An appropriate referral! Word retrieval treatment can benefit individuals with primary progressive aphasia despite disease progression

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Did you know that individuals with primary progressive aphasia (PPA) are less likely to be referred for SLP intervention than individuals with aphasia secondary to stroke? Research suggests that this may be because referring providers—and even treating clinicians—feel pessimistic about prognosis for this neurodegenerative disease. However, Henry et al. (2019) give us a reason to feel optimistic this month!

In this study, participants had mild–moderate logopenic or semantic variant PPA. Read about the three specific PPA variants here. Researchers manipulated treatment technique and dosage to investigate whether SLP intervention can preserve word retrieval skills up to 1 year.

The article gives an informative breakdown of what the clinician/participant actually did in each session. Yes! See Table 2 for the technique. Researchers call their hierarchical method “lexical retrieval treatment.” It combines several techniques you may already know, including semantic feature analysis and orthographic/phonemic cueing. Treatment was repetitive, strategy-focused, and trained specific target words at every session. When creating the targets at the start of treatment, participants generated functional words and used real photos to increase saliency. Researchers included an item if the participant was unable to produce the word in at least two of three attempts during pre-testing.

Now for dosage. Researchers had two groups. One received treatment 1x per week and the other 2x per week. Each session was one hour. The 2x per week folks trained double the number of items and received a “booster” treatment following the three month follow up visit. Importantly, all groups had daily homework for 15 minutes.

Participants named trained items better than at pre-testing in all follow-up sessions up to one year. Untrained items remained better than at pre-testing, but about the same as post-treatment data through six months. Psychosocial measures were favorable for both groups, as well. Keep in mind, this is despite disease progression! Surprisingly, there was no significant difference between the 1x versus 2x per week groups. Researchers suggest that maybe participants relied on strategy use day-to-day, which would have allowed them lots of practice even outside the treatment room. So, keep those referrals coming!

 

Henry, M.L., Hubbard, H.I., Grasso, S.M., Dial, H.R., Beeson, P.M., Miller, B.L., & Gorno-Tempini, M.L. (2019). Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0144