Evaluating a novel adaptation of word finding therapy for individuals with dementia

Dementia is often associated with word-finding difficulties impacting on everyday life. Previous research on constraint-induced aphasia therapy (CIAT) for word-finding difficulties in people with Primary Progressive Aphasia, a language-based dementia, has reported positive outcomes. No existing research uses CIAT-based therapy with people with other forms of dementia such as Alzheimer’s disease.
This study aimed to evaluate the effectiveness of CIAT-based therapy in improving communication for people with dementia and whether this generalised to more successful everyday communication.
A quantitative and qualitative mixed-methods approach was adopted, with the original described study protocol being significantly revised due to the impact of the coronavirus pandemic. The revised study protocol consisted of two main phases.
In Phase 1, two participants with Alzheimer’s disease and their communication partners were recruited. Following face-to-face cognitive and communication assessment, participants completed CIAT-based therapy using 60 chosen picture items in 9 face-to-face therapy sessions with the researcher, with additional home practice encouraged. Due to restrictions relating to the coronavirus pandemic, post-therapy communication assessments were redesigned and completed by video-call.
In Phase 2, one participant with Posterior Cortical Atrophy and their communication partner were assessed using video-call, and completed self-directed CIAT-based therapy at home. This was supported by one training session, and a written guide developed with the support of a focus group.
This study’s main contribution was being the first to evaluate CIAT-based therapy for people with Alzheimer’s disease. Analysis suggests naming performance did not improve following completion of CIAT-based therapy, although there is some evidence of maintenance of treated nouns for one participant.
The discussion considers the findings in the context of existing research. It highlights the limitations of research on impairment-based approaches such as CIAT-based therapy for word-finding difficulties and considers how meaningful language assessment might take place in the context of wider cognitive decline.