Communication Use and Participation in Life for Adults With Aphasia in Natural Settings

Ensuring effective use of communication and participation in life for adults with aphasia in their natural settings may require broader and more extensive interventions than previously envisioned or actively managed by speechlanguage pathologists. Acquired brain damage unquestionably diminishes the extent to which adults with aphasia make use of communication and participation in daily life. But optimal management of aphasia extends beyond an anatomic-physiologic basis of dysfunction or even concentrated efforts to remediate linguistic or communication disabilities. Past failures to achieve a solution to this problem may be more because of what is absent from aphasia treatment than the improper or incomplete repair or management of what currently is treated. Treatment may require inclusion and active integration of a means of managing the psychosocial handicap of the aphasia. However, with an expanded scope to aphasia treatment, the methods of inquiry must be equally appropriate for discerning pertinent facts about optimal functioning of adults with aphasia in natural settings. This topic, the epistemology of the problem, is the subject of a forthcoming publication.