Communication modes in primary progressive aphasia (Mooney et al., 2022)
Purpose: Primary progressive aphasia (PPA) is a clinical neurodegenerative dementia syndrome characterized by early, selective, and progressive language impairment. PPA onset is gradual, providing time to potentially identify additional or alternative expressive communication modes; however, reports of communication mode use and effectiveness by persons with PPA have not been described. This study characterized the use, frequency, and perceived effectiveness of communication modes reported by individuals with PPA.
Method: Forty-one participants with mild-to-moderate PPA completed a structured interview detailing the type, frequency, and perceived effectiveness of 12 potential communication modes, categorized by technology required (no-tech, low-tech, and high-tech). The ratio of modes used was compared across technology categories with a repeated-measures generalized linear model assuming a binomial distribution with an overall Wald chi-square statistic, followed by pairwise post hoc t-test comparisons.
Results: Of the 12 communication modes assessed, participants reported using a median of eight (range: 5–10). All participants affirmed using speech, facial expressions, and talking on the phone. Frequency and perceived effectiveness ratings for these three modes were endorsed at the “some/most of the time” level for more than 80% of the participants. No-tech mode use was significantly higher than reported high-tech and low-tech modes (p = .004 and p < .0001, respectively). Even so, while some high-tech modes (apps) and some low-tech modes (nonelectronic augmentative and alternative communication) had fewer users, effectiveness ratings were moderate to high for all but one user.
Conclusions: Persons with mild-to-moderate language impairment due to PPA report using a range of communication modes with moderate-to-high frequency and perceived effectiveness. These outcomes provide practical information when considering mode refinement or expansion during intervention to maximize communication participation. Barriers to modality use may include low awareness or access, which could be queried by future studies and supported by speech and language interventions.
Supplemental Material S1. Frequency of use and effectiveness when used by clinical variant.
Mooney, A. R., Bravo, M., Roberts, A., Salley, E., Blaze, E., Esparza, M., Fried-Oken, M., Khayum, B., Rao, L., Rademaker, A., & Rogalski, E. (2022). Use and perceived effectiveness of communication modes reported by persons with primary progressive aphasia. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2022_AJSLP-21-00386