Script club: motivating change through remote delivery of group script training for people with primary progressive aphasia

Abstract

Introduction: Primary Progressive Aphasia (PPA) describes a group of language led dementias. Script training is a speech and language therapy intervention that has been shown to improve fluency and grammatical well-formedness of speech or spoken output for people with nonfluent/agrammatic variant. Research studies exploring script training have been delivered on an individual basis, both face to face and remotely, via telehealth. Group therapy has the potential to increase access to therapy whilst promoting participation and generalisation to everyday conversational contexts. Aims: To conduct a clinical service improvement study, exploring the feasibility, acceptability, and impact on confidence and spoken script production, of an online script therapy group for people with PPA. Methods & Procedures: Sixteen people with PPA took part in four script groups delivered via telehealth within a national speech and language therapy service in the UK. “Script Club” was delivered to four cohorts of four participants over eight one-hour sessions. Feasibility and acceptability were assessed through attendance and focus group feedback. Pre- and post-intervention outcome measures were collected to evaluate the accuracy and fluency of spoken scripts. Communication confidence was measured using the Communication Confidence Rating Scale in Aphasia pre- and post-therapy, and 3-months later. Outcomes & Results: Fifteen people completed the intervention. Attendance at script club was 93%, and feedback overwhelmingly positive. Script production data was available for eight participants. Accuracy of personalised script production improved from 42.08% pre-treatment to 67.94% immediately post-treatment. Script fluency and intelligibility improved immediately post treatment, non-significantly. Communication confidence data was available for fifteen participants. Confidence improved non-significantly following therapy, reaching significance at 3-month follow up. Conclusion: Remote group script training was feasible and acceptable to run within the National Health Service in the UK. Non-significant improvements in communication confidence and speech fluency, accuracy and intelligibility were observed immediately following group participation. Significant improvements in communication confidence were observed 3-months after participation. This is thought to be due to “enactment”, or putting into practice gains made in “Script Club” in everyday life.