Supporting narrative retells for people with aphasia using augmentative and alternative communication: photographs or line drawings? Text or no text?

PURPOSE The purpose of this study was to examine how the interface design of an augmentative and alternative communication (AAC) device influences the communication behaviors of people with aphasia during a narrative retell task. METHOD A case-series design was used. Four narratives were created on an AAC device with combinations of personally relevant (PR) photographs, line drawings (LDs), and text for each participant. The narrative retells were analyzed to describe the expressive modality units (EMUs) used, trouble sources experienced, and whether trouble sources were repaired. The researchers also explored the participants' perceived helpfulness of the interface features. RESULTS The participants primarily used spoken EMUs to retell their narratives. They relied on PR photographs more frequently than LDs; however, they reported both picture types to be equally helpful. Text was frequently used and reported as helpful by all 4 people with aphasia. Participants experienced similar rates of trouble sources across conditions; however, they displayed unique trends for successful repairs of trouble sources. CONCLUSION For narrative retells, LDs may serve as an effective visual support when PR photographs are unavailable. Individual assessment is necessary to determine the optimum combination of supports in AAC systems for people with aphasia.