Narrative and procedural discourse production by severely aphasic patients

Five cbronically aphasic subjects were trained on a computerized iconographic communication system (C-VIC). Their performance in producing single sentences scripts. and narratives was assessed using both spoken English and C-VIC. The requisite vocabulary necessary and the narrative complexity of the target productions were controlled. Subject performance using C-VIC indicates that the ability to construct discourse at the macrostructural level is largely intact. Despite significant improvements in spoken production after C-VIC training, especially at the single sentence level, the subjects' spoken discourse remains severely impaired by their failures at the microlinguistic level. These results point to the limits of currently available approaches to the remediation of aphasia and suggest avenues for future research.