The Effect of Remnant and Pictographic Books on the Communicative Interaction of Individuals with Global Aphasia

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Abstract
People with global aphasia are known to have difficulty comprehending or using external symbols, such as line drawings of single objects, during conversations. It was hypothesized that remnants, actual objects, or photographs of events or items of personal significance, may be a more useful means of representing conversational topics for individuals with global aphasia than generic pictographic symbols. In this study, changes in the communication behaviors of two adults with global aphasia across the three conversational conditions of baseline (no symbols), pictographic topic symbols, and remnants were measured. Results indicated that participants with aphasia initiated more topics and had fewer unrepaired communication breakdowns in both of the symbol conditions than when no symbols were available. Participants engaged in more pointing behavior with remnants than with pictographic symbols, and communication partners' subjective evaluations also favored remnants over pictographs. As expected, some variability was observed between and within participants. Remnant books were still in use at the rehabilitation facility for patients with global and severe aphasia three years after termination of the study.