PODD as an AAC Option for Aphasia Patients

Abstract

Aphasia is a neurogenic communication disorder resulting from injury to language centers of the brain, most commonly caused by stroke but also arising from traumatic brain injury, brain tumors, or progressive neurological conditions (ASHA, 2026). The disorder affects an individual’s ability to speak, understand, read, and/or write, yet does not impair intelligence or cognitive capacity. Individuals with aphasia retain their thoughts and communicative intent; the impairment lies in the brain’s ability to produce and process language (ASHA, 2026). Given the impact of aphasia on daily communication and quality of life, Augmentative and Alternative Communication (AAC) is frequently incorporated into treatment. AAC encompasses any tool or strategy that supplements or replaces spoken language and is an established component of comprehensive aphasia intervention.

Pragmatic Organisation Dynamic Display (PODD) is an AAC system developed by speech-language pathologist Gayle Porter, originally designed for children with complex communication needs (Porter & Cafiero, 2009). However, PODD is not a single product but a set of organizational principles and design strategies for symbol-based vocabulary (Porter, 2017). Originally designed for paper communication books, it can be utilized with partner-assisted scanning and is structured to support genuine, spontaneous, and independent communication across the full range of communicative functions. Its flexible framework allows customization across a wide variety of displays, tailored to an individual’s language level, sensory profile, and physical access needs. While the authors found no documented use of PODD with adults with an acquired need for AAC, this flexibility suggested that it could be helpful.

This presentation will show the clinical adaptation of PODD for use with an adult with severe aphasia, exploring the rationale, implementation process, and functional outcomes. The client is an adult male with global aphasia and apraxia of speech, presenting with hemiparesis affecting his dominant side and limited functional spoken language. Prior AAC trials with high-tech devices were unsuccessful due to the motor planning and cognitive-communication demands. A PODD communication book was created by his clinicians, personalized to reflect his relationships, preferences, and daily life. Physical access was optimized for his non-dominant hand, and partner-assisted scanning facilitated efficient navigation.

Clinical observations demonstrated meaningful communicative participation across contexts. The client used PODD to independently express emotion and spontaneously contribute humor to a conversation. These interactions extend well beyond simple yes/no exchanges. These examples illustrate PODD’s capacity to support authentic, multifunctional communication for adults with severe aphasia, suggesting its potential as a valuable framework beyond its original pediatric context. Clinicians working with adults with aphasia are encouraged to consider PODD as a flexible, low-barrier AAC option that prioritizes communicative participation.

American Speech-Language-Hearing Association. (2026). Aphasia. Practice Portal. Retrieved July 8, 2026, from https://www.asha.org/practice-portal/clinical-topics/aphasia/

Porter, Gayle (2017). Introductory Workshop manual: Pragmatic Organization Dynamic Display Communication Books. Victoria: Cerebral Palsy Education Centre.

Porter, Gayle & Cafiero, Joanne M. (2009). Pragmatic Organization Dynamic Display (PODD) Communication Books: A Promising Practice for Individuals With Autism Spectrum Disorders. Perspectives on Augmentative and Alternative Communication, 18(4), 121–129. https://doi.org/10.1044/aac18.4.121