Multimodal communication in progressive aphasia (Robinaugh et al., 2026)

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Purpose: This study aimed to evaluate the feasibility and acceptability of the experience sampling method (ESM) in characterizing the communication behaviors of individuals with primary progressive aphasia (PPA) and to characterize the use of different communication modalities by five participants with PPA and their care partners.Method: Five dyads (participant with PPA and care partner) completed semistructured interviews followed by a 1-week data collection period. Surveys were delivered twice daily to participants via texted links. Participants reported on their use of communication modalities (speech, gesture, writing, etc.). Feasibility was measured by retention and adherence to the response schedule; acceptability was evaluated using the System Usability Scale and a measure of care partner assistance. Patterns of modality usage across participants were analyzed visually, and interview data were analyzed using reflexive thematic analysis to contextualize ESM findings.Results: Participants with PPA completed 100% of ESM surveys, and care partners completed 96% of ESM surveys. Results from the System Usability Scale indicated that among individuals with PPA, surveys were acceptable to one, marginally acceptable to two, and unacceptable to two participants. Surveys were acceptable to four care partners and marginally acceptable to one care partner. Participants reported using unaided communication (facial expression, gesture, and speech) most frequently, with varied use of other modalities. Thematic analysis of interviews yielded four themes related to multimodal communication.Conclusions: ESM was found to be feasible for both care partners and participants with PPA in the current study. The method was largely found to be acceptable to care partners. However, acceptability was adversely affected by cognitive–linguistic impairment in participants with PPA. Despite challenges to acceptability, ESM holds promise as a means to characterize communication behaviors in daily life in individuals with PPA and their care partners.Supplemental Material S1. Interview questions.Supplemental Material S2. Experience sampling method (ESM) surveys.Supplemental Material S3. Experience sampling method (ESM) distributions.Supplemental Material S4. Participant excerpts and themes.Robinaugh, G., Millanski, C., Tessmer, R., Wauters, L. D., González-Howard, M., Grasso, S. M., & Henry, M. L. (2026). Multimodal communication in progressive aphasia: A mixed-methods experience sampling study. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2026_AJSLP-25-00431Publisher Note: This article is part of the Special Issue: Select Papers From the 54th Clinical Aphasiology Conference.

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