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Drawing in aphasia: moving towards the interactive

This paper reviews the literature on the use of drawing to communicate by people whose language is restricted due to aphasia. The advantages of drawing over other forms of non-verbal communication for this population are detailed, followed by discussion of different approaches to communicative drawing with reference to descriptive reports, treatment studies and review papers. The two main approaches differ in their view of drawing either as an alternative to speech or as an augmentative tool in multimodal communication. In the former approach the focus is on drawing skill or quality. Successful transmission of messages is the goal, and this depends on the production of recognizable drawings. In contrast, in the latter approach quality of drawings is secondary to its value as an interactive medium. The focus is on interpersonal aspects of communication and drawing is used alongside other modalities as a medium of social connectedness. The main principles of interactive drawing are discussed with examples from recent therapy studies. These are: the importance of drawing "economically" rather than producing "good" drawings; the contribution of the communication partner in facilitating, developing and maintaining a shared interaction; and the importance of using interactive drawing within natural communication contexts, in particular conversation.