identify three major issues: associationist learning principles, the interconnectivity of

language with other cognitive systems, and the significance of learned non-use in the
persistence of behavioural deficits following brain injury.

The question of learned non-use is the most controversial and thought-provoking

when applied to aphasia therapy as it represents a significant challenge to total
communication approaches that encourage the use of alternative communication
channels such as use of communication books, drawing, or gesture in response to
speech or language impairment.

These various communicative routes are underpinned by different neural systems.

The facilitation of the alternative routes results in reduced activation within the
impaired speech and language neural assemblies, and, just as experience enhances a
system, lack of experience can cause atrophy within a network. Thus, therapy
directed at the compensatory mechanisms could result in increasing speech and
language impairment through encouraging learned non-use.

The issue of learned non-use has been explored in physical therapies where
constraint-induced movement therapies have been developed