Modified script training for nonfluent/agrammatic primary progressive aphasia with significant hearing loss: A single-case experimental design.

This was a single-case study, so the results cannot be assumed to apply to other people with nonfluent/agrammatic primary progressive aphasia and hearing loss. Only two baseline probes were collected, fewer than the three usually recommended for single-subject experimental designs. Aided hearing thresholds were not available, and the minimal pairs screening task may reflect auditory cortical dysfunction from aphasia as well as peripheral hearing loss. VISTA-R included several components at once, including audiovisual unison speech production, written text and oral reading, daily home practice, video rate increases, clinician-directed script tasks, and generalization conversations, so the contribution of any single component cannot be separated. Standardized language and motor speech scores showed gradual decline over 12 months, so the study does not show that treatment stopped disease progression. The spouse-rated Communication Effectiveness Index change was smaller than the measure's standard error, so it does not demonstrate a clear functional communication change. The comparison was to a previously collected cohort of 10 people, not to a concurrent control group. Treatment was delivered by telerehabilitation, and the audio and video signal may be degraded.

Do not conclude that adding reading alone caused the improvement. The participant received a package that included audiovisual unison speech production, written text and oral reading, daily home practice, video rate increases, clinician-directed script tasks, and generalization conversations, so the contribution of any single component cannot be separated. Do not generalise the result to other patients because this was one person.