The National Center for Evidence-Based Practice
in Communication Disorders
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Dementia
Cognitive-Communication Treatment

Restorative Treatments: Montessori-Based Treatment

 


 

External Scientific Evidence

  

Evidence-Based Practice Guidelines

No evidence-based practice guidelines were found.
 
 
 
 
 

Evidence-Based Systematic Reviews

Effectiveness of Environment-Based Interventions for People with Alzheimer's Disease and Related Dementias
Padilla, R. (2011).
American Journal of Occupational Therapy, 65(5), 514-22.
Added: June 2012
 
Description
This is a review of literature regarding the effect of environment-based interventions for individuals with Alzheimer’s disease (AD). 
 
Conclusions

A variety of outcomes from several environment-based interventions were presented. The following conclusions related to cognitive interventions that may be implemented by speech-language pathologists:

  • “External memory aids in the form of signs with the person’s name and portraitlike photographs can help people with AD navigate their environment” (p. 519).
  • “The Montessori philosophy is consistent with occupation-based, client-centered practice that emphasizes naturalistic treatment that can be graded for complexity. It engages older people to be active and can provide a rich social and caring environment” (p. 519).
  • “Most of the studies that have investigated these interventions are limited by small sample size; lack of randomization and follow-up; lack of control of intervening variables; and overuse of subjective, self-report outcome measures” (p. 519).
 
 
 
Evidence-Based Practice Recommendations for Working with Individuals with Dementia: Montessori-Based Interventions
Mahendra, N., Hopper, T., et al. (2006).
Journal of Medical Speech-Language Pathology, 14(1), xv-xxv
.
Added: July 2011 
 
Description
This is a review of experimental studies that investigated the use of Montessori-based interventions for individuals with Alzheimer's disease. This review is part of a series of reports from the Academy of Neurologic Communication Disorders and Science specific to the assessment and management of individuals with dementia. 
 
Conclusions
  • Findings from five studies support the use of Montessori-based interventions for individuals with Alzheimer's related dementia.
  • Montessori-based treatments may enhance cognitive-communication skills (e.g., engagement and participation in target activities, ability to participate in groups). However, little to no change in global cognitive function may be found.
  • Further research is needed from well-designed studies to strengthen the research base.
 
 
 
 
Systematic Review of Psychological Approaches to the Management of Neuropsychiatric Symptoms of Dementia
Livingston, G., Johnston, K., et al. (2005).
American Journal of Psychiatry, 162(11), 1996-2021.
 
Added: July 2011
 
Description
This is a systematic review of quantitative studies investigating the effects of psychological or psychosocial therapy for the management of neuropsychiatric symptoms of dementia. While the management of many neuropsychiatric symptoms is outside of the scope of speech-language pathology treatment, some symptoms are strongly related to cognitive-communication and several reviewed treatments are relevant to speech-language pathologists. Evidence was graded based on a scheme developed by the Oxford Centre for Evidence-based Medicine. Level A evidence is based on a randomized control (RCT) with narrow confidence interval or systematic review of RCTs. Level B evidence is based on extrapolations from Level A evidence and evidence from all other study designs with the exception of case control and poor quality cohort and case control studies. Level C evidence is based on extrapolations from Level B evidence and evidence from case control and poor quality cohort and case control studies. Level D evidence is based on expert opinion, basic research, or inconclusive or inconsistent evidence at any level. 
 
Conclusions
Interventions relevant to speech-language pathology that received a D Level of support included reminiscence therapy, validation therapy, reality orientation, simulated presence therapy, Montessori activities, social interaction, use of mirrors, signposting, and group living. Cognitive stimulation received a B level of support, and family counseling interventions received a C level of support. 
 
 
 
 

Clinical Expertise/Expert Opinion

 
Consensus Guidelines  
No consensus guidelines were found. 
 
 
 
 

Client/Patient/Caregiver Perspectives

 
Resident-Assisted Montessori Programming (RAMP): Training Persons with Dementia to Serve as Group Activity Leaders
Camp, C. J., & Skrajner, M. J. (2004).
Gerontologist, 44(3), 426-31
.
Added: June 2012
 
Description
This study was designed to assess the effects of Resident-Assisted Montessori Programming (RAMP). Participants were four individuals with early-stage dementia. Outcomes of interest included the degree to which leaders were able to learn the procedures of leading a group, satisfaction, and engagement
 
Conclusions
“All leaders responded that they enjoyed their role. In addition, all leaders felt that their involvement with other residents was worthwhile and said they would recommend the program to friends” (p. 429)
 
 
 
 
Use of Montessori-Based Activities by Visitors of Nursing Home Residents with Dementia
Schneider, N. M., & Camp, C. J. (2003).
Clinical Gerontologist, 26(1/2), 71-84
Added: June 2012
 
Description
This study evaluates the effects of Montessori-based activities for nine dyads of nursing home residents with dementia and their visitors. Outcomes included measurements of engagement, affect, visitor measures, and responses to an interview
 
Conclusions
“All [of the participating visitors] commented that they would recommend the training to other visitors, and that they saw positive changes in their loved ones during the use of the activities” (p. 80)
 
 
 
 
Clinical Comments: Early Stage Dementia Client as Group Leader
Camp, C. J., Skrajner, M. J., et al. (2005).
Clinical Gerontologist, 28(4), 81-5
Added: June 2012
 
Description
This article discusses findings from a case study of an individual with early-onset Alzheimer’s disease who acted as a leader for a program, the Resident and Volunteer Assisted Montessori Programming (ReVAMP) which allows people with dementia to fill social roles
 
Conclusions
The participant reported a high degree of satisfaction with the program. He indicated that “it took [his] mind off of unpleasant things and that it was “one of the most rewarding things [he had] ever done.” (p. 84)
 
 
 
 
Montessori-Based Training Makes a Difference for Home Health Workers & Their Clients
Gorzelle, G. J., Kaiser, K., et al. (2003).
Caring, 22(1), 40-42
Added: June 2012
 
Description
This article discusses the results of a Montessori-Based Training Program for home care health workers and their clients with dementia. Outcomes included levels of engagement, pleasure, anxiety, and inappropriate behavior
 
Conclusions
“There was a statistically significant increase in the amount of pleasure displayed by clients after health workers received training. This was seen in clients’ increased displays of signs of pleasure, such as smiling and laughing, after workers received training” (pp. 41-42)
 
 

 
 
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