Logopenic Progressive Aphasia, Logopenic Progressive Aphasia (LPA), Logopenic Variant of Primary Progressive Aphasia (LPA), Logopenic Variant Primary Progressive Aphasia, Nonfluent Aphasia, Progressive, Nonfluent Progressive Aphasia, Nonfluent Variant Primary Progressive Aphasia (nfvPPA), Primary Progressive Aphasia(PPA), Progressive Aphasia, Semantic Aphasia, Semantic Dementia, Semantic Variant Primary Progressive Aphasia (svPPA)
Conditions
Keywords
speech-language pathology, neurodegenerative disease, logopenic, nonfluent, semantic, script training, teletherapy, remote, multimodal communication training, partner training, augmentative and alternative communication, AAC, Communication Book, bilingual, Spanish, Hispanic, Latino
Brief summary
The goal of this clinical trial is to learn whether a personalized, multi-component, virtual speech language treatment program can improve communication and quality of life for adults with primary progressive aphasia (PPA) and their primary communication partners. The study will enroll participants who speak English and/or Spanish. The main questions the study aims to answer are: * Is the telerehabilitation program feasible and acceptable for people with PPA and their study partners? * Do participants with PPA and study partners find treatment beneficial? * What patterns of treatment response are seen in participants? * Which outcome measures are most useful for evaluating changes in communication and quality of life? Researchers will compare participants who receive intervention immediately to participants assigned to a waitlist control group (who will receive treatment after a delay) to see whether participation in the treatment program is associated with improvements in communication and quality of life. Participants will: * Take part in speech language therapy sessions delivered by video visit that combine restorative, compensatory, and partner-focused communication strategies. Treatment may take place after a waiting period. * Receive education and communication training together with their partner. * Complete speech, language, and cognitive assessments. * Complete questionnaires about communication abilities, daily functioning, and quality of life.
Interventions
BEHAVIORALMulticomponent Lexical Retrieval Cascade Training
In person or via teletherapy: A multi-component treatment incorporating elements of restitutive, compensatory, and care-partner focused interventions. Participants work on producing names of personally relevant targets in multiple communication modalities. Biweekly (45-90 minute) sessions with a clinician target multimodal communication and the use of strategies to support word retrieval. These skills are also trained via daily independent practice. The participant meets six times during the course of treatment with a study partner (e.g., spouse) for communication counseling, education, and practice of communication strategies.
BEHAVIORALMulticomponent Video Implemented Script Training in Aphasia
In person or via teletherapy: A multi-component treatment incorporating elements of restitutive, compensatory, and care-partner focused interventions. Treatment focuses on production of individually-tailored, personally relevant scripts. The participant completes 30 minutes per day of independent practice, during which they speak in unison with a video model. Biweekly (45-90 minute) sessions with a clinician target clear and accurate script production, memorization, and conversational usage, as well as multimodal communication. The participant meets six times during the course of treatment with a study partner (e.g., spouse) for communication counseling, education, and practice of communication strategies.
Sponsors
Maya Henry
National Institutes of Health (NIH)
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants in Arm 1, the immediate treatment group, will proceed immediately to initial assessments followed by the treatment phase (co-development of training materials and Multi-VISTA or Multi-LRCT treatment). Participants in Arm 2, the waitlist control group, will undergo initial assessment followed by a waiting interval of 12 (Multi-VISTA) or 13 (Multi-LRCT) weeks. Following the waiting period, they will be reassessed for cognitive-linguistic and participant-reported outcome measures prior to the treatment phase (co-development of training materials and Multi-VISTA or Multi-LRCT treatment).
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
for Persons with PPA: * A PPA (Gorno-Tempini et al., 2011) or "PPA-plus" (Mesulam et al., 2001) diagnosis * MMSE score of 15 or higher and must be able to produce single monosyllabic words intelligibly * Must speak English, Spanish or both languages (i.e., bilingual speakers of English or Spanish) * Hearing and vision adequate for participation in teleconference meetings * Must have a study partner available (someone who will commit to attending teleconference sessions, as needed, during assessment and treatment phases) Inclusion criteria for Care Partners: * Partners must express willingness to attend and participate in assessment and treatment sessions, including those targeting dyadic communication goals * Partners must speak English, Spanish or both languages (i.e., bilingual speakers of English or Spanish) * Partner's hearing and vision should be adequate for participation in teleconference meetings The participant and/or study partner must have basic experience using a computer.
Exclusion criteria
for persons with PPA: * Other central nervous system or medical diagnosis that can account for symptoms * Psychiatric diagnosis that can account for symptoms
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in spoken naming of trained/untrained items | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | Percent correctly named trained/untrained pictures |
| Change in script production accuracy | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | Percent correct intelligible, scripted words for trained/untrained scripts |
| Change in barriers and facilitators in dyad conversation | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | Number of conversation barriers and facilitators observed in conversation |
| Communication Modality Inventory | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | A likert-type survey characterizing frequency and type of communication modalities used in conversation, administered to both the person with PPA and their conversation partner. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change on Quick Aphasia Battery | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | A standardized aphasia assessment. |
| Change on Aphasia Impact Questionnaire | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | A psychosocial questionnaire for individuals with aphasia. Scores range from 0-84, with higher scores indicating greater impact of aphasia. |
| Acceptability and Perception of Change Survey | post-treatment (approximately 12-13 weeks after treatment onset) | A survey characterizing acceptability of and perceived response to treatment. |
| Change on Adult Carers Quality of Life Questionnaire | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | A measure evaluating quality of life for caregivers. Scores range from 0-100, with higher scores indicating greater quality of life. |
| Change on Brief - Coping Orientation to Problems Experienced Inventory (Brief-COPE) | change from pre-treatment or waitlist to post-treatment or waitlist (12-13 weeks), and follow-up at 3 months post-treatment | A survey characterizing care partner use of coping strategies. |
Countries
United States
Contacts
CONTACTHenry Lab Research Coordinator
CONTACTGrasso Lab Research Coordinator
PRINCIPAL_INVESTIGATORMaya L Henry, PhD
University of Texas at Austin
PRINCIPAL_INVESTIGATORStephanie M Grasso, PhD
University of Texas at Austin
Outcome results
None listed