Primary progressive aphasia therapy that helps you keep communicating
If language has been slowly changing, and finding words is getting harder over time, it's frightening, and you're not alone in it. Primary progressive aphasia (PPA) is a condition where language gradually changes, usually from an underlying neurodegenerative process. Speech therapy can't cure PPA, and it can't stop it. What it can do is help you keep communicating: building strategies, practicing the words and skills that matter most, and coaching the people around you. My aim is to help you hold onto function, independence, and connection for as long as possible.
A gradual change in language should be evaluated by a physician, often a neurologist, for an accurate diagnosis. Speech therapy works alongside your medical team, not in place of it.
What is primary progressive aphasia?
Primary progressive aphasia is a form of language change caused by a slow, underlying neurodegenerative process. Unlike aphasia after a stroke, which begins suddenly and often improves, PPA develops gradually over months and years. It can affect finding words, forming sentences, or understanding language, while other abilities may stay strong for a long time.
What can change
- Finding everyday words
- Putting words into sentences
- Understanding what others say
- Reading and writing
What therapy focuses on
- Keeping personally important words and phrases
- Communication supports and backup tools
- Coaching for family and care partners
- Planning ahead as needs change
How can speech therapy help with PPA or early dementia?
Therapy for a progressive condition looks different from recovery after a stroke. The aim is to protect communication and connection at each stage: strengthening the words and skills you use most, setting up supports before they're needed, and making sure the people around you know what helps. It's steady, practical work built around your life.
Focus on what matters most
We identify the words, names, phrases, and routines that are most important to you, and practice them while practice is most effective.
Build supports and backups
Communication books, personalized word lists, phones and simple AAC tools, so you have dependable ways to be understood as language changes.
Coach your care partners
Through Communication Partner Training (CPT), family and close friends learn how to support conversations, reduce frustration, and use the same strategies at home every day.
Plan ahead together
We revisit the plan over time and adjust it as needs change, keeping the focus on function, independence, and connection.
Supporting families and care partners
PPA and early dementia affect the whole family, not just one person. A large part of this work is helping care partners feel confident: how to give time, how to offer a word without taking over, how to use supports, and how to keep conversations warm even on hard days. When everyone shares the same strategies, connection holds. See how we support families and caregivers.
Marina Coakley, M.S., CCC-SLP
Licensed speech-language pathologist providing virtual therapy for adults with acquired and progressive neurological conditions across Tennessee, Kentucky, and North Carolina. Read Marina's background.
Common questions about PPA and early dementia
Why Marina
Hands-on experience, put to work for your family
Before I became a speech-language pathologist, I first studied music therapy, then worked as a registered behavior technician and as an SLP assistant in schools, with graduate training in skilled-nursing and outpatient rehab. For you, that means a clinician who has done the day-to-day, hands-on side of the work herself, and who builds plans you can actually carry out at home, between sessions, in real life.
Practice that feels natural
Music therapy is where I started, so rhythm, routine, and play shape the everyday practice we build together.
Plans you can actually do
Years as a behavior technician and SLP assistant taught me what works in a real day, not just on paper.
Help where you are
Secure video, anywhere in Tennessee, Kentucky, and North Carolina. No commute, no waiting room.
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