Speech-Language Therapy for PPA

Speech-Language Therapy for PPA Should be Highly Personalized 

Speech-language therapy should change over time as the person’s needs change. Your speech-language therapist can help plan ahead and teach helpful strategies before they are urgently needed. This is called proactive support.

It’s also important that therapy is based on your own values and things that are meaningful to you. Therapy should help with real-life activities that matter to the person with PPA, their care partners, and close others—not just focus on exercises.

Finding the Right Support

Look for a speech-language therapist who understands PPA and has experience with people who have it. If you live in the United States, speech-language therapy is often covered by health insurance with a doctor’s referral. Some therapists also offer telehealth (online appointments), which can be helpful if you don’t live near a specialist.

Select References for treatment of primary progressive aphasia: 

Dial, H., Hinshelwood, H., Grasso, S., Hubbard, H. I., Gorno-Tempini, M.-L., & Henry, M. (2019). Investigating the utility of teletherapy in individuals with primary progressive aphasia. Clinical Interventions in Aging, Volume 14, 453–471. https://doi.org/10.2147/CIA.S178878

Robinaugh, G., & Henry, M. L. (2022). Behavioral interventions for primary progressive aphasia. In Handbook of Clinical Neurology (Vol. 185, pp. 221–240). Elsevier. https://doi.org/10.1016/B978-0-12-823384-9.00011-6

Volkmer, A., Alves, E. V., Bar‐Zeev, H., Barbieri, E., Battista, P., Beales, A., Beber, B. C., Brotherhood, E., Cadorio, I. R., Carthery‐Goulart, M. T., Cartwright, J., Crutch, S., Croot, K., Freitas, M. I. d´Ávila, Gallée, J., Grasso, S. M., Haley, K., Hendriksen, H., Henderson, S., … Hardy, C. J. D. (2025). An international core outcome set for primary progressive aphasia (COS‐PPA): Consensus‐based recommendations for communication interventions across research and clinical settings. Alzheimer’s & Dementia, 21(1), e14362. https://doi.org/10.1002/alz.14362

Volkmer, A., Rogalski, E., Henry, M., Taylor-Rubin, C., Ruggero, L., Khayum, R., Kindell, J., Gorno-Tempini, M. L., Warren, J. D., & Rohrer, J. D. (2020). Speech and language therapy approaches to managing primary progressive aphasia. Practical Neurology, 20(2), 154–161. https://doi.org/10.1136/practneurol-2018-001921

Wauters, L. D., Croot, K., Dial, H. R., Duffy, J. R., Grasso, S. M., Kim, E., Schaffer Mendez, K., Ballard, K. J., Clark, H. M., Kohley, L., Murray, L. L., Rogalski, E. J., Figeys, M., Milman, L., & Henry, M. L. (2024). Behavioral Treatment for Speech and Language in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech: A Systematic Review. Neuropsychology Review, 34(3), 882–923. https://doi.org/10.1007/s11065-023-09607-1

Speech-language therapy includes many different ways to help with communication. Some focus on talking and understanding. Others focus on reading or writing. Here are a few common ones:

Script Training

Script training helps you say full sentences that are useful in daily life. You practice the same short script many times until it feels easy and natural to say. The steps move from simple practice to real-life talking.

Pick the Right Script:

• Look at a group of sentences and choose the ones that belong in your script.

Put Sentences in Order

• Put the script sentences in the right order, the way you would say them in conversation.

Read the Script Out Loud

• Practice reading the full script out loud, one sentence at a time.

Answer Questions Using the Script

• Practice using your script to answer simple questions. (Example: “What do you do in the morning?” → “I make coffee and feed the cat.”)

Say the Script from Memory:

• Try to say the full script without looking at it.

Use the Script in Real Life:

• Use your script to answer real questions in daily life—even if the question is a little different.

Speech Entrainment

Speaking in time with another person

• Watch a video of someone saying a sentence
• Speak at the same time as the speaker
• Focus on matching the rhythm and movement
• Helps with smoother, longer phrases

Select References for script training with speech entrainment (video-implemented script training):

• Grasso, S. M., Berstis, K., Schaffer Mendez, K., Keegan-Rodewald, W. R., Wauters, L. D., Europa, E., Hubbard, H. I., Dial, H. R., Hixon, J. G., Gorno-Tempini, M. L., Vogel, A., & Henry, M. L. (2025). Investigating changes in connected speech in nonfluent/agrammatic primary progressive aphasia following script training. Cortex, 183, 193–210. https://doi.org/10.1016/j.cortex.2024.09.019
• Henry, M. L., Hubbard, H. I., Grasso, S. M., Mandelli, M. L., Wilson, S. M., Sathishkumar, M. T., Fridriksson, J., Daigle, W., Boxer, A. L., Miller, B. L., & Gorno-Tempini, M. L. (2018). Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain, 141(6), 1799–1814. https://doi.org/10.1093/brain/awy101
• Schaffer, K. M., Evans, W. S., Dutcher, C. D., Philburn, C., & Henry, M. L. (2021). Embedding Aphasia-Modified Cognitive Behavioral Therapy in Script Training for Primary Progressive Aphasia: A Single-Case Pilot Study. American Journal of Speech-Language Pathology, 30(5), 2053–2068. https://doi.org/10.1044/2021_AJSLP-20-00361

Lexical Retrieval Treatment is a step-by-step method used in speech-language therapy to help the person with PPA find and say the word they are looking for. 

• Describing
  Think about what the word means and say something about it. (Example: “It’s red and round. I eat it for lunch.”)
• Writing
  Try writing the whole word—or just part of it, like the first letter. (If it’s hard to write part or all of the word, the therapist may give you the first letter)
• Saying the First Sound
  Say the first sound of the word out loud to help get it started. (If the sound is hard to find, the therapist may help model it.)
• Reading
  Look at the written word and read it out loud. (The therapist may show the written word if needed.)
• Repeating
  Say the word again and again to help your brain remember it. (This helps with saying and writing the word later.)
• Yes/No Questions (Clue Questions)
  Answer simple questions about the word to keep your brain focused. (Example: “Do you keep it in the fridge?” “Is it something you wear?”)
• Remembering
  Try to say the word again, on your own, without help. (Recall the word after you’ve practiced the steps above.)

Select references for lexical retrieval in Primary Progressive Aphasia: 

Beales, A., Bates, K., Cartwright, J., & Whitworth, A. (2019). Lost for words: Perspectives and experiences of people with primary progressive aphasia and Alzheimer’s disease and their families of participation in a lexical retrieval intervention. International Journal of Speech-Language Pathology, 21(5), 483–492. https://doi.org/10.1080/17549507.2019.1625439

Beales, A., Whitworth, A., & Cartwright, J. (2018). A review of lexical retrieval intervention in primary progressive aphasia and Alzheimer’s disease: Mechanisms of change, generalisation, and cognition. Aphasiology, 32(11), 1360–1387. https://doi.org/10.1080/02687038.2018.1491192

Croot, K., Raiser, T., Taylor-Rubin, C., Ruggero, L., Ackl, N., Wlasich, E., Danek, A., Scharfenberg, A., Foxe, D., Hodges, J. R., Piguet, O., Kochan, N. A., & Nickels, L. (2019). Lexical retrieval treatment in primary progressive aphasia: An investigation of treatment duration in a heterogeneous case series. Cortex, 115, 133–158. https://doi.org/10.1016/j.cortex.2019.01.009

Grasso, S. M., Peña, E. D., Kazemi, N., Mirzapour, H., Neupane, R., Bonakdarpour, B., Gorno-Tempini, M. L., & Henry, M. L. (2021). Treatment for Anomia in Bilingual Speakers with Progressive Aphasia. Brain Sciences, 11(11), 1371. https://doi.org/10.3390/brainsci11111371

Grasso, S. M., Shuster, K. M., & Henry, M. L. (2019). Comparing the effects of clinician and caregiver-administered lexical retrieval training for progressive anomia. Neuropsychological Rehabilitation, 29(6), 866–895. https://doi.org/10.1080/09602011.2017.1339358

Henry, M. L., Hubbard, H. I., Grasso, S. M., Dial, H. R., Beeson, P. M., Miller, B. L., & Gorno-Tempini, M. L. (2019). Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. Journal of Speech, Language, and Hearing Research, 62(8), 2723–2749. https://doi.org/10.1044/2018_JSLHR-L-18-0144

Taylor-Rubin, C., Croot, K., & Nickels, L. (2019). Adherence to lexical retrieval treatment in Primary Progressive Aphasia and implications for candidacy. Aphasiology, 33(10), 1182–1201. https://doi.org/10.1080/02687038.2019.1621031