IntroductionIndividuals with aphasia symptoms due to neurodegenerative disease are under-referred for speech–language therapy (SLT) services. We sought to determine the feasibility of utilizing telepractice, via Internet videoconferencing, to connect individuals with progressive aphasia to a speech–language pathologist (SLP) for treatment.MethodsParticipants received an initial evaluation, 8 person-centered Internet-based SLT sessions, and 2 post-therapy evaluations. The feasibility of providing Web-based SLT, strategies used and their compliance, functional gains, and the duration of benefit were assessed.ResultsThirty-four participants from 21 states and Canada were enrolled. Thirty-one participants completed the 6-month evaluation. SLP-assessed and self-reported functional gains and increased confidence in communication were documented at 2 months and maintained at 6 months postenrollment.DiscussionInternet-based SLT using person-centered interventions provides a feasible model for delivering care to individuals with dementia and mild and/or moderate aphasia symptoms who have an engaged care-partner and prior familiarity with a computer.
Objectives Previous reports established the feasibility of a telehealth model for delivering speech-language therapy via Internet videoconferencing, which connects individuals with primary progressive aphasia (PPA) to an expert speech and language pathologist for treatment. This study reports feasibility of the same telehealth intervention in a larger set of progressive aphasia participants and explores factors potentially influencing functional intervention outcomes. Methods Participants with PPA or progressive aphasia in the context of a neurodegenerative dementia syndrome and their communication partners were enrolled into an 8-session intervention, with 3 evaluations (Baseline, 2- and 6-months post-enrollment). Half of the participants were randomized into a “check-in” group and received three monthly half-hour sessions post-intervention. Mixed linear models with post hoc testing and percent change in area under the curve (AUC) were used to examine communication confidence over time, the primary patient reported outcome, as well as the influence of check-in sessions and role of communication partner engagement on communication confidence. Results Communication confidence improved at the 2-month evaluation and showed no significant decline at the 6-month evaluation. Item-level analysis revealed gains in communication confidence across multiple communication contexts. Gains and maintenance of communication confidence were only present for the engaged communication partner group and were not bolstered by randomization to the check-in group. Discussion Internet-based, person-centered interventions demonstrate promise as a model for delivering speech-language therapy to individuals living with PPA. Maintenance is possible for at least 6-months post-enrollment and is better for those with engaged communication partners, which supports the use of dyadic interventions.
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