VISUAL COMMUNICATION IN APHASIA

Aphasic patients who possessed little or no ability to communicate using natural language were taught a visual communication system (VIC). At issue on a theoretical level was whether those cognitive operations entailed in natural language may persist in the face of destruction of natural language capacities. Of practical interest was whether severely aphasic patients could communicate effectively using an alternative symbol system. The program included 2 levels of communicative functions. At Level 1 patients carried out commands, answered questions and described actions; at Level 2 patients employed the system spontaneously to express their desires and feelings. Of 8 patients given sufficient opportunity to master VIC, 5 completed Level 1, and 2 of these also satisfied the criteria for Level 2. Among these 5 patients performance in VIC far surpassed performance on matching tasks in English; error rates were quite low; the pattern of errors was remarkably similar; an inverse correlation obtained between ability at English and ability at VIC. The evidence suggests that some severely aphasic patients can master the basics of an alternative symbol system. Moreover several indices suggest that the communicative consequences of the system are appreciated, and that at least some of the cognitive operations entailed in natural language persist despite severe aphasia.