Individuals who sustain a CVA may have multiple problems, including dysarthria, apraxia of speech, aphasia, or dysphagia. Traditional speech-language pathology treatment can improve speech, language, and communicative functioning for clients with mild-moderate aphasia. However, for those clients who have more severe impairments, alternative intervention (AAC) must be considered (Fox & Fried-Oken, 1996). Table 1 lists several communication problems for which a client may require AAC in the form of a Speech Generating Device (SGD). The table includes the ICD-9 diagnosis code for each of the qualifying conditions, definitions, associated medical diagnosis, speech and language characteristics, differential diagnosis, and SGD implications.