Exploring the efficacy of teletherapy in individuals with primary progressive aphasia

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2016-05

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Abstract

There is growing evidence suggesting that restitutive treatment for speech and language deficits may have substantial, lasting benefits for individuals with primary progressive aphasia (PPA). Nonetheless, reimbursement restrictions, geographical constraints, and other factors limit the ability of clinicians to reach individuals with this diagnosis. The advent of teletherapy has allowed clinicians to treat otherwise unreachable patients and to increase treatment dosage for other patients. Currently, however, there is limited data regarding the benefit of teletherapy in PPA. We present data from two treatment studies in PPA, comparing treatment outcomes for face-to-face interventions with teletherapy. Specifically, we examined Lexical Retrieval Training (LRT) in fluent patients and Video Implemented Script Training in Aphasia (VISTA; a treatment for speech production/fluency) in nonfluent/agrammatic patients. Interventions were implemented with 25 participants, with 9 participants receiving teletherapy. We compare data from primary outcome measures as well as from generalization measures at post-treatment and three and six months post-treatment. For LRT, participants showed significant improvement on trained and untrained nouns, as well as the Boston Naming Test (BNT) at post-treatment. Maintenance of gains was observed for trained and untrained nouns at three and six months post-treatment and for the BNT at 3 months post-treatment. A direct comparison of traditional and teletherapy sub-groups revealed no differences between the two groups at any time point for any measure. For VISTA, participants showed significant improvement on trained and untrained scripts, as well as the Northwestern Anagram Test (NAT) at post-treatment. Maintenance of gains was observed for trained scripts and the NAT at three and six months post-treatment and for untrained scripts at 3 months post-treatment. A direct comparison of traditional and teletherapy sub-groups revealed no differences between the two groups at any time point for any measure. These results lend additional evidence to current research that documents positive treatment outcomes in individuals with PPA. In addition, these treatment benefits are lasting, both for trained and untrained targets. Finally, we demonstrate that treatments administered via face-to-face sessions and those administered via teletherapy produce comparable results at post-treatment and follow-up. Thus, teletherapy is a viable approach for treatment delivery in PPA.

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