What is Primary Progressive Aphasias?

Primary progressive aphasia is an acquired neurological condition that impairs a person’s ability to use language to communicate. This includes the loss of ability to understand (listen and read) or express (speak and write) language. Early presentation resembles aphasia, but primary progressive aphasias are in fact early onset forms of dementia.

There are three types of Primary Progressive Aphasia

1. Nonfluent (nfvPPA)

2. Semantic (svPPA)

3. Logopenic  (lvPPA)

Each type of PPA has a different language profile and different underlying neuropathology.

Semantic variant (type) svPPA

Symptoms include:

• Sentence structure and speech sound production is well preserved and fluent (early in the course of the disease)
• A gradual loss of meaning or comprehension for objects
• Difficulty with naming common objects and defining their meaning
  • Use of substitution of words (e.g., ‘table’ for ‘chair’)
• A reduction in the use of nouns (words for people, place or things) results in the sentence lacking in meaning.
• A verbal message can become progressively circumlocutory (talking around the word e.g., ‘it tells the time, I wear it on my wrist, it has hands’ = wristwatch), and empty, as less frequently used vocabulary such as ‘dachshund’ or ‘lady-bird’ is replaced by increasingly more generic words such as ‘animal’ or ‘thing’.
• May use increased conversational phrases repetitively (e.g., ‘Hi, how are you?’)
• In reading and writing words, a person may present with ‘surface dyslexia and dysgraphia’ (e.g., sounding and writing ‘island’ as ‘izland’)

It is important to know the following

• Progressive aphasia is an emerging area in Speech Pathology practice. In saying that, speech pathologists play a vital role as part of the multidisciplinary team in clinical diagnosis of the primary progressive aphasia variant.
• A speech pathologist has the clinical skill-set to detect and describe the subtle language features that often distinguish the variants.
• Identification of the primary progressive aphasia variant is important as identification contributes to overall speech pathology clinical care (i.e., the progression of symptoms and their accompanying impact on communication varies for each variant, and therefore requires a person-centered management approach).
• Providing additional information about prognosis for the person with primary progressive aphasia and their family/care partners enables some advance preparation for the likely future course and referral to appropriate health professional supports. 

How can speech pathology help?

A speech pathologist can: 

• Provide clinical confirmation of a primary progressive aphasia diagnosis and variant type as a member of the multi-disciplinary team.
• Provide treatments that target language impairment with the overall aim to maximise effective communication and quality of life for the person with primary progressive aphasia at every stage of the disease progression. All treatments focus on real-life, meaningful situations and tasks to enhance success in communication.
• Provide compensatory approaches in the form of Augmentative and Alternative Communication (AAC) to increase environmental support and reduce communication barriers.
• Provide communication partner training and support for the individual with primary progressive aphasia and their close communication partner/s. Knowledge and use of facilitative strategies by communication partners can enhance successful communication.
• Identify barriers and facilitators within the person’s communication environment, with the goal being – how to best support communication for the person with primary progressive aphasia within their community.
• Provide primary progressive aphasia specific education for the client and family

Please contact connect2community speech pathology if you have any concerns or questions regarding primary progressive aphasia or a recent diagnosis of primary progressive aphasia.