Treatment for anomia in bilingual speakers with progressive aphasia

Abstract

AbstractBackgroundAnomia is an early and prominent feature of primary progressive aphasia (PPA) and other neurodegenerative disorders. Research investigating treatment for lexical retrieval impairment has focused primarily on monolingual speakers.The purpose of this study was to examine the benefits of a naming intervention administered to bilingual speakers with PPA. We predicted that participants would show improved naming for trained stimuli, with maintenance at follow‐ups. In addition, we predicted that cognate pairs (e.g., rose and rosa) would demonstrate advantages in cross‐linguistic transfer.MethodIn this case series, treatment was administered to ten bilingual speakers with PPA using a single‐subject multiple‐baseline design. Treatment was administered in two phases, with one language targeted per phase. Cognates were included as treatment targets to investigate their potential to facilitate cross‐linguistic transfer. Participants spoke a variety of languages (Table 1), and underwent cognitive‐linguistic testing at pre‐treatment (Table 2). Performance on trained and untrained stimuli was evaluated before, during, and after treatment, and at 3‐, 6‐, and 12‐months post‐treatment.The Lexical Retrieval Cascade (Henry et al., 2013; 2019) was used to target individually tailored and matched word sets. The intervention targets naming by leveraging relatively spared cognitive‐linguistic abilities, with the goal of retraining specific vocabulary as well as instilling word‐retrieval strategies more broadly. Treatment sessions occurred twice weekly (Table 3) and were complemented with daily home practice. Participants’ performance was analyzed via d‐statistics (Beeson & Robey, 2006) and simulation analysis.ResultParticipants demonstrated significant treatment effects in each of their treated languages, with maintenance up to one‐year post‐treatment for the majority of participants (Figure 1). Most individuals in the cohort showed a significant cross‐linguistic transfer effect for trained cognates in both the dominant (8/10) and nondominant (7/10) language, with fewer than half of participants showing a significant effect for noncognates.ConclusionFindings support the implementation of dual‐language intervention approaches for bilingual speakers with PPA, irrespective of language dominance. In addition, our findings indicate that monolingual clinicians may select cognates to support gains across languages. Further research is needed to determine whether measures related to disease severity or language history are predictive of treatment and transfer effects.