Project Description:
Key Question/Problem: AAC for persons with degenerative language disorders has not become standard of care, yet its value for improved language production has been described in case studies, clinical textbooks, and websites for consumers and their families. To date, we have stages of AAC treatment for individuals with degenerative motor speech impairments (see Clinical Pathways for Communication in ALS prepared by the AAC-RERC I), and AAC tools for persons with static language disorders from severe, chronic aphasia (see VSD in RERC-II). But AAC for adults with degenerative language disorders is a relatively unexplored area that needs our attention as the population grows and individuals need to engage verbally in daily activities. Empirical data are needed for staging intervention, and to support the development of AAC management guidelines for social participation.
Motivation/Aim/Purpose/Justification: Our goals are to produce sound empirical data that can add to our understanding of the language intervention associated with degenerative language disorders, and to suggest staging guidelines for AAC interventions. Mesulam (2001) states that, ?an informed approach to this syndrome will increase the effectiveness with which clinicians can address the unique challenges associated with diagnosis and care? (p. 425). This project evaluates the effect of aided communication management on persons with degenerative language disorders.
The guidelines for the management of neurodegenerative disease (that includes language disorders) published by the American Geriatrics Society in 2003 do not mention communication intervention, though providers have clearly recognized the importance of early language treatment, in terms of compensatory strategies, for persons with degenerative language disorders. No practice guidelines or evidence exist to help employers support individuals with degenerative language disorders, to drive intervention goals, to justify medical insurance reimbursement, or to help family members advocate for their loved ones. Evidence on intervention staging and types of AAC that are beneficial need to be available to support persons and their families with daily expressive communication.
Goals/Hypothesis: This 4-year investigation will involve two studies designed to address three objectives and associated research hypotheses. Videotaped conversations will be obtained from 10 participants with PPA during AAC-supported and unsupported conversations and from 10 age-matched elders without language impairments. Study 1 tests the effect of the AAC intervention on conversations conducted under controlled conditions. Study 2 tests the effect of the AAC intervention on conversations conducted during Instrumental Activities of Daily Living (IADLs) that occur in natural conditions. We hypothesize that in both controlled and natural conditions, AAC-supported conversations are associated with improved conversational performance and fewer communication difficulties than are unsupported conversations, and that the supported conversations resemble conversations of non-impaired control group. Improved conversational performance is operationalized with specific conversational variables that are discussed in the data analysis section of this proposal. The two goals and associated research hypotheses are presented below.
Target Audience:
Professionals and Para-Professionals, Family Members/Caregivers, Adults with Disabilities, Children/Adolescents with Disabilities/SHCN
