The term primary progressive aphasia (PPA) describes a group of neurodegenerative disorders with predominant speech and language dysfunction as their main feature. There are three main variants – the semantic variant, the nonfluent or agrammatic variant and the logopenic variant – each with specific linguistic deficits and different neuroanatomical involvement. There are currently no curative treatments or symptomatic pharmacological therapies. However, speech and language therapists have developed several impairment-based interventions and compensatory strategies for use in the clinic. Unfortunately, multiple barriers still need to be overcome to improve access to care for people with PPA, including increasing awareness among referring clinicians, improving training of speech and language therapists and developing evidence-based guidelines for therapeutic interventions. This review highlights this inequity and the reasons why neurologists should refer people with PPA to speech and language therapists.

Background: Primary progressive aphasia (PPA) is a clinical dementia syndrome characterised by the gradual dissolution of language without impairment of other cognitive domains for at least the first 2 years of illness (Mesulam, 2001 Mesulam, M. M. 2001. Primary progressive aphasia.. Annals of Neurology, 49: 425–432. [Crossref], [PubMed], [Web of Science ®] [Google Scholar] ). In recent years the authors had observed an increase in the number of referrals of individuals with a queried diagnosis of PPA to their speech pathology service. However, they perceived a lack of information on the best management path for these individuals. Aims: The aim of this study was to collate information about current service provision for clients with PPA living in the Australian state of New South Wales (NSW) and their caregivers. This information would identify current referral rates and speech pathology management of this population. This information, when combined with a review of the literature and an examination of overseas service provision, would be used to develop a framework for future speech pathology service provision for progressive aphasia. Method & Procedures: Data relating to individuals with queried or confirmed PPA was collected from speech pathologists via a survey. Speech pathology services with an adult neurological caseload were surveyed in rural and metropolitan regions across NSW. Questions asked for information relating to referral patterns, demographics, and interventions provided. Outcomes & Results: Responses from the survey indicated that only a small number of clients with PPA are referred to speech pathologists state‐wide. At facilities where individuals were referred with queried PPA, all respondent speech pathologists provided some form of intervention. All clients were assessed and various intervention types were delivered including individual therapy, group therapy, intermittent review, and client and carer education. Overwhelmingly respondents talked of an emerging field of practice, and the need for more accessible information for clinicians and people with PPA and their carers. Conclusion: PPA appears to be an area of under‐referral for speech pathologists in NSW. We would like to see increased referrals to speech pathology services and promotion of the role of the speech pathologist on dementia care teams. There is evidence that speech pathology intervention with this population can be effective. It is recommended that intervention targets both impairment and activity‐participation levels but also we stress the importance of education and support that is specifically tailored to those with progressive language disorders.

Primary progressive aphasia (PPA) is a language-led dementia associated with Alzheimer’s pathology and fronto-temporal lobar degeneration. Multiple tailored speech and language interventions have b...

Background: The aim of lexical retrieval treatment for people with anomia is not just to improve accessibility of lexical items for confrontation naming but to carry over this improvement to communicative situations. However, there is no consensus on what measures are the most suitable to evaluate whether such changes have occurred. Anomia is one of the core presenting symptoms for people with primary progressive aphasia (PPA), yet while there is increasing evidence for the efficacy of word retrieval treatments in PPA, there is minimal information about how improvements in picture naming transfer to connected speech. Aims: This paper evaluates a word retrieval treatment targeting personally relevant words conducted with two people with PPA, focusing on patterns of generalisation. Methods & Procedures: The study is a single-blind single-case experimental design. Participants and primary communication partners identified words related to two topics that are personally relevant for conversation. Participants completed three baseline and one or two post-test measures of their ability to produce these words in picture naming and a structured interview. Therapy activities lasting 10–15 min/day were carried out over a 2-week period at home, with participants viewing a picture of each target word on a computer screen together with its written and spoken name and repeating/reading the name. Half of the words from one topic were treated; a matched set of words from the treated topic and words from the untreated topic served as controls to allow us to assess generalisation within and across topic. Outcomes & Results: At post-test, the participants’ naming improved for the treated items, showing generalisation to different pictures of these items. There was neither generalisation to untreated items, nor to retrieval of the same words in a structured interview. Conclusions: Further research is required to understand the limits and the potential of word retrieval treatments to improve conversation in both acute-onset and progressive aphasia.

Background: Primary progressive aphasia (PPA) affects a range of language and cognitive domains that impact on conversation. Little is known about conversation breakdown in the semantic variant of PPA (svPPA, also known as semantic dementia). This study investigates conversation of people with svPPA. Methods: Dyadic conversations about everyday activities between seven individuals with svPPA and their partners, and seven control pairs were video recorded and transcribed. Number of words, turns, and length of turns were measured. Trouble-indicating behaviors (TIBs) and repair behaviors were categorized and identified as successful or not for each participant in each dyad. Results: In general, individuals with svPPA were active participants in conversation, taking an equal proportion of turns, but indicating a great deal of more trouble in conversation, shown by the significantly higher number of TIBs than evidenced by partners or control participants. TIBs were interactive (asking for confirmation with a shorter repetition of the original utterance or a repetition which included a request for specific information) and non-interactive (such as failing to take up or continue the topic or a minimal response) and unlike those previously reported for people with other PPA variants and dementia of the Alzheimer type. Communication behaviors of the partner were critical to conversational success. Conclusions: Examination of trouble and repair in 10-min conversations of individuals with svPPA and their important communication partners has potential to inform speech pathology interventions to enhance successful conversation, in svPPA and should be an integral part of the comprehensive care plan.