The impact of contextualization and personal relevance on communicative performance by people with severe aphasia

Aphasia greatly influences a person\u27s communication due to the vast corruption it can exact on all language and communication modalities. Aphasia is not confined to a solitary language process; rather, it interferes with a person\u27s speaking, reading, writing, and comprehending of language. It is a complex disorder of language that limits a person\u27s processing and manipulation of all types of symbolic information. Many individuals who are stricken with aphasia have chronic, severe language impairments and never recover sufficiently to become functional communicators (Helm-Estabrooks, 1984). Because language restoration may only be partially successful, a secondary intervention focus for people likely to experience some form of chronic aphasia is instruction in compensatory strategies that augment residual speech and language skills and improve communicative efficiency. These compensatory strategies often involve AAC techniques, strategies, and devices. The specific purposes of this research were to ascertain whether 8 participants with moderate, severe, or profound chronic aphasia: (a) preferred personally-relevant, contextualized pictures, non-personally-relevant, contextualized pictures, or non-contextualized symbols; (b) identified with greater accuracy and speed information represented by personally-relevant, contextualized pictures, non-personally-relevant, contextualized pictures, or non-contextualized symbols; (c) identified pictured information in the form of personally-relevant, contextualized pictures, non-personally-relevant, contextualized pictures, and non-contextualized symbols with greater accuracy and speed when target words varied according to linguistic function—at is whether they functioned as an episode, verb, or noun. Three major findings emerged from the data analysis. First, participants with moderate, severe, or profound chronic aphasia indicated a clear preference for using their own personally-relevant, contextualized pictures to represent target words. This finding held true regardless of whether the pictures were representing episodic events, actions (i.e., verbs), or people or objects (i.e., nouns). Second, the participants identified personally-relevant, contextualized photographs with a significantly higher level of accuracy (97%) than they did other types of pictures, and, once again, the type of word or event corresponding with the stimuli did not impact accuracy. Third, although not statistically significant, a trend was evident regarding the speed with which participants identified target words associated with the stimulus pictures. Specifically, average response times were fastest when participants matched target words with personally-relevant, contextualized pictures and were slowest when participants matched target words with non-contextual symbols