Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study
Background: Primary progressive aphasia (PPA) is a neurodegenerative disease characterised by isolated and gradual language decline that can negatively affect discourse. Behavioural treatments for PPA have typically targeted linguistic processes at the micro-structure (word or sentence) level rather than the macro-structure (discourse) level, with minimal generalisation to discourse. There is a growing consensus that non-linguistic mechanisms such as attention are imperative for complex language execution such as discourse. Intentional language use (Nadeau, Rothi, & Rosenbek, 2008) is another mechanism thought to promote language generalisation by encouraging verbal language to the exclusion of other modalities. Attentive Reading and Constrained Summarisation (ARCS) is a novel discourse-level treatment derived from cognitive principles and operating on macro-structure and micro-structure linguistic levels.
Aims: In this case report of one participant with PPA we anticipated post-treatment discourse-level improvements in coherence, cohesion, and informativeness/efficiency with unlikely maintenance due to the neurodegenerative nature of PPA.
Methods & Procedures: “Stanley”, a 76-year-old gentleman with PPA and concomitant attention impairments, received the ARCS treatment. ARCS focuses attention during reading and promotes intentional language use by summarisation with constraints.
Outcomes & Results: Pre- to post-treatment and maintenance improvements on coherence, cohesion, and percent correct information units were observed.
Conclusions: The current findings are intriguing but must be interpreted with prudence given that this is a case study with limitations related to lack of experimental control. However, ARCS is a novel behavioural treatment for PPA and the post-treatment and 2-months maintenance results warrant consideration.