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The Progressive Aphasia Communication Toolkit (PACT): A Strengths-Based Approach to Multidomain Evaluation for Intervention

Gallee, J.; Cartwright, J.; Henry, M. L.; Mooney, A.; Stark, B. C.; Volkmer, A.; Dietz, A.; Nakano, C.; Battista, P.; Beales, A.; Beber, B. C.; Cadorio, I.; Caldwell, M.; Davies, K.; Ezzes, Z.; Gauch, M.; Graney, T.; Grobler, S.; Haley, K.; Hausmann, A.; Herrera, E.; Hubbard, H. I.; Jokel, R.; Kot, L.; Lowe, M.; McGowan, E.; Meteyard, L.; Montagut, N.; Nowenstein, I.; Pozzebon, M.; Talbot, R.; Taylor, C.; Walker, F.; Winsnes, I. E.; Fredericksen, R. J.; Domoto-Reilly, K.; Crane, P. K.

2025-12-04 rehabilitation medicine and physical therapy
10.64898/2025.11.25.25340904 medRxiv
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INTRODUCTIONTools to document communicative ability in people living with primary progressive aphasia (PwPPA) are limited. This work describes the development of a strengths-based and ecologically-valid instrument--the Progressive Aphasia Communication Toolkit (PACT). METHODSThis work consisted of five experiments: two to develop (Experiments 1 and 2) and three to pilot (Experiments 3-5) a novel instrument for PPA. Ninety-five individuals worldwide contributed to this work: 80 researchers and clinicians, 9 PwPPA, and 6 care partners. RESULTSExperiments 1-2 culminated in an instrument comprising four scales that capture quantitative and qualitative feedback. Experiments 3-5 resulted in structural refinement and digitization of the tool, revealed PwPPA and care partner preference for the PACT over traditional neuropsychological evaluation, and demonstrated strong inter-rater agreement for general measurability (91%) and strength ratings (85%). DISCUSSIONCurrent findings indicate that the PACT provides a holistic profile of communication strengths for PwPPA and can guide clinicians in developing functional therapeutic targets.

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