Few variables have been found to predict successful use of augmentative and alternative communication devices (AAC) by persons with aphasia. The present study used a single case alternating treatment design to test whether choice of conversational topic improved the ability of three adults with aphasia to use symbol-based communication aids in clinical dialogues with familiar and unfamiliar partners, and in natural environment conversations with family members and friends. Results showed that the youngest participant with most recent onset of aphasia benefited clinically from choice in communication aid training. However, the benefit of topic choice did not extend to natural environments. At home and in other natural environments, use of communication aids was dependent on multiple social and contextual factors. Findings of this study were interpreted using a model of human motivation that considers both personal and environmental influences on achievement.
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