Revisiting the Role of Augmentative and Alternative Communication in Aphasia Rehabilitation

Aimee Dietz, Sarah E. Wallace and Kristy Weissling

Key Takeaways:

  • AAC should be introduced earlier and more broadly in the post-stroke journey
  • AAC should focus beyond basic wants/needs to increase life participation and connection
  • Combining traditional interventions with AAC can address needs today while also working to enhancing language abilities for the future
  • Use AAC to increase ability while focusing on participation – these goals are not mutually exclusive.


This article examined the role that AAC can play in aphasia rehabilitation. The researchers acknowledged persisting trends that exist with aphasia and AAC, including that AAC is primarily used to support basic needs; only people with the most severe aphasia are given AAC; and that traditional therapy is prioritized. However, recent research and publications have highlighted the need for a more integrated approach to using AAC, including ASHA’s Communication Bill of Rights, Light’s Four Purposes of Communication, and the Life Participation Approach to Aphasia framework. Each of these acknowledge that AAC can have a positive impact in a variety of communicative settings that are meaningful to people with aphasia beyond basic wants/needs. These include maintaining social closeness, participating in life activities, and sharing personal identity, attitudes and feelings, among many others.

Client uses a MiniTalk to talk to his daughter at lunch.

The authors stressed that using AAC alongside traditional interventions allows as much language rehab as possible while focusing on life participation. Incorporation of AAC also ensures there is a back-up communication plan. While the focus of AAC is often on its compensatory function, clinicians can also focus on using AAC to enhance abilities, including self-cueing. This helps mitigate any concern of “learned non-use” and promotes language recovery due to the coupling of the language and visual processing networks in the brain.

Finally, the article argued for the earlier introduction of AAC. Because AAC is still often seen as a last resort by clinicians and patients alike, many are hesitant to move forward due to a seeming sense of permanence of the recommendation. If AAC were introduced earlier and more broadly, it would no longer carry this association. This would help dispel the myth that AAC is permanent and only for people who will not recover their speech. Furthermore, introducing AAC earlier can increase communicative confidence by providing a known back-up plan.

Incorporating the Research into Clinical Practice with Lingraphica

Lingraphica AAC device the perfect tool to put these authors’ suggestions into action. Because Lingraphica’s devices are simple to program and use, you can incorporate a client’s life participation goals immediately. If you are using a device with a client, start right away with adding in icons for meaningful, personal topics – family, a hobby, or independence in the community. Even though the devices come pre-programmed with thousands of icons, this research suggests that your clients will be more successful with topics that are personally relevant. Lingraphica’s team can assist with suggestions and programming.

With the combination of a picture, written text, and verbal output, the devices are built to enhance language abilities and be a tool for self-cueing. The devices even feature built-in mouth position videos for an additional way to self-cue. When using a device with a patient, encourage your client to identify icons or to try to repeat what the device says, depending on your patient’s skills and abilities.

Finally, keep in mind that it’s not too soon to try a device with your patient. Lingraphica is happy to provide loaner devices in an inpatient or post-acute rehab setting, so that you can start normalizing the incorporation of AAC as a back-up plan and building confidence right away. It’s important to stress to your patients that an AAC device does not have to be forever, and that it is just one tool available to them – it’s not replacing their speech. 

To learn how more about how AAC devices can help with aphasia rehabilitation, schedule a free consultation.

Lingraphica Can Help

We help adults with speech and language impairments to reconnect with family and friends, improve communication, and live their best lives. Call us at 866-570-8775 or visit the link below to get started.