Abby Barnes, M.S., CCC-SLP
Dementia is a challenging condition that affects not only the diagnosed person, but their family and caregivers as well. In this article, we explain frontotemporal dementia (FTD), which has two types: behavioral variant frontotemporal dementia and primary progressive aphasia. Learn about the symptoms, how frontotemporal dementia affects speech and communication, and how speech therapy can help.
What is frontotemporal dementia?
Frontotemporal dementia is a progressive disease caused by nerve cell loss in the frontal lobes or temporal lobes of the brain. The frontal lobes are right behind the forehead, and the temporal lobes are right behind the ears. This is what gives the disease its name: fronto and temporal.
What causes frontotemporal dementia?
In most cases, the cause of FTD is unknown. However, people with a family history of frontotemporal dementia are more likely to develop the disorder.
What are the symptoms of behavioral variant frontotemporal dementia?
As mentioned, there are two types of FTD. The first is called behavioral variant frontotemporal dementia (bvFTD). bvFTD causes issues with judgment, empathy, and behavior in social settings.
bvFTD typically begins somewhere in a person’s 50s or 60s, but it can appear in younger or older people as well.
What are the symptoms of primary progressive aphasia?
Primary progressive aphasia (PPA) is the other type of frontotemporal dementia. PPA affects speech and communication skills. People with PPA typically see declining abilities to talk, write, and use and understand language.
The symptoms of PPA typically occur before a person turns 65, but the disease can also appear later in life.
There are a couple key features that distinguish the type of primary progressive aphasia a person may have. Some people with PPA become unable to understand and use words to create sentences that make sense.
For other people with PPA, their speech becomes nonfluent. It becomes very hard for them to physically get their sounds and words out. However, they’re still able to understand language and can create sentences that make sense, even if the words are hard to speak. This can feel extremely frustrating and isolating for the person affected.
What are the effects of frontotemporal dementia?
It’s not uncommon for people with FTD to begin to withdraw from daily routines. Challenges in social interactions and general communication can make these routines very discouraging. People with FTD may communicate with others less and less.
To help prevent depression, it’s important to continue to involve the person in everyday life as much as possible and keep them interacting with people frequently.
How is frontotemporal dementia treated?
Frontotemporal dementia can be hard on everyone involved, and speech therapy serves both the client and the caregiver.
Speech therapy provides support for daily communication situations that may be challenging. Speech therapists can also help families navigate the changes they’re experiencing, such as by recommending a support group. Many caregivers benefit from talking with other people who are going through the same situation.
Those with bvFTD and PPA are both candidates for speech therapy.
Those with bvFTD and PPA are both candidates for speech therapy. Something to note is that those with bvFTD may have variable deficits in speech and language. Some people with bvFTD deal with minor communicative issues, while others have more severe communicative impairments. For example, some individuals have problems with motor speech, or the movements of the mouth needed to speak. Others may have difficulty with reading or with prosody of speech (the rhythm of speech). Regardless, there is a chance that speech therapy can benefit people with bvFTD.
For people with primary progressive aphasia, speech therapy is a significant form of treatment. Let’s look at how speech therapy works for people with PPA.
How speech therapy helps people with primary progressive aphasia
The goal of speech therapy is to maximize the person’s communication skills. Because of the progressive nature of the disease, this may include using other ways to communicate, such as writing, gestures, or other forms of augmentative and alternative communication (AAC).
Speech therapists provide personalized tasks to promote communication that is important to the person with aphasia. They may work on naming family members, or maintaining as many conversation skills as possible. Creating a memory book is a great way to support a person’s memory and language skills. They can have pictures of family, their house, friends, and other places they frequent. They can then practice naming and talking with their speech therapist about the pictures.
Regardless of the person’s challenges, the goal of speech therapy is to keep them functioning in their daily routines as well as possible, for as long as possible.
The person with PPA will also likely work on maintaining the ability to request things they need or want, such as food or medicine. If they have issues with sentence comprehension and formulation, their speech therapist will help them structure their sentences as clearly as possible.
As mentioned above, AAC may be used. This could be a high-tech system such as a speech-generating device. For other people, low-tech forms of AAC, like drawing, writing, or using body language and facial expressions, allow them to communicate what they need.
Speech therapists will work with the person’s family and caregivers as well. They’ll discuss ways to promote better communication, such as talking face-to-face and simplifying language. They’ll also focus on ways to continue to show dignity and respect to the person with aphasia.
Speech therapists may also provide clients and their caregivers with education about overall brain health, such as getting appropriate exercise, sleeping enough, and following a brain-healthy diet.
Regardless of the person’s communication challenges, the goal of speech therapy is to keep them functioning in their daily routines and interactions as well as possible, for as long as possible.
How do I find a speech therapist for frontotemporal dementia?
If you or your loved one is suspected of having frontotemporal dementia and has not yet been seen by a speech therapist, it’s important to start this process. The earlier treatment can begin, the better.
Speak with any physicians or health care professionals who are already providing care. It’s likely that they have referrals for speech therapists. You can also contact Expressable for a free phone consultation with a licensed speech therapist.
No one should have to deal with the speech and language effects of dementia alone. Your speech therapist will be right beside you each step of the way.
