPA in the UK.What this paper adds to existing knowledge SLT respondents report using informal assessment tools such as interviewing, or those designed for stroke-related aphasia, not for dementia. SLTs report that they were more likely to select communication partner training than

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Effects of functional communication interventions for people with primary progressive aphasia and their caregivers: a systematic review

Cited by 59 publications

References 52 publications

Primary Progressive Aphasia: Toward a Pathophysiological Synthesis

Primary Progressive Aphasia: Toward a Pathophysiological Synthesis

Language training for oral and written naming impairment in primary progressive aphasia: a review

Speech and language therapy for primary progressive aphasia across the UK: A survey of current practice

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