What is Functional Communication? A Theoretical Framework for Real-World Communication Applied to Aphasia Rehabilitation

Abstract

Aphasia is an impairment of language caused by acquired brain damage such as stroke or traumatic brain injury, that affects a person’s ability to communicate effectively. The aim of rehabilitation in aphasia is to improve everyday communication, improving an individual’s ability to function in their day-to-day life. For that reason, a thorough understanding of naturalistic communication and its underlying mechanisms is imperative. The field of aphasiology currently lacks an agreed, comprehensive, theoretically founded definition of communication. Instead, multiple disparate interpretations of functional communication are used. We argue that this makes it nearly impossible to validly and reliably assess a person’s communicative performance, to target this behaviour through therapy, and to measure improvements post-therapy. In this article we propose a structured, theoretical approach to defining the concept of functional communication. We argue for a view of communication as “situated language use”, borrowed from empirical psycholinguistic studies with non-brain damaged adults. This framework defines language use as: (1) interactive, (2) multimodal, and (3) contextual. Existing research on each component of the framework from non-brain damaged adults and people with aphasia is reviewed. The consequences of adopting this approach to assessment and therapy for aphasia rehabilitation are discussed. The aim of this article is to encourage a more systematic, comprehensive approach to the study and treatment of situated language use in aphasia.

Gesture–speech coupling in persons with aphasia: A kinematic-acoustic analysis.

“…Acoustic markers of prosody were reported to be different, especially in the use of (rise-)falling F0 contours that were more prevalent in PWA as compared to NBI. These differences in acoustic markers do not mean “impaired” prosodic modulations though, but rather differently “situated” (Doedens & Meteyard, 2022) ways of using prosody. Interestingly, Ferré (2021) further reports that the beat gestures were very prevalent (even more so than NBI) and also suggests that these beat gestures seemed to serve as anchors for the “pace of speech and [thereby creating] a rhythmic effect of entrainment…” (p. 13; which is also reported by Orgassa, 2005).…”

Adaptation of the Aphasia Impact Questionnaire-21 into Greek: A Reliability and Validity Study

“…Aphasia is linked to poor functional communication outcomes [7,10], little opportunity of return to work [11,12] and reduced activities of daily living (ADL) [6,13]. A high incidence of depression is also reported, with estimates ranging between 62 and 70% and higher, for PWA compared to stroke survivors without aphasia [14].…”

“…PWA also have reduced access to health and social services because of physical and communication barriers. Therefore, it is crucial for PWA to gain back their communication skills to express their thoughts, everyday needs, emotions and enjoy meaningful interactions [10].…”

Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis

“…Communication is a shared activity representing the coordinated actions of two or more people to achieve a common goal [ 1 ]. Successful communication involves a dynamic complex of hearing, listening, language and cognition that can be significantly disrupted when a hearing loss (HL) is present.…”