The Progressive Aphasia Communication Toolkit (PACT): a strengths-based approach to multidomain evaluation for...

Area of Science:

• Neurology
• Speech and Language Pathology

Background:

• Existing assessments for people with primary progressive aphasia (PwPPA) often focus on diagnosis and impairment.
• There is a need for a strengths-based, ecologically valid instrument to evaluate communication in PwPPA.

Purpose of the Study:

• To develop and pilot the Progressive Aphasia Communication Toolkit (PACT), a novel instrument for assessing communication in PwPPA.
• To create a tool that captures functional, real-world communication ability and provides a shared framework for describing communicative competence.

Main Methods:

• The PACT was developed through five experiments involving 95 international participants, including researchers, clinicians, PwPPA, and care partners.
• The development involved creating a four-scale instrument with quantitative and qualitative feedback, followed by structural refinement and digitization.

Main Results:

• The PACT comprises quantitative and qualitative feedback, capturing functional communication ability.
• The tool demonstrated strong acceptance among PwPPA and care partners.
• High inter-rater agreement was observed for general observability (91%) and perceived communication strength (85%).

Conclusions:

• The PACT offers a holistic profile of communication strengths for PwPPA.
• The instrument is ecologically valid, minimally burdensome, and clinically feasible.
• The PACT can guide clinicians in developing functional therapeutic targets for PwPPA.