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40 ACQ Volume 13, Number 1 2011 ACQuiring knowledge in speech, language and hearing
selection of words to target in treatment given the lack of
evidence for generalisation. Consultation will also include full
disclosure to the client and communication partners about
the limits to the evidence that any therapy will work, the need
to rehearse to maintain any relearned vocabulary, the
eventual loss of learning with disease progression, and the
fact that the aim of therapy is to maintain current abilities or
slow decline, not return to previous levels of function.
Regular review
Some people with progressive aphasia have deteriorated
rapidly, within 1–2 years, while others maintained very good
communicative abilities over 8 or more years (Croot, 2009).
Therefore regular reviews will be essential, and it will be
important to discuss with the client the need to proactively
manage anticipated decline (Rogers & Alarcon, 1998).
Conclusion
Can your service offer an evidence-based approach to
intervention in progressive aphasia? In your view, the limited
empirical evidence suggests that intervention may be
appropriate. Hence you conclude that for each case you will
base your clinical decision-making on the combination of the
best currently available evidence, your own clinical expertise,
and the client’s values (Harasty, 2010).
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Dr Karen Croot is a lecturer in psychology at the University of Sydney
with teaching and research interests in speech and language production.
She has been researching progressive aphasia for over 15 years, and
recently co-edited with Lyndsey Nickels the first book on intervention
and management in progressive aphasia.Cathleen Taylor is Australia’s
leading speech pathologist clinician and researcher in the area of
progressive aphasia. She has established a specialist service for this
client group at War Memorial Hospital Waverley, and recently chaired
the 2010 Australian Aphasia Association Biennial National Conference,
where she for the first time introduced a session devoted to the
unique needs of people with progressive aphasia. Professor
Lyndsey Nickels is a research speech pathologist, currently an
NHMRC Senior Research Fellow and Professor at Macquarie
University. She has a long history of research into the nature of the
impairments in acquired language disorders and their treatment.
Correspondence to:
Dr Karen Croot
School of Psychology A18
University of Sydney, NSW Australia 2006
phone: +61 2 9869 4696
fax: +61 2 9356 5223
email: