Comprehensive intervention combining group and personalized language therapy in primary progressive aphasia: Quantitative and qualitative findings

Abstract

INTRODUCTION: Increasingly, studies are demonstrating language and communication improvement after behavioral interventions for primary progressive aphasia (PPA), and the caregiver perspective has been highlighted as critically important to determining treatment success in this population. This is an exploratory study investigating a comprehensive, person-centered intervention promoting everyday communication, functional independence, and quality of life for people with PPA (PwPPA) and their caregivers. METHODS: Four intervention programs were run separately in 6 to 8 week blocks with a total of 14 dyads (PwPPA and caregiver) enrolled. Group sessions lasted 2 hours and included communication strategy training, PPA education from multidisciplinary experts, speech therapy for PwPPA, and a support group for caregivers (blocks 1 and 2). Personalized language exercises were assigned for home practice, using apps or paper-and-pencil tasks. Quantitative and qualitative outcomes were measured before and after each treatment block and included: the Revised Western Aphasia Battery (WAB-R) Aphasia Quotient (AQ) and subtest scores, content information units (CIUs) on the WAB-R picture description task, and qualitative content analysis of semi-structured interviews, gathered from both PwPPA and caregivers. RESULTS: No statistically significant changes were noted in mean WAB-AQ score pre- to post-intervention. Mean CIUs produced on the WAB-R picture description task pre- to post-intervention increased and approached significance (β = 2.7; confidence interval: −0.45, 5.86, p = 0.09). Qualitative findings from PwPPA and caregivers were very positive, and underscored the sense of community, improved language, communication, and well-being, and access to multidisciplinary expertise and resources afforded by the program. DISCUSSION: Further investigation into the most appropriate assessment tools and intervention approaches for PPA is warranted and has the potential to make a significant positive impact on PwPPA and their families. Highlights: We combined quantitative and qualitative measures of efficacy in treating primary progressive aphasia. Language skills were maintained and communication improvement approached significance. Participants noted the benefits of peer support, education, and communication practice.