Event Abstract

Back to Event

MyWordTrainer: improving word retrieval using app-based therapy in semantic variant Primary Progressive Aphasia

Sharon Savage1*, Craig Newman2, Rupert Noad3 and Adam Zeman4
  • 1 Department of Psychology, College of Life and Environmental Sciences, University of Exeter, United Kingdom
  • 2 Peninsula Medical School, Faculty of Medicine and Dentistry, University of Plymouth, United Kingdom
  • 3 Derriford Hospital, United Kingdom
  • 4 The Institute of Health Research, Medical School, University of Exeter, United Kingdom

Background and aims. Difficulty with naming is one of the most striking features of semantic variant primary progressive aphasia (sv-PPA), significantly impacting upon communication and quality of life (Gorno-Tempini et al., 2011; Jokel et al., 2017). While numerous single case studies and patient series have demonstrated that word retraining programs can improve word retrieval performance (Carthery-Goulart et al., 2013; Croot, 2018; Jokel et al., 2014), these programs are not yet easily accessible. This study aimed to firstly convert an existing, successful experimental approach into an app and then explore its usability in people with sv-PPA. Method. The program used by Savage et al (2014, 2015) was recoded as an Android app, to include both an administrative section (for constructing personalized learning lists, scheduling practice) and a user’s section (for completing training and naming assessments). To test usability, two people with sv-PPA were recruited via the Join Dementia Research UK database (Table 1). A multiple-baseline-across-behaviours (word lists) single case experimental design was implemented in each participant’s home, where each phase (baseline, intervention list 1, intervention list 2) ran for 3 weeks, after which treatment was withdrawn. To begin, the researcher worked with each family to build three tailored lists of words within the app (drawing upon semantic categories of food, clothing, household appliances, kitchen utensils). Through the app, training stimuli (photographs and audio recorded labels for each target word) were constructed via the device’s camera and microphone capabilities. Word retraining involved a Look, Listen, Repeat practice (Jokel et al., 2006; Savage et al., 2014) offered 5 days per week for 3 weeks each list, with weekly tests to monitor learning success. Follow-up was conducted 5 months later, at which point participants and their families were also interviewed regarding their experiences of using the app, and asked to rate its usefulness and provide suggestions for improvement. A final naming test was administered to measure retention. Feasibility and acceptability were measured via treatment adherence (number of sessions completed), time spent engaged with the program, and satisfaction data from the semi-structured interview. Word retrieval outcomes were measured via picture naming tests conducted at baseline and immediately post-intervention. Results. All features of the original program were successfully translated into the app. Sessions took approximately 30 minutes and were completed up to 5 times per week for 6 weeks. Both participants considered the app useful and felt the program had assisted their ability to name objects. In particular, they valued the ability to personalize the stimuli and complete the training in the home setting. One participant completed training independently, while the other always completed sessions with her spouse beside her. Analysis of naming performance pre- to post-training confirmed significant improvements in word retrieval for trained lists (McNemar’s Test, p<.001; see Figure), but no change for untrained words. While certain words relearned were retained 5 months later, the result was no longer significant. Conclusions. App-based word retraining appears a feasible option for people with PPA. Future research is needed to test definitively the effectiveness of this treatment.

Figure 1
Image
Figure 2
Image

Acknowledgements

This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. This abstract is part of the symposium "Aphasia in neurodegenerative conditions."

References

Carthery-Goulart, M., Silveira, A., Machado, T., Mansur, L., Parente, M., Senaha, M. L. H., et al. (2013). Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: a systematic review of the literature. Dementia & Neuropsychologia 7, 122–131. Croot, K. (2018). Treatment for Lexical Retrieval Impairments in Primary Progressive Aphasia: A Research Update with Implications for Clinical Practice. Seminars in Speech and Language 39, 242–256. doi:10.1055/s-0038-1660783. Gorno-Tempini, M. L., Hillis, A. E., Weintraub, S., Kertesz, A., Mendez, M., Cappa, S. F., et al. (2011). Classification of primary progressive aphasia and its variants. Neurology 76, 1006–1014. doi:10.1212/WNL.0b013e31821103e6. Jokel, R., Graham, N. L., Rochon, E., and Leonard, C. (2014). Word retrieval therapies in primary progressive aphasia. Aphasiology 28, 1038–1068. doi:10.1080/02687038.2014.899306. Jokel, R., Meltzer, J., D.R., J., D.M., L., J.C., J., A.N., E., et al. (2017). Group intervention for individuals with primary progressive aphasia and their spouses: Who comes first? Journal of Communication Disorders 66, 51–64. doi:10.1016/j.jcomdis.2017.04.002. Jokel, R., Rochon, E., and Leonard, C. (2006). Treating anomia in semantic dementia: Improvement, maintenance, or both? Neuropsychological Rehabilitation: An International Journal 16, 241–256. doi:10.1080/09602010500176757. Savage, S., Hsieh, S., Leslie, F., Foxe, D., Piguet, O., and Hodges, J. R. (2013). Distinguishing subtypes in primary progressive aphasia: application of the Sydney language battery. Dement Geriatr Cogn Disord 35, 208–218. doi:10.1159/000346389. Savage, S. A., Piguet, O., and Hodges, J. R. (2014). Giving Words New Life: Generalization of Word Retraining Outcomes in Semantic Dementia. J. Alzheimers Dis. 40, 309–317. doi:10.3233/JAD-131826. Savage, S. A., Piguet, O., and Hodges, J. R. (2015). Cognitive Intervention in Semantic Dementia: Maintaining Words Over Time. Alzheimer Dis Assoc Disord 29, 55–62. doi:10.1097/WAD.0000000000000053.

Keywords: dementia care, Progressive aphasia, technology assisted care, Person-centered approach, Semantic dementia (SD), naming accuracy

Conference: Academy of Aphasia 57th Annual Meeting, Macau, Macao, SAR China, 27 Oct - 29 Oct, 2019.

Presentation Type: Symposium

Topic: Not eligible for student award

Citation: Savage S, Newman C, Noad R and Zeman A (2019). MyWordTrainer: improving word retrieval using app-based therapy in semantic variant Primary Progressive Aphasia. Front. Hum. Neurosci. Conference Abstract: Academy of Aphasia 57th Annual Meeting. doi: 10.3389/conf.fnhum.2019.01.00072

Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.

The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.

Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.

For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.

Received: 02 May 2019; Published Online: 09 Oct 2019.

* Correspondence: Dr. Sharon Savage, Department of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, England, EX4 4QG, United Kingdom, s.a.savage@exeter.ac.uk