Family-centered language rehabilitation in post-stroke aphasia: a narrative review of current evidence and clinical applications

Abstract

Post-stroke aphasia is a profoundly disruptive neurogenic communication disorder that severely impacts not only the individual’s linguistic capacity but also the entire structural, functional, and emotional fabric of the family unit. Historically, clinical speech and language therapy (SLT) has prioritized impairment-based, individual-centric intervention models focusing on isolated linguistic recovery within clinical walls. However, contemporary neuro-rehabilitation is undergoing a critical paradigm shift toward family-centered language rehabilitation, recognizing the domestic environment as the vital locus of recovery. This narrative review synthesizes current evidence regarding the efficacy of family-inclusive interventions, delineates core mutualized clinical training programs—including Supported Conversation for Adults with Aphasia (SCA™), Supporting Partners of People with Aphasia in Relationships and Conversation (SPPARC), and Better Conversations with Aphasia (BCA)—and critically examines the systemic, financial, and interdisciplinary barriers that challenge clinical adherence. Across the studies reviewed, training the family as an integrated therapeutic unit is associated with improved functional communication outcomes, greater real-world life participation, and reduced third-party disability and caregiver burden; however, this evidence base is heterogeneous and largely non-experimental, and the findings should be interpreted as promising rather than conclusive.