Case Study
Primary Progressive Aphasia
Age: 65
Time since diagnosis: 3 years
Problems
John’s family wanted him to get help for his language problems so he could participate in their family business. Boosting his language skills could also help slow his decline. They didn’t have good education about the disease process or know what to do.Primary Progressive Aphasia (PPA) will present differently in each person. While there are three general classifications of PPA, John didn’t fit into any of them. He could not understand spoken language, but he could understand gestures and moderately complex written information. His speech was fluent, but he frequently inserted "a there's" at the end of words or within a sentence. He wasn't aware he was doing this. His family had a difficult time communicating with him about anything. His dream was to write a book for his company.
Assessment
Using some WAB-R subtests
- Used no strategies to help himself — no awareness of his speech problems
- Object naming 100%
- Reading, writing and overall processing were slowed.
- No comprehension of spoken words, reading was best input
- No repetition of spoken words
- Sentence writing with “a there’s” interspersed throughout, minimal grammatical errors. Writing was his best output.
- Sometimes become enraged and frustrated that he didn't understand
- Picture description example: “And he has a buck-it-a-there and a shovel theres used the used the sander there”
Treatment
He completed a 4-week program with tDCS
Results
Before
After
Repetition
16%
58%
Auditory comprehension
2%
75%
Writing to dictation
0%
50%
Outcome
- He learned new ways to use technology and other strategies to increase his comprehension and his expression.
- He began writing his book with minimal assistance for grammar, topic, etc. John learned to ask for clarification if he didn't understand
- He read short paragraphs with 80% accuracy.
- His family was thrilled with his progress, having thought that there was no hope for him.
Primary progressive aphasia is a degenerative disease, but intensive aphasia therapy that targets the client's deficits can definitely be beneficial.