Autonomy and empowerment in aphasia assessment and therapy: Isn't it the road more travelled?

In the lead article, the author expresses her serious concerns regarding the state-of-the-art in the functional assessment and treatment of aphasia. She offers social models of literacy and disability, which are referred to as 'radical approaches', as a means of addressing this current dilemma in aphasia rehabilitation. In reading the lead article, one senses that clinical aphasiologists have been down this road before. Back in 1977, Holland discussed the issue of functionality in aphasia therapy by recommending the utilization of contextualized-based strategies in treatment, thus emphasizing the 'real-worldiness' (p. 168) of this notion. Since that time, Holland (1977, 1982, 1991) and others have espoused the need for, as well as the virtues of, functional approaches to assessment and treatment of aphasia (Aten 1994, Blomert 1990, Chapey 1986,1992, Code and Muller 1989, Davis and Wilcox 1981,1985, Frattali 1992, Holland and Wertz 1988, Leiwo 1994, Lesser 1985, 1991, Lubinski 1981, 1994, Newhoff and Ape1 1989, 1990, Peach 1992, Rosenbek et al. 1989). Others have reported on the implementation and/or efficacy of such functional approaches (Aten et al. 1982, Carlomagno etal. 1991, Ferguson 1994, Florance 1981, Holland 1991, Linebaugh et al. 1982, Lyon 1992, Newhoff et al. 1981, Pulvermuller and Roth 1991, Wertz et al. 1986).