Mobile technology to support lexical retrieval during activity retell in primary progressive aphasia

ABSTRACT

Background: Augmentative and alternative communication (AAC) strategies and tools developed for individuals with chronic aphasia have been found to facilitate generative language skills. There exists a need to identify effective AAC strategies and tools for individuals experiencing primary progressive aphasia (PPA), a neurodegenerative dementia, for which compensatory treatment paradigms are yet to be systematically evaluated.

Aims: To examine the treatment effects of a novel language compensation tool, CoChat, and to determine if lexical retrieval skills improve are maintained during activity retell with use of this AAC application.

Methods and procedures: Six individuals with PPA participated. The study was implemented using a single-subject alternating treatments experimental design to compare lexical retrieval during activity retell in three conditions: Absence of technology support, presence of photos only, and presence of CoChat app, with photo and labels. The number of target words produced by the participant during activity retell with a conversation partner was the primary dependent variable. There were two phases of this experiment: Three conditions presented in a fixed-order and three conditions presented in a counterbalanced order. For one participant, an additional implementation of CoChat was piloted at 6- and 9-month post-intervention to examine sustained effect of CoChat during activity retell.

Outcomes and results: In the fixed-order phase, results indicated a higher number of target words produced in the CoChat condition for all participants. In the counterbalanced phase, results indicated a higher number of target words in the CoChat condition for two-thirds of the participants. Maintenance probes showed same level of lexical retrieval at 6 and 9 months following intervention.

Conclusions: This single-case research design demonstrated that mobile technology compensatory strategies provide necessary support during natural conversations about personally relevant topics for people with PPA. CoChat, a newly developed mobile technology research app that uses social networks and an NLP engine to create a co-constructed external lexicon with visual scene display, significantly increased lexical retrieval during activity retell. Future research should further develop AAC strategies and tools that aid in maintenance of vocabulary access and communication participation for people with PPA over the course of disease progression.

KEYWORDS:

• Primary progressive aphasia
• augmentative and alternative communication
• natural language processing
• single case design
• compensatory intervention
• mobile technology

Acknowledgements

The authors thank the dedicated participants with PPA and their engaged CPs, Oliver Chesley for manuscript preparation, and our colleagues at OHSU and Northwestern University who offered support during the investigation and manuscript preparation. We dedicate this manuscript to Glory Noethe, whose attention to detail improved the success of this experiment. Her passion to work with older adults with communication impairments was a driving force in our research laboratory.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by grant [#DC014099-01] from NIH/NIDCD.