Language and psychiatric symptom overlap in FTD: an SLP perspective

Frontotemporal dementia (FTD) often presents with complex behavioural and communication changes that are frequently misinterpreted as primary psychiatric disorders, contributing to delayed diagnoses, inappropriate interventions, and caregiver distress. This commentary explores overlapping clinical features of psychiatric and language symptoms in FTD and highlights the important role that speech-language pathologists (SLPs) can play in early identification, care planning, and psychosocial support. Drawing on two illustrative vignettes, an individual living with behavioural variant frontotemporal dementia (bvFTD) and another living with semantic variant primary progressive aphasia (svPPA), this paper examines how communication impairments overlap psychiatric conditions and how SLP-led interventions can clarify diagnoses, reframe behaviours, and foster functional participation. These cases emphasise the importance of SLP involvement in interdisciplinary teams, not only for language rehabilitation but also for caregiver education and relational scaffolding. Despite a growing understanding of FTD, clinical frameworks often fail to integrate speech-language assessment early into pathways, particularly in younger individuals. This paper advocates for earlier SLP referral, structured caregiver supports, and formal recognition of communication disorders as diagnostic and therapeutic entry points for neurodegenerative disease. Enhanced awareness of the communicative dimensions of FTD may improve diagnostic accuracy, reduce stigma, and promote more holistic and relationship-centred models of care.