None listed
Conditions
Brief summary
This study aims to modify and evaluate the feasibility and effectiveness of a highly novel therapy approach that has been trialled with other neurological populations (e.g. stroke, traumatic brain injury). The intervention is predicted to improve the informativeness and efficiency of everyday communication and quality of life in people living with early stage dementia. The study will recruit 15 adults with a diagnosis of dementia and progressive language impairment. Each participant will act as his or her own control. The study will provide pilot data to inform a future large-scale trial, help to optimise the treatment protocol, and discern the most appropriate candidates for the intervention.
Interventions
The NARNIA (Novel Approach to Real-life communication: Narrative Intervention in Aphasia) intervention approach is based upon established models of how language is organised and prepared for speaking and draws on the thinking processes that are used in everyday communication. NARNIA is a structured, yet highly interactive behavioural intervention that revolves around usual conversational speaking. The protocol uses discourse frameworks for everyday communication (i.e. giving opinions, explaining
The NARNIA (Novel Approach to Real-life communication: Narrative Intervention in Aphasia) intervention approach is based upon established models of how language is organised and prepared for speaking and draws on the thinking processes that are used in everyday communication. NARNIA is a structured, yet highly interactive behavioural intervention that revolves around usual conversational speaking. The protocol uses discourse frameworks for everyday communication (i.e. giving opinions, explaining procedures, recounting personal memories) to scaffold and extend language output. This involves talking about recent experiences and events, different topics, including current affairs and opinion topics, and sharing stories from the person’s own life. A detailed NARNIA treatment protocol is followed. Prior to the 10 week intervention period, participants will undergo two weeks of initial baseline assessment. A range of cognitive and language assessments will be completed, including the Curtin University Discourse Protocol and a self-report quality of life measure. The intervention will be delivered by a research assistant (i.e. graduate speech pathologist) who will be trained in the treatment protocol provided with ongoing support throughout the project. The intervention will be delivered individually and face to face in the participants' own home. The intervention will be delivered twice weekly over 10 weeks, for one hour. The intervention will be personalised for each participant, focusing on discourse topics that are meaningful to them and that align with their interests, current activities and upcoming events. This means that while the discourse genres targeted are standardised (e.g. procedures, opinions, recounts), the topics are personalised (e.g. opinions on politics vs. AFL). This will ensure the salience of intervention and specificity to their everyday communication. Homework practice will be provided following each session, encouraging participants to practice the discourse topics and use of the discourse frameworks during everyday conversations. Participants will be provided with worksheets from the intervention sessions for reference where appropriate. Treatment fidelity will be monitored by the chief investigator. One session per fortnight will be video recorded and coded against essential elements of the treatment protocol. Any deviation from the prescribed intervention protocol will be discussed with the research assistant and noted for statistical analysis.
Sponsors
Curtin University
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: (1) clinical diagnosis of a dementia syndrome (i.e. major neurocognitive disorder, DSM-5), including Alzheimer’s disease, frontotemporal dementia and/or PPA or progressive language impairment (e.g. complaints of word finding and/or communication difficulties that are worsening over time), (2) early to moderate stage of disease progression as determined by the MMSE (13-25 points) or ACE-III (38-88 points; So et al., 2018), noting that cut off criteria may be adjusted for each participant based on their age and years of education in consultation with their medical specialist, (3) capacity to consent to participation as determined by their treating medical specialist, (4) normal or corrected hearing and vision, and (5) proficient in English (used English in everyday communication [no interpreter required for therapy]).
Exclusion criteria
Exclusion criteria: (1) severe dementia (MMSE < 13; ACE-III <38; So et al., 2018), (2) primary impairment of apraxia of speech (AoS) or dysarthria, (3) a prior diagnosis of stroke, head injury or neurosurgery, and (4) clinically diagnosed major depression.
Outcome results
None listed