To implement AAC as a dual-purpose tool requires a shift in how AAC is applied.

Specifically, AAC instruction must avoid an approach that promotes a “learned non-use." This concept was first described in the context of language recovery by Drs. Pulvermuller and Berthier (2008, p. 569). When applied to AAC intervention, our feasibility data (Dietz et al., 2018) suggest that we can actively promote language recovery through the coupling of the language and visual processing neural networks via self-cueing (rather than AAC being used as a replacement for spoken language). This work is ongoing. For detailed information, see our open-access tutorial (Dietz et al., 2025). 

However, to achieve this goal, intervention is different from the typical approach of providing AAC and asking the PWA to point to pictures or words, or to rely on the device to speak for them.

Consistent with Alexander Luria’s theory of intersystemic reorganization (1972), the relatively intact visual and motor modalities are leveraged to strengthen the impaired spoken language modality via the performance act of AAC. PAIL-RcA© is designed to instruct PWA to use AAC to self-cue during anomic events to reduce learned non-use of spoken language.

Central to this approach is the prevention of “learned non-use” by ensuring AAC drives, rather than replaces, spoken language production, while simultaneously supporting functional communication. AAC is used to promote experience-dependent neural plasticity by coupling language, motor, visual, and auditory neural systems via AAC-supported self-cueing, thereby strengthening the language system. This contrasts with traditional AAC approaches that emphasize access and message transmission, but do not explicitly target AAC-supported self-cueing as a mechanism to support spoken language recovery.

PAIL-RcA© Materials

All materials below are freely available. 

• Full open-access tutorial: [Read the tutorial] 

Promoting AAC-Induced Language-Recovery in Chronic Aphasia (PAIL-RcA) © 2012-2026 by Aimee Dietz is licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC-BY-NC). We encourage the adaptation/translation of the PAIL-RcA© materials provided here. This is permissible under the terms of the Creative Commons Attribution License. 

We invite you to share your translation or adaptation with us so that this site may serve as a repository to increase access for the broader community. 

• Please click on "Adaptations" under the three bars in the top left corner and available options will appear.

Treatment Step Prompt Guides

Data Collection Sheets

Funding Acknowledgments

This project was developed with support from National Institute on Deafness and Other Communication Disorders Grant R15 DC017280-01: A Preliminary Study of the Neurobiology of AAC-Induced Language Recovery in Post-Stroke Aphasia (PI: Aimee Dietz), an Institutional Training Award (KL2) from the University of Cincinnati (UC) and Cincinnati Children’s Hospital Medical Center for Clinical & Translational Science & Training (CCTST) via the National Center for Research Resources and the National Center for Advancing Translational Sciences (PI: Aimee Dietz), National Institutes of Health, Grants [8KL2 TR000078-05; 8UL1 TR000077-05] (PI: Aimee Dietz). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, UC, CCHMC, or the CCTST; KL2 [TR000078-05]; Junior T1 [UL1 TR000077-05].

Copyright 2012-2026 Aimee Dietz, PhD, CCC-SLP
Email: aac.languagerecovery@gmail.com