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Untangling Primary Progressive Aphasia, Part Two: Intervention and quality of life

A deep-dive into treating and supporting people living with PPA.

July 4, 2023

In  our (free) Part 1 of this series on Primary Progressive Aphasia, we defined PPA and discussed assessment, classification, and goal setting. Here in Part 2, we’ll break down treatment approaches for all stages of PPA and, of course, a discussion about maintaining quality of life. 


Maintain language 


Early in the disease process, a focus on maintenance of language skills may be appropriate. What does this look like in the context of a progressive condition? If it’s important to your client with PPA to more easily come up with the word, phrase, or sentences that they want when they want it, think about these principles…

Mooney, A., Beale, N., & Fried-Oken, M. (2018). Group communication treatment for individuals with PPA and their partners. Seminars in Speech and Language. https://doi.org/10.1055/s-0038-1660784


Clark, H. M., Utianski, R. L., Duffy, J. R., Strand, E. A., Botha, H., Josephs, K. A., & Whitwell, J. L. (2020). Western Aphasia Battery–Revised profiles in primary progressive aphasia and primary progressive apraxia of speech. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2019_ajslp-cac48-18-0217 [available to ASHA members]


Flurie, M., Ungrady, M., & Reilly, J. (2020). Evaluating a maintenance-based treatment approach to preventing lexical dropout in progressive anomia. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2020_JSLHR-20-00059 [available to ASHA members]


Foxe, D., Hu, A., Cheung, S. C., Ahmed, R. M., Cordato, N. J., Devenney, E., Hwang, Y. T., Halliday, G. M., Mueller, N., Leyton, C. E., Hodges, J. R., Burrell, J. R., Irish, M., & Piguet, O. (2022). Utility of the Addenbrooke’s Cognitive Examination III online calculator to differentiate the primary progressive aphasia variants. Brain Communications. https://doi.org/10.1093/braincomms/fcac161 [open access]


Fried-Oken, M., Mooney, A., & Peters, B. (2015). Supporting communication for patients with neurodegenerative disease. NeuroRehabilitation. https://doi.org/10.3233/nre-151241 [open access]

Gallée, J., Cartwright, J., Volkmer, A., Whitworth, A., & Hersh, D. (2023). “Please don’t assess him to destruction”: The R.A.I.S.E. assessment framework for primary progressive aphasia. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2022_ajslp-22-00122 [open access]


Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., Cappa, S. F., Ogar, J. M., Rohrer, J. D., Black, S., Boeve, B. F., Manes, F., Dronkers, N. F., Vandenberghe, R., Rascovsky, K., Patterson, K., Miller, B. L., Knopman, D. S., Hodges, J. R., Mesulam, M. M., & Grossman, M. (2011). Classification of primary progressive aphasia and its variants. Neurology.  https://doi.org/10.1212/wnl.0b013e31821103e6 [open access]


Henry, M. L., & Grasso, S. M. (2018). Assessment of individuals with primary progressive aphasia. Seminars in Speech and Language. https://doi.org/10.1055/s-0038-1660782 [open access]

Henry, M. L., Hubbard, H. I., Grasso, S. M., Dial, H. R., Beeson, P. M., Miller, B. L., & Gorno-Tempini, M. L. (2019). Treatment for word retrieval in semantic and logopenic variants of primary progressive aphasia: Immediate and long-term outcomes. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2018_jslhr-l-18-0144 [available to ASHA members]

Janssen, N., Roelofs, A., van den Berg, E., Eikelboom, W. S., Holleman, M. A., in de Braek, D. M. J. M., Piguet, O., Piai, V., & Kessels, R. P. C. (2021). The diagnostic value of language screening in primary progressive aphasia: Validation and application of the Sydney Language Battery. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2021_jslhr-21-00024 [available to ASHA members]


Khayum, B., Wieneke, C., Rogalski, E., Robinson, J., & O’Hara, M. (2012). Thinking outside the stroke: Treating primary progressive aphasia (PPA). Perspectives on Gerontology. https://doi.org/10.1044/gero17.2.37


Marshall, C. R., Hardy, C. J. D., Volkmer, A., Russell, L. L., Bond, R. L., Fletcher, P. D., Clark, C. N., Mummery, C. J., Schott, J. M., Rossor, M. N., Fox, N. C., Crutch, S. J., Rohrer, J. D., & Warren, J. D. (2018). Primary progressive aphasia: a clinical approach. Journal of Neurology. https://doi.org/10.1007/s00415-018-8762-6 [open access]


Mesulam, M.-M., Rogalski, E. J., Wieneke, C., Hurley, R. S., Geula, C., Bigio, E. H., Thompson, C. K., & Weintraub, S. (2014). Primary progressive aphasia and the evolving neurology of the language network. Nature Reviews Neurology. https://doi.org/10.1038/nrneurol.2014.159 [open access]


