Working with aphasia is one of the main reasons I became a speech-language pathologist. Speech Therapy for Frontotemporal Dementia and Primary Progressive Aphasia (PPA) can look different than treatment for aphasia after a stroke. This is because of the progressive nature and unique challenges that come with the three variants of PPA. It is important to share what therapy can look like for this population and their families because therapy is often perceived as purely “rehab”- work on a deficit until it’s fixed. There are other interventions that are just as important if not more appropriate and impactful for this population.
Restorative and Compensatory Therapy Approaches:
This may include speech and language treatment targeting the person’s natural speech or communication attempts e.g., encouraging the person to express what they can say or to communicate in whatever way possible such as writing, drawing, and gesturing. A speech-pathologist also may teach script-training along with providing physical and tactile cues, if these types of cues are helpful for that particular person. A speech-language pathologist and the person with PPA determine what cues are the most helpful for them.
Aided Therapy Approaches:
Aided therapy approaches include Alternative and Augmentative Communication systems to help aid or supplement a person’s speech. These can be in the form of low tech (paper-based) with images/symbols of messages the person wants to say or high-tech (speech-generating devices) with images/symbols that are personalized to the person’s needs and interests. Depending on the variant of PPA, pictures may not work if the person's concept of that object is lost or fading. However, other concepts may not be, and some pictures and video modeling cues could be highly beneficial. Additionally, someone with PPA is not required to have operational competence of the device. A device can be used as a visual cue, with the family or friends navigating to the category or "Topic". A speech-language pathologist is the expert in training the family how to make it the most accessible e.g., modifying the page set and icons to the right size, programming personalized images onto the device, and showing the family or friends how to use the device during conversation.
Communication Partner Training and Environmental Therapy Approaches:
This may include communication strategies/coaching for family, friends, and caregivers.
In addition, a speech-pathologist may provide education on ways to adapt the environment to optimize communication, memory, and independence. For example, a speech-pathologist may provide communication partner training, providing valuable and applicable feedback to enhance communication.
Learn more about our course, Connections Within Primary Progressive Aphasia here:
Access my FREE guide on implementing communication partner training at home below. https://balanced-kiwi-90986.myflodesk.com/c8t8jwkxsf
Access my FREE Handout on ways to use an AAC Device with someone who has PPA or Aphasia:
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