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, 32(1), 298–305. https://doi.org/10.1044/2022_AJSLP-21-00386

目的：原发性进行性失语症（PPA）是一种以早期、选择性及进行性语言障碍为特征的神经退行性痴呆综合征。PPA的发作过程循序渐进，为识别其他或替代的表达交流方式提供了时间；然而，关于PPA患者使用交流方式及其有效性的报告尚未见诸文献。本研究旨在描述PPA患者报告的交流方式的使用情况、频率及感知有效性。方法：41名轻度至中度PPA患者完成了结构化访谈，详细说明了12种潜在交流方式（按所需技术分类为无技术、低技术和高技术）的类型、频率和感知有效性。通过重复测量的广义线性模型比较了不同技术类别中模式的使用比例，该模型假设二项分布，并使用总体Wald卡方统计量，随后进行成对事后t检验比较。结果：在评估的12种交流方式中，参与者报告了使用中位数为八种（范围：5-10）。所有参与者都确认使用言语、面部表情和电话交谈。超过80%的参与者对这三种模式的使用频率和感知有效性评价为“大多数时间”。无技术模式的使用显著高于报告的高技术模式和低技术模式（p = .004和p < .0001，分别）。尽管如此，尽管一些高技术模式（应用）和一些低技术模式（非电子辅助和替代交流）的用户较少，但所有参与者（除一例外）的有效性评价均为中等至高。结论：由于PPA引起的轻度至中度语言障碍的患者报告使用多种交流方式，这些方式的使用频率和感知有效性均为中等至高。这些结果在考虑干预措施中模式优化或扩展以最大化沟通参与度时提供了实际信息。使用模式的障碍可能包括认知度低或可及性差，这可以通过未来的研究进行查询，并得到言语和语言干预的支持。补充材料S1：临床变种的频率使用和有效性。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). 原发性进行性失语症患者报告的交流方式的使用和感知有效性。美国言语-语言病理学杂志，32(1)，298–305. https://doi.org/10.1044/2022_AJSLP-21-00386