Clinical Interventions in Aging (Feb 2019)
Investigating the utility of teletherapy in individuals with primary progressive aphasia
Abstract
Heather R Dial,1,* Holly A Hinshelwood,2,* Stephanie M Grasso,1 H Isabel Hubbard,3 Maria-Luisa Gorno-Tempini,4 Maya L Henry1 1Communication Sciences and Disorders, University of Texas at Austin, Austin, TX, USA; 2Speech Pathology, Wake Forest Baptist Health, Winston-Salem, NC, USA; 3Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada; 4Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA *These authors contributed equally to this work Introduction: Primary progressive aphasia (PPA) is a neurodegenerative disorder characterized by progressive deterioration of speech and language. A growing body of research supports the utility of speech and language intervention in individuals with PPA, although access to these services remains limited. One potential means of increasing treatment accessibility is the delivery of treatment via telemedicine. Evidence supports the use of teletherapy in stroke-induced aphasia, but research examining the application of teletherapy in PPA is limited. In the current study, a non-randomized group comparison design was used to evaluate the feasibility and utility of treatment delivered via teletherapy relative to treatment administered in person for individuals with PPA. Methods: Two treatment protocols were administered as part of a larger study investigating treatment for speech and language deficits in PPA. Participants with semantic (n=10) and logopenic (n=11) PPA received lexical retrieval treatment and individuals with nonfluent/agrammatic PPA (n=10) received video-implemented script training for aphasia designed to promote speech production and fluency. Treatment was administered via teletherapy for approximately half of the participants receiving each intervention. Treatment outcomes and performance on standardized tests were assessed at pre-treatment and post-treatment, as well as 3, 6, and 12 months post-treatment. Results: Overall, both treatment approaches resulted in significant gains for primary outcome measures. Critically, comparison of in-person and teletherapy groups revealed comparable outcomes. Generalization to untrained targets and tasks and maintenance of treatment-induced gains were also comparable for traditional vs teletherapy participants. Conclusion: Overall, treatment outcomes were largely equivalent for individuals receiving treatment via teletherapy vs traditional, in-person delivery. Results support the application of teletherapy for administering restitutive interventions to individuals with mild-to-moderate PPA. Potential implications for using teletherapy in the treatment of cognitive-linguistic and motoric impairments in other disorders and suggestions for administering treatment via telemedicine are discussed. Keywords: PPA, lexical retrieval treatment, script training, telemedicine, telerehabilitation, telepractice
