Assessment and Treatment of the Adult with Severe Aphasia: Aiming for Functional Generalisation

Traditional assessment and treatment procedures for the severe aphasic are reviewed and details of the CADL are given. Concern is expressed over the lack of treatment carryover into the aphasic's everyday communicative attempts and reasons for this are discussed. Ways to enhance the effectiveness and generalisation of treatment are detailed. Particular reference is made to the need to incorporate components of normal conversation into treatment by: maintaining the need to communicate, incorporating contextual settings and interactions, working with numerous speech acts and maintaining linguistic realism.In addition to this, the need to focus on communicative efficiency rather than single modality production is stressed, and strategy treatment is outlined.