PPA Communication Project – pilot results
Tracks
6
Adult
Aged care
Alternative and Augmentative Communication (AAC)
Aphasia
Dementia
Research
Therapy
Wellbeing
| Friday, June 13, 2025 |
| 10:30 AM - 10:40 AM |
Overview
Prof Kirrie Ballard
Details
⏫ Research insights
⏲️ 10.30am - 10.50am
⌛ 20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
⏲️ 10.30am - 10.50am
⌛ 20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
Presenter
Dr Kirrie Ballard
University Of Sydney
PPA Communication Project – pilot results
10:30 AM - 10:50 AMPresentation summary
This presentation focuses on primary progressive aphasia (PPA), the language led younger-onset dementias. It will outline the preliminary findings of the PPA Communication Project, a person and family-centred intervention approach co-designed with individuals with PPA and their care partners.
Despite growing awareness of the benefits of rehabilitative-focused intervention for communication impairments in PPA, access to such interventions and translation of the growing body of evidence into practice is slow. Further, the literature exploring intervention for communication impairments in PPA, and dementia more broadly, is growing in scope and breadth but thus also reflects variability in type and duration of intervention, and client populations explored. Two primary areas of focus are evident - word retrieval and conversational discourse. These two areas have formed the pillars of the Project’s intervention approach. The key point of difference to other studies is that these target areas are embedded within a Life Participation Approach to impairment management. In other words, target areas are addressed with the aim to promote maintenance and/ or improvement of meaningful communication participation, as defined by the client. This mixed methodology study explores 1) whether this treatment approach helps maintain or improve communication participation, and communication effectiveness and efficiency pre- to post-intervention; and 2) participant perceptions of the acceptability of the intervention approach.
The intervention program is underway, with seven participants currently enrolled. Single case experimental design is applied: multiple baselines across participants and behaviours with two blocks of 8-week intervention. Primary outcome will be Communication Participation. Secondary outcomes include communication effectiveness and efficiency. Results comparing pre- to post-intervention performance on quantitative and qualitative outcomes will be discussed. Findings will be interpreted within the context of the wider, evolving movement towards reablement approaches to management of symptoms of neurodegenerative diseases.
Despite growing awareness of the benefits of rehabilitative-focused intervention for communication impairments in PPA, access to such interventions and translation of the growing body of evidence into practice is slow. Further, the literature exploring intervention for communication impairments in PPA, and dementia more broadly, is growing in scope and breadth but thus also reflects variability in type and duration of intervention, and client populations explored. Two primary areas of focus are evident - word retrieval and conversational discourse. These two areas have formed the pillars of the Project’s intervention approach. The key point of difference to other studies is that these target areas are embedded within a Life Participation Approach to impairment management. In other words, target areas are addressed with the aim to promote maintenance and/ or improvement of meaningful communication participation, as defined by the client. This mixed methodology study explores 1) whether this treatment approach helps maintain or improve communication participation, and communication effectiveness and efficiency pre- to post-intervention; and 2) participant perceptions of the acceptability of the intervention approach.
The intervention program is underway, with seven participants currently enrolled. Single case experimental design is applied: multiple baselines across participants and behaviours with two blocks of 8-week intervention. Primary outcome will be Communication Participation. Secondary outcomes include communication effectiveness and efficiency. Results comparing pre- to post-intervention performance on quantitative and qualitative outcomes will be discussed. Findings will be interpreted within the context of the wider, evolving movement towards reablement approaches to management of symptoms of neurodegenerative diseases.
Refrences
Baylor, C., Eadie, T., & Yorkston, K. (2021). The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults. Seminars in Speech and Language, 17(3), 225–239. https://doi.org/10.1055/s-0041-1729947
Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J., & Mackie, N. S. (2000). Life Participation Approach to Aphasia: A Statement of Values for the Future. ASHA Leader, 5(3),4.
