Taking words to a new level: a preliminary investigation of discourse intervention in primary progressive aphasia

© 2017 Informa UK Limited, trading as Taylor & Francis Group Background: Despite a growing literature characterising connected speech and discourse impairments associated with primary progressive aphasia (PPA), intervention in PPA has focused predominantly on lexical retrieval and picture-naming treatments, with limited generalisation of therapy gains reported. Recent developments in the post-stroke aphasia literature with discourse-level approaches have provided highly promising findings for the generalisation of language gains to everyday communication, and an opportunity to investigate whether the same benefits may be found in the PPA population. Aims: This study evaluated the effectiveness of a discourse intervention in two individuals with PPA to determine whether significant improvements were seen in word retrieval and discourse organisation in everyday discourse. Methods & Procedures: KW, a 54-year-old man, who presented with semantic variant PPA, and AS, a 59-year-old woman, presenting with logopenic variant PPA, completed the NARNIA intervention programme (Whitworth, Leitão et al., 2015) in 20 sessions over a 10-week period. Discourse performance was sampled prior to intervention across 10 tasks involving four different genres, at one time point, and compared to performance immediately and four weeks post intervention. The multilevel intervention protocol aimed to increase awareness of word retrieval, sentence structure, and macrostructure of a range of discourse genre. Outcomes & Results: Both participants made significant gains in discourse production immediately after intervention and when reassessed four weeks later, in the absence of change on naming tasks and in the context of stable overall cognitive performance. Significant gains were seen in the amount of overall output, noun and verb usage, and the number of body elements in macrostructure in everyday discourse in topics that were not trained in treatment. Further to the findings of the original N