Primary Progressive Aphasia (PPA) is a progressive neurological condition that begins by affecting language and/or motor speech skills. There are three variants, as well as an associated condition called Primary Progressive Apraxia of Speech (PPAOS).
I went into detail about each variant and the details of a 2023 systematic review on my blog (Wauters et al., 2023), but I wanted to share the bottom line here.
There is good evidence that speech-language therapy can help people with PPA, including generalization and maintenance.
That's huge news! For quite awhile, the message had been that there wasn't much SLPs could do, beyond teaching AAC. Thankfully, the researchers have been working away, trialing therapies and gathering evidence.
Cicerone et al. (2019) provide guidelines for assigning recommendations to treatments: practice standard, practice guideline, and practice option.
We don't (yet) have practice standards for PPA - we need more research.
We have two treatments that meet the level of practice guidelines: lexical retrieval treatment (for all PPA variants) and script training for nonfluent/agrammatic PPA.
Lexical retrieval includes generative naming, cueing or self-cueing for word retrieval, synonyms and antonyms, errorless learning, and conversational practice with a communication partner. These are the types of interventions we can use with all variations of PPA.
And we have several treatments that are practice options:
Script training.
Constraint-induced aphasia therapy.
Using AAC or an assistive device (like a smartphone to search for target words in a recipe).
Written naming treatment.
Training multimodal communication (ex. writing, gesturing).
Explicit instruction of morphosyntactic structures.
PPAOS is a relatively new diagnosis, and we don't have much research yet. All Wauters et al. (2023) could say was that we should:
Rely on the evidence for treating nondegenerative AOS.
Use clinical experience and judgement.
Seek out the current expert opinion.
Follow general principles for treating other degenerative motor speech disorders.
If you want more info or the free 6-page clinician cheat sheet, check out my blog article. You'll find much more information there, including a discussion on different therapy activities we can provide, based on each element of the WHO-ICF.