Using self-captured photographs to support the expressive communication of people with aphasia

Background: Methods to support language generation by people with aphasia often include supplementary materials to provide content clues, thereby simultaneously helping both the speaker and listener understand communicative intents. Photographic images are one means of providing referents for keywords and creating a joint communication space. However, photograph use in conversation may not be intuitive for people with aphasia. They may lack experience capturing photographs to support conversations and may need instruction about referencing them to resolve communication breakdowns. Aims: The purpose of this study was to analyse the performance of individuals with aphasia as they observed, captured photographs of, and later participated in a conversation with a novel communication partner about a series of demonstrated wellness activities. Methods & Procedures: This multiple case study design included five adults with chronic aphasia. The experimental task included two phases—image capture and conversational interaction. Participants observed research team members performing wellness activities and took photographs, as desired, throughout the process. Each participant then engaged in a conversation about the observed wellness activities while having access to captured photographs. Outcomes & Results: Participants varied in number of photographs captured, spontaneous image use to support conversation, and success in relaying novel information to an unfamiliar partner. Participants who referenced photographs generated more content units with greater specificity than participants who did not reference photographs. Also, those referencing photographs talked more about the specified topic and made fewer off-topic or disability-related comments than those not referencing photographs. Conclusions: Overall, conversational interaction comparisons between participants who did and did not use photographs to support communication provide evidence that photograph capturing and referencing increases content specificity and facilitates topic maintenance by people with aphasia. Researchers need to explore further how photographic supports alter communicative efficiency and whether direct training about photograph capture and use is beneficial to adults with aphasia.