CHICAGO – A novel web-based speech therapy program for people with language problems due to dementia significantly improved their ability to recall words they had “lost,” reports a new Northwestern Medicine study.
Reviving memories:
One woman could once again identify the tulips and daffodils in her garden. And a man restored his ability to issue commands to his border collie to herd the sheep on his farm and order his favorite meal from the drive-through at Steak ‘n Shake.
People with Alzheimer’s dementia or primary progressive aphasia often have language problems, struggling to retrieve the name of a grandchild or find the words to order dinner at a restaurant.
But their aphasia often goes untreated because most speech-language pathologists are trained to help children or individuals with stroke, not those with dementia.
A new program called The Communication Bridge, developed by Northwestern scientists are closing that gap, in which specially trained speech language pathologists offer personalized therapy over the web to those with dementia-related language impairment-aphasia.
A new pilot study found that the participants made significant improvement in recalling words they had trouble with after 2 months of therapy and retained improvement after 6 months.
A Colorado woman, after 8 weeks of therapy and practice with virtual flashcards, could name once again the flowers in her garden and identify her golf swings. A woman from Alabama was able to retrieve the names of her grandchildren.
“These improvements are especially exciting because in neurodegenerative diseases we would expect declines, but these dementia patients are holding onto these gains,” said lead author Emily Rogalski, associate professor at the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University Feinberg School of Medicine. The new study showing the feasibility and early results of the program is published in the journal Alzheimer’s & Dementia: Translational Research & Clinical Interventions.
As quoted by Rogalski, “There is a misconception that speech-language pathologists can’t help people with dementia, although they have many tools that can be helpful. This is not a cure; however, we may be able to delay some of the progression and maximize that person’s remaining abilities”
The study:
The program starts with an evaluation to determine a person’s challenges and strengths. Then it includes 8 therapy sessions with a specialized speech pathologist via a secure video-chat platform, videos to reinforce what was taught during the sessions and home assignments like virtual flashcards and a communication notebook to support language memory. Irrespective of where the patient or pathologist lives, the therapy could be held.
It included 31 participants with early to mid-stage dementia from 21 states and Canada and their care-partner. A care partner (usually a spouse or family member) and the patient participate in the session together. The author reported a overwhelmingly positive response from the participants about the program.
“If you are an avid golfer and you want to talk to your golfing friends, it’s frustrating to be an expert but not able to retrieve those related words as easily anymore because of the disease,” Rogalski said. “The flashcards and strategies in this program are designed to help people retrieve those words again and maximize their daily lives. The goal is to help individuals engage in meaningful conversations and activities.”
Some individuals might make communication notebook with pictures and labels or write down a script and rehearse it. Patients avoid answering phone calls or feel uncomfortable in doctors’ visits, however this could be tackled by creating scripts that they could practice overtime and become confident. It also helped patients in reading novels again, a pleasure some of them had lost, by simultaneously listening to the book on audio and reading it.
he Communication Bridge grew out of conversations with dementia patients and their families who traveled from around the country to the Northwestern clinic for evaluation and treatment. When they returned home, they were frustrated that they didn’t have access to a specialized speech-language therapist.