Adherence to lexical retrieval treatment in Primary Progressive Aphasia and implications for candidacy

Abstract

ABSTRACT Background: Word-finding difficulties are a frequent, frustrating problem for people with Primary Progressive Aphasia (PPA), for which lexical retrieval treatment is a preferred behavioural intervention. The continuation of treatment over a long-term period is a proposed predictor of successful outcomes (i.e., maintenance of initial treatment gains). However, little is known about factors influencing adherence to lexical retrieval treatment in PPA. Aims: The overarching aim of this study was to examine adherence in order to better inform candidacy for lexical retrieval treatment in PPA. We investigated the rate of adherence to lexical retrieval treatment and factors that contribute to continuing or discontinuing the treatment regime. Methods & Procedures: We invited 30 caregivers of pwPPA who commenced lexical retrieval treatment at a specialist PPA clinic to complete a survey on their own and their partner with PPA’s experience of lexical retrieval treatment. Outcomes & Results: 20 caregivers responded (66%). Reported rate of adherence to treatment was 60%. Adherence was more likely when the treatment commenced in the year of diagnosis. Caregivers of the pwPPA who continued treatment gave higher agreement ratings to statements indicating the importance of positive personal factors (patient motivation and mood) than statements about social support (presence of caregiver during therapy). Caregivers of pwPPA who ceased treatment within the first three months rated lack of motivation as more important than all other factors and as significantly more important than time constraints and physical illness. Conclusions: This study provides indications of the characteristics of pwPPA who are likely to adhere to a lexical retrieval treatment regime and who are, therefore, preferred candidates for treatment. These results can inform clinical practice, guide participant recruitment for research, and assist in the development of clinical practice guidelines for speech pathology in PPA.