Beyond Speech: Centering Identity and Connection in Aphasia Intervention
When people think about aphasia, they often think about speech—how to get it back, how to practice it, how to restore what was lost. But speech is just one piece of communication.
At The Big Picture SLP, we believe that intervention should focus not only on what’s missing but on what still connects us: identity, relationships, and the many ways we can express ourselves. The goal isn’t just more words—it’s more connection.
🧠 Rethinking Aphasia Therapy: It’s About More Than Talking
Research increasingly supports what many families and clinicians know intuitively: restoring spoken language is essential, but not always possible-or necessary—for meaningful communication.
According to Dietz et al. (2019), individuals with aphasia who are given access to augmentative and alternative communication (AAC)—such as high-tech speech-generating devices or low-tech visual supports—can experience improved communication outcomes and increased participation in daily life. The key is early access and individualized design.
Likewise, Mooney et al. (2023) remind us that, especially for individuals with Primary Progressive Aphasia (PPA), communication needs evolve. Effective intervention must include multiple communication modes—gestures, visual cues, writing, partner-supported strategies, and yes, AAC—designed around each person’s values and preferences.
🧰 Tools That Support Identity and Connection
Here are some core tools and strategies that go beyond speech and focus on whole-person communication:
🔤 AAC (Augmentative and Alternative Communication)
AAC can include devices, apps, or picture boards. It’s not a “last resort”—it’s a language access tool that can be introduced early and used alongside speech therapy to build communication confidence.
Dietz et al. (2019) found that AAC, when embedded into meaningful contexts, can complement language recovery and empower participation.
🖼 Visual Scene Displays (VSDs)
VSDs are personalized images—like a family barbecue or a favorite park—embedded with touchpoints that allow a person to select phrases or words related to that context. They're invaluable for individuals with limited reading skills or those who benefit from context-rich cues.
🌍 Language and Cultural Considerations
As Hung et al. (2022) point out, many AAC systems are not bilingual or culturally tailored, creating barriers for multilingual individuals. A one-size-fits-all approach erases identity. Intervention should include family-preferred languages, dialects, and culturally significant vocabulary.
💡 Shifting the Goalposts: Communication, Not Just Conversation
Aphasia intervention isn’t about chasing a “normal” that may never return. It’s about redefining success.
Connection can happen through:
A shared glance at a visual board
A gesture toward a favorite photo
A laugh at the right moment, even without words
A pre-recorded message that says, “Happy anniversary” in a familiar voice
Communication is about being known, not just being understood.
💬 A Message to Families
It’s okay to grieve what’s been lost. But don’t let speech be the only measure of progress. Success can manifest as a conversation with a device, a smile at the right moment, or a hug given after using a visual cue.
As Aphasia Access reminds us, life participation is the ultimate goal, not just speech accuracy.
At The Big Picture SLP, we partner with families to honor identity, empower autonomy, and celebrate every way a person communicates.
🗓 Ready to Explore AAC or Communication Supports?
Whether you’re a caregiver navigating new diagnoses or a clinician rethinking goals, we’re here to help.
Visit bigpicturespeechlanguageservices.com to book a consultation or learn more about our aphasia-focused services.
References
Dietz, A., Wallace, S., & Weissling, K. (2019). AAC in Aphasia: Supporting Recovery and Participation
Hung, S., Davidson, B., & Worrall, L. (2022). Barriers to Bilingual SGD Access
Mooney, A., et al. (2023). PPA Intervention Through Multimodal Communication
Visual Scene Displays article