Access and social inclusion in aphasia: Interactional principles and applications

Abstract

Background: People with aphasia are often excluded from full participation in communicative events and social interactions. Many consider the aphasic language deficit as the cause of social exclusion. However, social exclusion is a complex process that is situated within the wider realm of human social action. While the aphasia literature has provided data on resources and strategies that impact on inclusion and participation, other realms of social science have targeted social action in all its authenticity and complexity, and have focused on how social action is effectively established, negotiated, and sustained. A study of this literature can expand our understanding of issues involved in inclusion, participation, and communicative access of people with aphasia. Aims: This article will review a selected corpus of social science research that is outside the clinician's typical experience, but that is relevant to the issues of accessibility and social inclusion in aphasia. Main Contribution: Four interactional principles relevant to the enhancement of social accessibility and social inclusion will be discussed. These four principles concern social constructionism, local negotiation of social action, the collaborative nature of social action, and ways that social dimensions are manifested in social action. Understanding of broad principles of social interaction will improve our ability to enable social participation and inclusion of people with aphasia. Conclusions: This paper will describe four principles of human social interaction and highlight clinical implications involving various therapeutic strategies and communicative values related to communicative inclusion and social participation.