Both word meaning (i.e., loss of the ability to attach meaning to words) and the grammatical organization of words into a sentence (i.e., sentence structure) play an important role in comprehension. When either of these components is impaired, comprehension may be difficult. In Frontotemporal degeneration spectrum disorders, some patients have difficulty understanding the meaning of single words while other patients have trouble with sentence comprehension due to impaired processing of grammatical phrase structure (3). The language impairments may leave you and the person with Frontotemporal degeneration (FTD) feeling frustrated and disengaged. Strategies to support language and improve comprehension include speaking slowly and using shorter sentences, keeping propositions simple. Be redundant, changing words until you are understood. Speak in context so that if you are having a conversation about lunch, have the conversation in the kitchen. Lastly, the use of hand movements or gestures can clarify meaning and improve understanding.
Reading is a complex activity that requires many cognitive processes working together. Simple environmental adjustments that may help if your loved one is struggling with reading include reading short stories or large print books or newspaper to reduce the amount of text. Encourage your loved one to use a T-square while reading to maintain their place on the page, limiting distractibility caused by other columns. Lastly, audio books may be a good substitute especially if there is visual-spatial difficulty present.
Visual-spatial function refers to the ability to identify things in the environment and their location. Visual-spatial functioning is sometimes compromised in FTD spectrum disorders, particularly CBD patients. Limb apraxia, a related clinical difficulty, can make it difficult to perform purposeful skills. A variety of strategies can be used to optimize visual-spatial functioning to enhance function and reduce risk of falls. Orient your loved one frequently to place and location. Use bright colored tape as a guide for stairs and other hazard areas where falls can occur. Remove throw rugs and toys, which also increase risk of tripping and falling. Create wide pathways for common walking areas. Physical therapy and occupational therapy can be good resources for recommendations about adaptive devices and other environmental modifications.