https://link.gale.com/apps/doc/A60099746/AONE?u=usyd&sid=bookmark-AONE&xid=db410cd1
Cytrynbaum, S., Ginath, Y., Birdwell, J., & Brandt, L. (1979). Goal Attainment Scaling: A Critical Review. Evaluation Quarterly, 3(1),
5-40. https://doi.org/10.1177/0193841X7900300102
de la Torre–Luque, A., Viera–Campos, A., Bilderbeck, A. C., Carreras, M. T., Vivancos, J., Diaz–Caneja, C. M., Arango, C. (2022). Relationships between social withdrawal and facial emotion recognition in neuropsychiatric disorders. Progress in Neuro–Psychopharmacology and Biological Psychiatry, 113, 110463–110463. https://doi.org/10.1016/j.pnpbp.2021.110463
El–Wahsh, S., Monroe, P., Kumfor, F., & Ballard, K. (2021). Communication interventions for people with dementia and their communication partners. In Lee–Fay, L., & Laver, K. (Eds.), Dementia rehabilitation: Evidence–based interventions and clinical recommendations (pp. 35–56). San Diego: Elsevier Science & Technology
Forbes–McKay, K. E., & Venneri, A. (2005). Detecting subtle spontaneous language decline in early Alzheimer’s disease with a picture description task. Neurological Sciences, 26(4), 243–254. https://doi.org/10.1007/s10072–005–0467–9
Hinshelwood, H., & Henry, M. (2016). Helping Them Hold On: Through phased treatment, speech-language pathologists can help clients with primary progressive aphasia function as normally as possible—for as long as they can. ASHA Leader, 21(10), 44–51. https://doi.org/10.1044/leader.FTR1.21102016.44
Kaye, R. C., & Cherney, L. R. (2016). Script Templates: A Practical Approach to Script Training in Aphasia. Topics in language disorders, 36(2), 136–153. https://doi.org/10.1097/TLD.0000000000000086
Kiresuk, T. J., & Sherman, R. E. (1968). Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community mental health journal, 4(6), 443–453. https://doi.org/10.1007/BF01530764
Leaman, M. C., & Edmonds, L. A. (2019). Revisiting the Correct Information Unit: Measuring Informativeness in Unstructured Conversations in People With Aphasia. American journal of speech-language pathology, 28(3), 1099–1114. https://doi.org/10.1044/2019_AJSLP-18-0268
Low, L. F., & Laver, K. (2020). Dementia Rehabilitation: Evidence-Based Interventions and Clinical Recommendations. Elsevier Science & Technology. https://doi.org/10.1016/C2018-0-04195-X
Mahalingam, G., Samtani, S., Lam, B. C. P., Lipnicki, D. M., Lima–Costa, M. F., Blay, S. L., Castro–Costa, E., Shifu, X., Guerchet, M., Preux, P.–M., Gbessemehlan, A., Skoog, I., Najar, J., Sterner, T. R., Scarmeas, N., Yannakoulia, M., Dardiotis, T., Kim, K.–W., Riedel–Heller, S., … Brodaty, H. (2023). Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing. Alzheimer's & dementia: the journal of the Alzheimer's Association, 10.1002/alz.13072. Advance online publication. https://doi.org/10.1002/alz.13072
Nicholas, L. E., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. Journal of speech and hearing research, 36(2), 338–350. https://doi.org/10.1044/jshr.3602.338
Olthof-Nefkens, M. W. L. J., Derksen, E. W. C., Lambregts, B., de Swart, B. J. M., Nijhuis-van der Sanden, M. W. G., & Kalf, J. G. (2023). Clinimetric Evaluation of the Experienced Communication in Dementia Questionnaire. The Gerontologist, 63(1), 40–51. https://doi.org/10.1093/geront/gnab187
Savage, S. A., Ballard, K. J., Piguet, O., & Hodges, J. R. (2013). Bringing words back to mind - Improving word production in semantic dementia. Cortex; a journal devoted to the study of the nervous system and behavior, 49(7), 1823–1832. https://doi.org/10.1016/j.cortex.2012.09.014
Savage, S., Hsieh, S., Leslie, F., Foxe, D., Piguet, O., & Hodges, J. R. (2013). Distinguishing subtypes in primary progressive aphasia: Application of the Sydney Language Battery. Dementia and Geriatric Cognitive Disorders, 35(3-4), 208–218. https://doi.org/10.1159/000346389
Shaw, J. G., Farid, M., Noel–Miller, C., Joseph, N., Houser, A., Asch, S. M., Bhattacharya, J., & Flowers, L. (2017). Social isolation and Medicare spending: Among older adults, objective social isolation increases expenditures while loneliness does not. Journal of Aging and Health, 29(7), 1119–1143. https://doi.org/10.1177/0898264317703559