Mooney, A. R., Bravo, M., Roberts, A., Salley, E., Blaze, E., Esparza, M., Fried-Oken, M., Khayum, B., Rao, L., Rademaker, A., & Rogalski, E. (2023). Use and perceived effectiveness of communication modes reported by persons with primary progressive aphasia. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2022_ajslp-21-00386 [available to ASHA members]


Roberts, A. C., Rademaker, A. W., Salley, E. A., Mooney, A., Morhardt, D., Fried-Oken, M., Weintraub, S., Mesulam, M., & Rogalski, E. (2022). Communication Bridge™-2 (CB2): an NIH Stage 2 randomized control trial of a speech-language intervention for communication impairments in individuals with mild to moderate primary progressive aphasia. Trials.  https://doi.org/10.1186/s13063-022-06162-7 [open access]


Rogalski, E. J., & Khayum, B. (2018). A life participation approach to primary progressive aphasia intervention. Seminars in Speech and Language.  https://doi.org/10.1055/s-0038-1660786 [open access]


Ruggero, L., Croot, K., & Nickels, L. (2020). How evidence-based practice (E3BP) informs speech-language pathology for primary progressive aphasia. American Journal of Alzheimer’s Disease & Other Dementias. https://doi.org/10.1177/1533317520915365 [open access]


Schaffer, K. M., & Henry, M. L. (2021). Counseling and care partner training in primary progressive aphasia. Perspectives of the ASHA Special Interest Groups. https://doi.org/10.1044/2021_persp-20-00296 [available to ASHA SIG members]


Staiger, A., Schroeter, M. L., Ziegler, W., Pino, D., Regenbrecht, F., Schölderle, T., Rieger, T., Riedl, L., Müller-Sarnowski, F., & Diehl-Schmid, J. (2023). Speech motor profiles in primary progressive aphasia. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2023_ajslp-22-0031 [open access]


Tetzloff, K. A., Duffy, J. R., Clark, H. M., Utianski, R. L., Strand, E. A., Machulda, M. M., Botha, H., Martin, P. R., Schwarz, C. G., Senjem, M. L., Reid, R. I., Gunter, J. L., Spychalla, A. J., Knopman, D. S., Petersen, R. C., Jack Jr., C. R.., Lowe, V. J., Josephs, K. A., & Whitwell, J. L. (2019). Progressive agrammatic aphasia without apraxia of speech as a distinct syndrome. Brain. https://doi.org/10.1093/brain/awz157 [open access]


Utianski, R. L., Botha, H., Martin, P. R., Schwarz, C. G., Duffy, J. R., Clark, H. M., Machulda, M. M., Butts, A. M., Lowe, V. J., Jack Jr., C. R., Senjem, M. L., Spychalla, A. J., Whitwhill, J. L., & Josephs, K. A. (2019). Clinical and neuroimaging characteristics of clinically unclassifiable primary progressive aphasia. Brain and Language. https://doi.org/10.1016/j.bandl.2019.104676 [open access]


Volkmer, A., Cartwright, J., Ruggero, L., Beales, A., Gallée, J., Grasso, S., Henry, M., Jokel, R., Kindell, J., Khayum, R., Pozzebon, M., Rochon, E., Taylor-Rubin, C., Townsend, R., Walker, F., Beeke, S., & Hersh, D. (2022). Principles and philosophies for speech and language therapists working with people with primary progressive aphasia: an international expert consensus. Disability and Rehabilitation. https://doi.org/10.1080/09638288.2022.2051080 [open access]


Volkmer, A., Rogalski, E., Henry, M., Taylor-Rubin, C., Ruggero, L., Khayum, R., Kindell, J., Gorno-Tempini, M. L., Warren, J. D., & Rohrer, J. D. (2019). Speech and language therapy approaches to managing primary progressive aphasia. Practical Neurology. https://doi.org/10.1136/practneurol-2018-001921 [open access]


Volkmer, A., Spector, A., Meitanis, V., Warren, J. D., & Beeke, S. (2019). Effects of functional communication interventions for people with primary progressive aphasia and their caregivers: a systematic review. Aging & Mental Health. https://doi.org/10.1080/13607863.2019.1617246


Volkmer, A., Walton, H., Swinburn, K., Spector, A., Warren, J. D., & Beeke, S. (2023). Results from a randomised controlled pilot study of the Better Conversations with Primary Progressive Aphasia (BCPPA) communication partner training program for people with PPA and their communication partners. Pilot and Feasibility Studies. https://doi.org/10.1186/s40814-023-01301-6 [open access]

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