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deficits in two variants of primary progressive aphasia. Aphasiology , 23 (7–8), 823–834. NHMRC (2009). NHMRC additional levels of evidence and grades for recommendations for developers of guidelines . Retrieved from http://www.nhmrc.gov.au/_files_nhmrc/file/ guidelines/final_draft_levels_and_grades_dec_09.pdf O’Halloran, R., & Rose, T. (2010). What’s the evidence? Communicatively accessible healthcare environments. ACQuiring Knowledge in Speech, Language and Hearing , 11 (3), 123–126. Pattee, C., Von Berg, S., & Ghezzi, P. (2006). Effects of alternative communication on the communicative effectiveness of an individual with progressive language disorder. International Journal of Rehabilitation Research , 29 , 151–153. Rapp, B., & Glucroft, B. (2009). The benefits and protective effects of behavioural treatment for dysgraphia in a case of primary progressive aphasia. Aphasiology , 23 (2), 236–265. Robinson, S., Druks, J., Hodges, J., & Garrard, P. (2009). The treatment of object naming, definition, and object use in semantic dementia: The effectiveness of errorless learning. Aphasiology , 23 (2), 175–191. Rogalski, Y., & Edmonds, L. A. (2008). Attentive readings and constrained summarization (ARCS) treatment in primary pro- gressive aphasia: A case study. Aphasiology , 22 (7–8), 763–775. Rogers, M. A., & Alarcon, N. B. (1998). Dissolution of spoken language in primary progressive aphasia. Aphasiology , 12 (7/8), 635–650. Rogers, M. A., King, J. M., & Alarcon, N. B. (2000). Proactive management of primary progressive aphasia. In D. R. Beukelman, K. M. Yorkston, & J. Reichle (Eds.), Augmentative and alternative communication for adults with acquired neurologic disorders (pp. 305–337). Baltimore: Brookes. Schneider, S. L., Thompson, C. K., & Luhring, B. (1996). Effects of verbal plus gestural matrix training on sentence production in a patient with primary progressive aphasia. Aphasiology , 10 , 297–317. Tate, R.L., McDonals, S., Perdices, M., Togher, L., Schultz, R., & Savage, S. (2008). Rating the methodological quality of single-subject designs and n-of-1 trials: Introducing the Single-Case Experimental Design (SCED) Scale. Neuropsychological Rehabilitation , 18 (4), 385–401. Taylor, C., Miles-Kingma, R., Croot, K., & Nickels, L. (2009). Speech pathology services for primary progressive aphasia: Exploring an emerging area of practice. Aphasiology , 23 (2), 161–174. 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.

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). References Cartwright, J., & Elliott, K. A. E. (2009). Promoting strategic television viewing in the context of progressive language impairment. Aphasiology, 23 (2), 266–285. Cress, C. J., & King, J. M. (1999). AAC Strategies for people with primary progressive aphasia without dementia: Two case studies. AAC Augmentative and Alternative Communication , 15 , 248–259. Croot, K. (2009). Progressive aphasia: Definitions, diagnoses, and prognoses. Aphasiology, 23 (2), 302–326. Croot, K., Nickels, L., Laurence, F., & Manning, M. (2009). Impairment- and activity/participation-directed interventions in progressive language impairment: Clinical and theoretical issues. Aphasiology , 23 (2), 125–160. Diehl, J., Mayer, T., Forstl, H., & Kurz, A.F. (2003). A support group for patients with frontotemporal dementia. Dementia: The International Journal of Social Research and Practice , 2 (2), 151–161. Harasty, J. (2010). What’s the evidence? ACQuiring Knowledge in Speech, Language and Hearing , 12 (1), 42–44. Henry, M.L., Beeson, P.M., & Rapcsak, S.Z. (2008a). Treatment for anomia in semantic dementia. Seminars in Speech and Language , 29 (1), 60–70. Henry, M.L., Beeson, P.M., & Rapcsak, S.Z. (2008b). Treatment for lexical retrieval in progressive aphasia. Aphasiology , 22 (7–8), 826–838. Jokel, R., Cupit, J., Rochon, E., & Leonard, C. (2009). Re-learning lost vocabulary in non-fluent progressive aphasia with Mosstalk Words ® . Aphasiology , 23 (2), 175–191. Jokel, R., Rochon, E., & Anderson, N.D. (2010). Errorless learning of computer-generated words in a patient with semantic dementia. Neuropsychological Rehabilitation , 20 (1), 16–41. McNeil, M. R., & Duffy, J. R. (2001). Primary progressive aphasia. In R. Chapey (Ed.), Language intervention strategies in adult aphasia (4th ed., pp. 472–486). Baltimore: Lippincott, Williams & Wilkins. McNeil, M. R., Small, S. L., Masterson, R. J., & Tepanta, R. D. (1995). Behavioural and pharmacological treatment of lexical-semantic deficits in a single patient with primary progressive aphasia. American Journal of Speech-Language Pathology , 4 , 76–93. Newhart, M., Davis, C., Kannan, V., Heidler-Gary, J., Cloutman, L., & Hillis, A. E. (2009). Therapy for naming

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: karen.croot@sydney.edu.au

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ACQ uiring knowledge in speech, language and hearing