Volkmer, A., Spector, A., Warren, J. D., & Beeke, S. (2020). Speech and language therapy for primary progressive aphasia: Referral patterns and barriers to service provision across the UK. Dementia (London, England), 19(5), 1349-1363. https://doi.org/10.1177/1471301218797240
Volkmer, A., Spector, A., Warren, J. D., & Beeke, S. (2019). Speech and language therapy for primary progressive aphasia across the UK: A survey of current practice. International journal of language & communication disorders, 54(6), 914-926. https://doi.org/10.1111/1460-6984.12495
Wauters, L. D., Croot, K., Dial, H. R., Duffy, J. R., Grasso, S. M., Kim, E., Schaffer Mendez, K., Ballard, K. J., Clark, H. M., Kohley, L., Murray, L. L., Rogalski, E. J., Figeys, M., Milman, L., & Henry, M. L. (2023). Behavioral Treatment for Speech and Language in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech: A Systematic Review. Neuropsychology Review. https://doi.org/10.1007/s11065-023-09607-1
Whitworth, A., Cartwright, J., Beales, A., Leitão, S., Panegyres, P. K., & Kane, R. (2018). Taking words to a new level: a preliminary investigation of discourse intervention in primary progressive aphasia. Aphasiology, 32(11), 1284-1309. https://doi.org/10.1080/02687038.2017.1390543
Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J., & Mackie, N. S. (2000). Life Participation Approach to Aphasia: A Statement of Values for the Future. ASHA Leader, 5(3),4.
https://link.gale.com/apps/doc/A60099746/AONE?u=usyd&sid=bookmark-AONE&xid=db410cd1
Cytrynbaum, S., Ginath, Y., Birdwell, J., & Brandt, L. (1979). Goal Attainment Scaling: A Critical Review. Evaluation Quarterly, 3(1),
5-40. https://doi.org/10.1177/0193841X7900300102
de la Torre–Luque, A., Viera–Campos, A., Bilderbeck, A. C., Carreras, M. T., Vivancos, J., Diaz–Caneja, C. M., Arango, C. (2022). Relationships between social withdrawal and facial emotion recognition in neuropsychiatric disorders. Progress in Neuro–Psychopharmacology and Biological Psychiatry, 113, 110463–110463. https://doi.org/10.1016/j.pnpbp.2021.110463
El–Wahsh, S., Monroe, P., Kumfor, F., & Ballard, K. (2021). Communication interventions for people with dementia and their communication partners. In Lee–Fay, L., & Laver, K. (Eds.), Dementia rehabilitation: Evidence–based interventions and clinical recommendations (pp. 35–56). San Diego: Elsevier Science & Technology
Forbes–McKay, K. E., & Venneri, A. (2005). Detecting subtle spontaneous language decline in early Alzheimer’s disease with a picture description task. Neurological Sciences, 26(4), 243–254. https://doi.org/10.1007/s10072–005–0467–9
Hinshelwood, H., & Henry, M. (2016). Helping Them Hold On: Through phased treatment, speech-language pathologists can help clients with primary progressive aphasia function as normally as possible—for as long as they can. ASHA Leader, 21(10), 44–51. https://doi.org/10.1044/leader.FTR1.21102016.44
Kaye, R. C., & Cherney, L. R. (2016). Script Templates: A Practical Approach to Script Training in Aphasia. Topics in language disorders, 36(2), 136–153. https://doi.org/10.1097/TLD.0000000000000086
Kiresuk, T. J., & Sherman, R. E. (1968). Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community mental health journal, 4(6), 443–453. https://doi.org/10.1007/BF01530764
Leaman, M. C., & Edmonds, L. A. (2019). Revisiting the Correct Information Unit: Measuring Informativeness in Unstructured Conversations in People With Aphasia. American journal of speech-language pathology, 28(3), 1099–1114. https://doi.org/10.1044/2019_AJSLP-18-0268
Low, L. F., & Laver, K. (2020). Dementia Rehabilitation: Evidence-Based Interventions and Clinical Recommendations. Elsevier Science & Technology. https://doi.org/10.1016/C2018-0-04195-X
