Behavioral and Pharmacological Treatment of Lexical-Semantic Deficits in a Single Patient With Primary Progressive Aphasia

Abstract

In the context of a hybrid multiple-baseline design, this study demonstrated the positive effects of a behavioral + pharmacological (dextroamphetamine) treatment for lexical-semantic deficits in an individual with primary progressive aphasia (PPA). Behavioral treatment entailed application of a cuing hierarchy to predicative adjectives in order to facilitate lexical retrieval. Treatment was effective for both antonym and synonym adjectives, although extended practice was required to achieve criterion. Generalization to nontreated adjectives, verbs, and prepositions was observed, and maintenance was difficult to disambiguate from the progressive nature of the disease. It was proposed that the mechanisms of activation and inhibition were responsible for improved performance. Differential effects between behavioral and behavioral + pharmacological treatment were not observed.

Patterns of language decline in non-fluent primary progressive aphasia

“…Therefore, the distinction between the two profiles seen here is not supported by the presence or absence of motoric disturbance. Indeed, numbers of cases of PPA with concomitant dysarthria have been reported in the literature (Kempler et al 1990, McNeil et al 1995, Northern et al 1990, Scully etal. 1986.…”

Functionally relevant items in the treatment of aphasia (part I): Challenges for current practice

“…However, the prominence of adjectives and adverbs may be a slight surprise given that they have received so little attention in the aphasia treatment literature. As far as we are aware, only two studies have focused on adjectival word finding as part of aphasia treatment (McNeil et al, 1997;McNeil, Small, Masterson, & Fossett, 1995) while no single treatment study can be found on producing adverbs in this context. This is despite the fact that items in both of these categories bear many useful functions.…”

Progressive language impairments: Definitions, diagnoses, and prognoses

“…Frontier areas of research into progressive language impairments include pharmacological therapies (Burns & O'Brien, 2006;Huey, Putnam, & Grafman, 2006;McNeil et al, 1995;Reed, Johnson, Thompson, Weintraub, & Mesulam, 2004), early diagnostic indicators (Grossman et al, 2005) and genetics (Bertram & Tanzi, 2005;Blacker & Lovestone, 2006), ensuring that our knowledge of these disorders will continue to increase for many years to come. Given the emerging role of speech pathologists, psychologists, and other health professionals in assessment, education, intervention, advocacy, and policy development related to progressive language impairments (Croot et al, 2008 this issue;Taylor et al, 2008 this issue), it will be essential to follow the ongoing and rapid developments in clinicopathological diagnosis and treatment of these disorders.…”

“…There is nonetheless a small emerging literature on this client group that includes expert opinion on therapy approaches (McNeil & Duffy, 2001;Robinson, 2001;Rogers, King, & Alarcon, 2000;Snowden & Griffiths, 2000; Thompson & Johnson, 2006), and two-to-three dozen or so published therapy reports ranging from descriptions of therapy activities included as part of a case report (Hart, Beach, & Taylor, 1997;Holland, McBurney, Moossy, & Reinmuth, 1985) to controlled studies (K. S. Graham, Patterson, Pratt, & Hodges, 1999;McNeil, Small, Masterson, & Tepanta, 1995;Schneider, Thompson, & Luhring, 1996), including the reports in this special issue of Aphasiology. We pick up some of the key themes emerging from this literature in the final paper of this special issue (Croot, Nickels, Laurence, & Manning, 2008 this issue).…”