Enhancing communication effectiveness for people with Primary Progressive Aphasia

In primary progressive aphasia (PPA), the loss of ability to communicate severely impacts multiple facets of life for the individual and their close others. The research reported in this thesis aims to advance the evidence base for behavioural interventions for people living with PPA.

The first study (Chapter 2) suggests the characteristics of people with PPA who are likely to adhere to lexical retrieval treatment and who may, therefore, optimally benefit from, and be preferred candidates for treatment. 

Chapters 3 and 4 focus on generalisation of positive gains from treatment to connected speech. A Cueing experiment (Chapter 3) examines the ability of people with PPA to produce verb phrases, when provided with a spoken or written verb or noun cue. Across the case series, both verb and noun cueing are shown to significantly improve verb phrase production, with provision of the verb significantly more effective than provision of the noun. This is further investigated in Chapter 4 where, in five single case studies, individuals with PPA participate in a sequence of verb and noun treatments. Production of treated nouns and/or verbs in isolation are shown to significantly improve following treatment for four of five participants. Two participants with semantic variant PPA demonstrate generalisation to production of treated verbs in verb phrases. Verb phrase production improves most after lexical retrieval treatment of both nouns and verbs, suggesting this may be the most fruitful approach for clinical practice.

Finally, the benefits of a group PPA-specific education and support session in the early post diagnosis period were evaluated (Chapter 5). Caregivers and people with PPA report significant benefits from the intervention; particularly from increased knowledge, support and practical coping strategies.

In summary, this thesis provides evidence of the utility of a range of behavioural interventions for enhancing communication for people with PPA and their close others and has direct clinical application.