Mahalingam, G., Samtani, S., Lam, B. C. P., Lipnicki, D. M., Lima–Costa, M. F., Blay, S. L., Castro–Costa, E., Shifu, X., Guerchet, M., Preux, P.–M., Gbessemehlan, A., Skoog, I., Najar, J., Sterner, T. R., Scarmeas, N., Yannakoulia, M., Dardiotis, T., Kim, K.–W., Riedel–Heller, S., … Brodaty, H. (2023). Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing. Alzheimer's & dementia: the journal of the Alzheimer's Association, 10.1002/alz.13072. Advance online publication. https://doi.org/10.1002/alz.13072
Nicholas, L. E., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. Journal of speech and hearing research, 36(2), 338–350. https://doi.org/10.1044/jshr.3602.338
Olthof-Nefkens, M. W. L. J., Derksen, E. W. C., Lambregts, B., de Swart, B. J. M., Nijhuis-van der Sanden, M. W. G., & Kalf, J. G. (2023). Clinimetric Evaluation of the Experienced Communication in Dementia Questionnaire. The Gerontologist, 63(1), 40–51. https://doi.org/10.1093/geront/gnab187
Savage, S. A., Ballard, K. J., Piguet, O., & Hodges, J. R. (2013). Bringing words back to mind - Improving word production in semantic dementia. Cortex; a journal devoted to the study of the nervous system and behavior, 49(7), 1823–1832. https://doi.org/10.1016/j.cortex.2012.09.014
Savage, S., Hsieh, S., Leslie, F., Foxe, D., Piguet, O., & Hodges, J. R. (2013). Distinguishing subtypes in primary progressive aphasia: Application of the Sydney Language Battery. Dementia and Geriatric Cognitive Disorders, 35(3-4), 208–218. https://doi.org/10.1159/000346389
Shaw, J. G., Farid, M., Noel–Miller, C., Joseph, N., Houser, A., Asch, S. M., Bhattacharya, J., & Flowers, L. (2017). Social isolation and Medicare spending: Among older adults, objective social isolation increases expenditures while loneliness does not. Journal of Aging and Health, 29(7), 1119–1143. https://doi.org/10.1177/0898264317703559
Volkmer, A., Spector, A., Warren, J. D., & Beeke, S. (2020). Speech and language therapy for primary progressive aphasia: Referral patterns and barriers to service provision across the UK. Dementia (London, England), 19(5), 1349-1363. https://doi.org/10.1177/1471301218797240
Volkmer, A., Spector, A., Warren, J. D., & Beeke, S. (2019). Speech and language therapy for primary progressive aphasia across the UK: A survey of current practice. International journal of language & communication disorders, 54(6), 914-926. https://doi.org/10.1111/1460-6984.12495
Wauters, L. D., Croot, K., Dial, H. R., Duffy, J. R., Grasso, S. M., Kim, E., Schaffer Mendez, K., Ballard, K. J., Clark, H. M., Kohley, L., Murray, L. L., Rogalski, E. J., Figeys, M., Milman, L., & Henry, M. L. (2023). Behavioral Treatment for Speech and Language in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech: A Systematic Review. Neuropsychology Review. https://doi.org/10.1007/s11065-023-09607-1
Whitworth, A., Cartwright, J., Beales, A., Leitão, S., Panegyres, P. K., & Kane, R. (2018). Taking words to a new level: a preliminary investigation of discourse intervention in primary progressive aphasia. Aphasiology, 32(11), 1284-1309. https://doi.org/10.1080/02687038.2017.1390543
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Kirrie Ballard (PhD Northwestern University USA, FSPA) is Professor at University of Sydney, a dual-certified speech pathologist (Australia, USA), and Fellow of Speech Pathology Australia. Her research advances basic knowledge, diagnostic protocols and interventions for childhood and acquired disorders of speech motor control. With engineers and game designers, she has developed a novel highly effective and engaging AI-based system for remote assessment and treatment of children, that aims to achieve equitable access to services across Australia. This internationally funded work has received innovation awards from both Australian and American peak bodies, and the AMP. She is also founder of the PPA Communication Project, a student-led clinic for diagnosis, treatment, and support for individuals with dementia-related communication disorders and their carers. She served as Editor-in-Chief for International Journal of Speech-Language Pathology 2014-2019.
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