Comparing the effects of clinician and caregiver-administered lexical retrieval training for progressive anomia

Abstract

There is a growing body of literature indicating that lexical retrieval training can result in improved naming ability in individuals with neurodegenerative disease. Traditionally, treatment is administered by a speech-language pathologist, with little involvement of caregivers or carry-over of practice into the home. This study examined the effects of a lexical retrieval training programme that was implemented first by a clinician and, subsequently, by a trained caregiver. Two dyads, each consisting of one individual with anomia caused by neurodegenerative disease (one with mild cognitive impairment and one with logopenic primary progressive aphasia) and their caregiver, participated in the study. Results indicated medium and large effect sizes for both clinician- and caregiver-trained items, with generalisation to untrained stimuli. Participants reported improved confidence during communication as well as increased use of trained communication strategies after treatment. This study is the first to document that caregiver-administered speech and language intervention can have positive outcomes when paired with training by a clinician. Caregiver-administered treatment may be a viable means of increasing treatment dosage in the current climate of restricted reimbursement, particularly for patients with progressive conditions.

Keywords: Primary progressive aphasia; anomia; caregiver; lexical retrieval; treatment.

Conflict of interest statement

Disclosure statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1

Clinical magnetic resonance images of CT1 acquired three years prior to his participation in this study. Red arrows indicate bilateral hippocampal and temporal lobe atrophy.

Figure 2

Pre-treatment structural magnetic resonance scan for CT2. Red arrows highlight left greater than right anterior temporal and inferior parietal lobe volume loss.

Figure 3

Post-treatment survey data for CT1, CT2 and their caregivers. The x-axis displays ratings for each item on the survey, on the following scale: 3 = “A lot better,” 2 = “Better,” 1 = “Somewhat better,” 0 = “Unchanged,” −1 = “Somewhat worse,” −2 = “Worse,” and −3 = “A lot worse.”

Figure 4

Multiple-baseline data for CT1’s performance during and after lexical retrieval training for clinician and caregiver-trained sets. Additional post-treatment probes were collected at 2 and 4 weeks posttreatment for caregiver-trained sets. Phases of treatment are indicated by vertical lines, including baseline, treatment, maintenance, post-treatment, and follow-up visits. Tx = Treatment, Wk = Week, F.u. = Follow-up, and CG = Caregiver.

Figure 5

Multiple-baseline data for CT1’s performance during and after lexical retrieval training for untrained sets. Phases of treatment are indicated by vertical lines, including baseline, treatment, post-treatment, and follow-up time points. Tx = Treatment and F.u. = Follow-up.

Figure 6

Multiple-baseline data for CT2’s performance during and after lexical retrieval training for clinician and caregiver-trained sets. Additional post-treatment probes were collected at 2 and 4 weeks posttreatment for caregiver-trained sets. Phases of treatment are indicated by vertical lines, including baseline, treatment, maintenance, post-treatment, and follow-up visits. Tx = Treatment, Wk = Week, F.u. = Follow-up and CG = Caregiver.

Figure 7

Multiple-baseline data for CT2’s performance during and after lexical retrieval training for untrained sets. Phases of treatment are indicated by vertical lines, including baseline, treatment, post-treatment, and follow-up time points. Tx = Treatment and F.u. = Follow-up.