If your aphasia therapy sessions are feeling stuck…or your clients are…then it may be time for a refresh. In this post, you'll get specific, actionable ways to upgrade your treatment through evidence-based, person-centered care. We’ll challenge outdated norms like the plateau myth and dive into tools like AAC, LPAA, and social supports that foster lasting change. Let’s get into it!

Why Aphasia Treatment Needs a Refresh in 2025

You know the drill: worksheet after worksheet, naming pictures until you’re blue in the face, and repetition tasks that feel childlike. PSA friend - we’re long past the days of “one-size-fits-all” therapy.

Aphasia is complex — and so are the people who live with it. Our treatment needs to reflect the lived experience, not just the impairment. When we shift toward life participation and person-centered care, outcomes become more meaningful and sustainable.

6 Tips to Refresh Your Aphasia Treatment Approach

1. Ditch the Plateau Myth, There’s Always Room to Grow

The idea that people with aphasia plateau after 6–12 months is outdated. Instead, educate patients and caregivers that progress can happen at any stage, especially when goals are functional and engaging. (*Honorable mentions: patient mental health, motivation, and home/community support also play a huge role in progress.)

Evidence: Studies support neuroplasticity well beyond 1 year post-stroke when therapy is motivating and consistent.

2. Prioritize Person-Centered Goals (Not Just Language Domains)

Move beyond the “impairment checklist.” Functional therapy should answer:

What are the real communication needs of this person?
How can we support their role (grandparent, musician, voter, teacher, etc.)?

Use tools like:

Communication Participation Item Bank (CPIB)
Confidence Communication Rating Scale for Aphasia

3. Consider Social Determinants of Health (SDOH)

SDOH include the conditions in the environments where people are born, live, learn, work, play, worship, and age. These conditions can affect a wide range of health, functioning, and quality-of-life outcomes and risks. Just think…transportation, income, digital literacy, and housing all affect speech therapy success. If you work in an outpatient clinic, and your patient doesn’t have consistent access to transportation to get to your visits…are you labeling them noncompliant and discharging…or referring to MSW to assist with transportation?

Other SDOH to consider during your sessions:

Safe housing and neighborhoods
Racism, discrimination, and violence
Education and job opportunities
Access to nutritious foods and physical activity opportunities
Polluted air and water
Language and literacy skills

Use intake questions, your evaluation, and therapy sessions to uncover the SDOH impacting your patients. For example:

Do they have internet access?
If you’re a cash pay practice, can they afford consistent treatment?
Are they socially isolated due to communication barriers?

Learn more about SDOH and grab a detailed question list to help your patients know exactly what to say at doctor’s appointments, rehab facilities, or during tough family conversations.

Prevalence of SDOH Needs in U.S.

Study from the National Institute of Health (NIH). There were 11,817 survey participants (weighted sample of 463 million US adults) and more than half (54.4%, weighted) of the population had one or more SDOH need.

Kim, E. J., Abrahams, S., Uwemedimo, O., & Conigliaro, J. (2020). Prevalence of Social Determinants of Health and Associations of Social Needs Among United States Adults, 2011-2014. Journal of general internal medicine, 35(5), 1608–1609. https://doi.org/10.1007/s11606-019-05362-3

4. Incorporate AAC Early and Often

AAC isn’t a “last resort.” It’s a tool for communication, access, and confidence. Consider:

Low tech AAC: non-digital based methods of communication (ex: paper & pen, communication board, gestures)
High tech AAC: digital-based methods of communication (ex: communication devices/speech generating devices, apps, texting)

Research shows that AAC can enhance communication, promote independence, and support participation in daily activities. Studies have shown that using AAC devices does not hinder or slow down natural speech recovery, but rather can facilitate progress and support language skills. What are you waiting for friend?!

Resources:

Lean more about AAC in this free, 1-hour educational webinar
IG Reels on how I use AAC in therapy, Idea 1, Idea 2
Download research on aphasia & AAC

5. Embrace the Life Participation Approach to Aphasia (LPAA)

LPAA is a treatment approach for including language practice into everyday life. It prioritizes the person with aphasia and their goals. The primary goal? Enhanced life participation. The model? Collaboration where you’re working with your patient their family, and other communication partners.

Therapy activities should engage your patient in activities that are important to THEM. Like gardening, cooking, speaking on the phone, going to the bank, and more!

Remember when choosing your therapy activities, aphasia is a language problem — not an intelligence problem. Don’t treat your patients like kids. Meet them where they are. Some questions to ask yourself to incorporate LPAA into therapy:

What does success look like for my patient?
How can the environment be changed to support communication?
Am I treating the person or just the impairment?

Learn more about LPAA.

6. Refer to or Create a Support Group

Research tells us that 90% of people with aphasia feel lonely and socially isolated (Ross, K., Lapointe, L., & Katz, R. (2008)). If we’re working on language, isn’t it important to make sure your patients have people or a community to use that language with!

Over the last year, I’ve hosted 3-4 support groups a month for people with aphasia, on Virtual Connections. Honestly, it’s been such a beautiful time and I can’t believe I didn’t do this earlier in my SLP career! One of my groups is a monthly art club where members share holiday decorations, pics from vacation, personal crafts, and we look at famous art from around the world. They love giving their artistic opinions and hyping each other up!

Some kind words I’ve recently heard during my Empowered Communication and Aphasia Advocacy support groups:

“This group helped me find friends again.”
“Before…no one, lonely. Now…talking with friends.”
“I feel like this is the only place I can ask questions and learn.”

Who’s cutting onions?! It’s been so cool to see group members become friends, start podcasts together, and support each other. I’ve even see a few SLPs joining during their therapy sessions… which I 10/10 recommend!

Support groups reduce isolation and provide natural communication opportunities for your patients. If one doesn’t exist near you:

Collaborate with a local rehab center or university to host one
Incorporate trained conversation partners or graduate students
Start one yourself!