Functional Communication for Individuals with Aphasia: A Literature Review

Communicating thoughts to family, friends, and acquaintances is an obstacle for individuals with chronic aphasia. Day-to-day interactions often diminish, reducing communication opportunities and confidence. Speech-language pathologists aim to restore communication abilities to reduce the potential for isolation and social withdrawal. However, these communication obstacles often persist after dismissal from therapy. Therefore, additional information is needed to update and guide clinicians in designing therapy sessions and measuring outcomes of functional communication approaches to enhance life participation for individuals with aphasia.



This systematic literature review addresses the effectiveness of a functional communication approach to therapy for persons with aphasia after the first six months post-stroke. Functional communication involves communicating using any modality (speech, writing, signing, gestures, drawing) in everyday real-life situations.



Three trained researchers reviewed the effects of functional communication on persons with aphasia (PWA) and communication, PWA and quality of life, and caregivers and quality of life. We examined peer-reviewed articles published between 2012 and 2022 in the United States within three electronic databases. Each study targeted functional communication. The search yielded 4 articles with 161 PWA and 63 caregivers. Interventions involved group and/or individual therapy related to naturalistic communication, total communication, multidisciplinary practice with physical, occupational, and speech therapy, as well as exercise, cooking, painting, and music. For PWA, outcomes showed significant changes in linguistic measures as well as improved quality of life. Caregivers reported less caregiver burden. Results show that a variety of functional communication strategies impact life participation for individuals with aphasia and their caregivers.