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Treatment of spoken and written word retrieval in primary progressive aphasia

Trudy Krajenbrink1*, Karen Croot1, 2, Cathleen Taylor1, 3 and Lyndsey A. Nickels1
  • 1 ARC Centre of Excellence in Cognition and its DIsorders (CCD), Macquarie University, Department of Cognitive Science, Australia
  • 2 The School of Psychology, University of Sydney, Australia
  • 3 War Memorial Hospital, Speech Pathology Department, Australia

Primary progressive aphasia (PPA) is a neurodegenerative disease, with loss of language functions marking the onset of the disease. Despite the progressive nature of the condition, language impairment in PPA can be responsive to treatment (e.g., Jokel, Graham, Rochon, & Leonard, 2014), and, importantly, previous studies suggest that treated words seem to be somewhat protected from the decline associated with PPA. However, challenges remain regarding the generalisation of these effects to untreated items and to using treated words outside the context of picture naming (Croot et al., 2015; Savage, Piguet, & Hodges, 2014). Furthermore, even though PPA treatment has mainly focused on spoken language, spelling impairment (dysgraphia) is a common feature of PPA (Graham, 2014). Given the often limited speech pathology resources for PPA (e.g., Taylor, Miles-Kingma, Croot, & Nickels, 2009), a treatment method focusing on both spoken and written modalities would be desirable. Only three evaluations of spelling treatment have been reported to date (Rapp & Glucroft, 2009; Tsapkini, Frangakis, Gomez, Davis, & Hillis, 2014; Tsapkini & Hillis, 2013), with only one variant of PPA (logopenic variant). The current study investigates 1) whether spelling can be improved in the semantic variant of PPA (svPPA), and 2) whether spelling can provide extra support for spoken word retrieval. The study will compare the effects of two variants of a lexical retrieval treatment used in progressive aphasia treatments (Repetition and/or Reading In the Presence of a Picture; RRIPP: Croot et al., 2015): 1) using spoken naming only, and 2) using a combination of spoken and written naming. Participant DSN was diagnosed with svPPA and showed impaired word retrieval and comprehension, and characteristics of spelling impairment which could be categorised as surface dysgraphia. Two phases of RRIPP treatment will be administered. In three pre- and three post-therapy assessments all treated and untreated words will be administered for spoken and written naming, to test for treatment effects and generalisation. A set of 120 personally relevant items was created based on informal conversation with DSN and his spouse. Based on pre-treatment accuracy, items will be divided into three matched sets: set 1 will be treated in spoken naming treatment (RRIPP) only; set 2 will be treated using spoken and written naming; and set 3 will act as untreated controls. A picture of each treated item will be presented with its corresponding written name, and with a sound file playing the spoken form. In the first treatment phase DSN repeats the picture name, and in phase two DSN also writes down the picture name. To ensure treatment improves word retrieval processes beyond simply associating a lexical item with the picture used in treatment (see Croot et al., 2015), different picture exemplars will be used for pre- and post-tests and treatment. The study is currently underway. Our research will investigate 1) whether treatment of svPPA using RRIPP results in improved spoken and written word retrieval, and 2) whether adding a written component to a lexical retrieval treatment results in larger gains.

References

Croot, K., Taylor, C., Abel, S., Jones, K., Krein, L., Hameister, I., Ruggero, L., & Nickels, L. (2015). Measuring gains in connected speech following treatment for word retrieval: a study with participants with primary progressive aphasia. Aphasiology, 29(11), 1265-1288.

Graham, N. (2014). Dysgraphia in primary progressive aphasia: Characterisation of impairments and therapy options. Aphasiology, 28, 8-9, 1092-1111.

Jokel, R., Graham, N. L., Rochon, E., & Leonard, C. (2014). Word retrieval therapies in primary progressive aphasia. Aphasiology, 18, 1–31.

Rapp, B., & Glucroft, B. (2009). The benefits and protective effects of behavioural treatment for dysgraphia in a case of primary progressive aphasia. Aphasiology, 23, 236-265.

Savage, S. A., Piguet, O., Hodges, J. R. (2014). Giving words new life: Generalization of words retraining outcomes in semantic dementia. Journal of Alzheimer’s Disease, 40(2), 309-317.

Taylor, C., Miles-Kingma, R., Croot, K. & Nickels, L. (2009). Speech pathology services for primary progressive aphasia: Exploring an emerging area of practice. Aphasiology, 23, 161-174.

Tsapkini, K., Frangakis, C., Gomez, Y., Davis, C., & Hillis, A. E. (2014). Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges. Aphasiology, 28(8-9), 1112-1130.

Tsapkini, K., & Hillis, A. E. (2013). Spelling intervention in post-stroke aphasia and primary progressive aphasia. Behavioural neurology, 26, 55-66.

Keywords: primary progressive aphasia, lexical retrieval therapy, Spoken naming, Written naming, dysgraphia

Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016.

Presentation Type: Platform Sessions

Topic: Academy of Aphasia

Citation: Krajenbrink T, Croot K, Taylor C and Nickels LA (2016). Treatment of spoken and written word retrieval in primary progressive aphasia. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00071

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Received: 29 Apr 2016; Published Online: 15 Aug 2016.

* Correspondence: Dr. Trudy Krajenbrink, ARC Centre of Excellence in Cognition and its DIsorders (CCD), Macquarie University, Department of Cognitive Science, Macquarie University, Australia, trudy.krajenbrink@mq.edu.au