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Background: Gesture frequently accompanies speech in healthy speakers. For many individuals with aphasia, gestures are a target of speech-language pathology intervention, either as an alternative form of communication or as a facilitative device for language restoration. The patterns of gesture production for people with aphasia and the participant variables that predict these patterns remain unclear. Aims: We aimed to examine gesture production during conversational discourse in a large sample of individuals with aphasia. We used a detailed gesture coding system to determine patterns of gesture production associated with specific aphasia types and severities. Methods & Procedures:We analysed conversation samples from AphasiaBank, gathered from 46 people with post-stroke aphasia and 10 healthy matched controls all of whom had gestured at least once during a story re-tell task. Twelve gesture types were coded. Descriptive statistics were used to describe the patterns of gesture production. Possible significant differences in production patterns according to aphasia type and severity were examined with a series of analyses of variance (ANOVA) statistics, and multiple regression analysis was used to examine these potential predictors of gesture production patterns. Outcomes & Results: Individuals with aphasia gestured significantly more frequently than healthy controls. Aphasia type and severity impacted significantly on gesture type in specific identified patterns detailed here, especially on the production of meaning-laden gestures. Conclusions: These patterns suggest the opportunity for gestures as targets of aphasia therapy. Aphasia fluency accounted for a greater degree of data variability than aphasia severity or naming skills. More work is required to delineate predictive factors.

This paper examines the evidence for community and outpatient aphasia groups using the International Classification of Functioning, Disability and Health (ICF) framework. A systematic search of the literature using eight electronic databases was completed; 29 studies met inclusion and exclusion criteria. Level of evidence and methodological quality was assessed and effect sizes calculated where possible. Evidence favouring community and outpatient groups centred on four level ii and level iii-i studies that examined the efficacy of highly structured group activities for improving specific linguistic processes with five medium-large effect sizes calculated. Medium and large effect sizes were also calculated on a level iii-i study examining number of friendships and community access. No effect sizes were available for level ii or level iii studies examining communication activity and participation. Overall, the results indicate that community and outpatient group participation can improve specific linguistic processes. There is also some evidence that group participation can benefit social networks and community access. However, there is limited evidence demonstrating improvement in functional communication as a consequence of group participation. The current evidence is not comprehensive. Further well-designed studies, particularly examining activity and participation, and contextual factors are required to advance community and outpatient aphasia group practice and participation.