Can I come along? Focusing on activities in the community for a better understanding of the participation of a man living with severe poststroke expressive aphasia

PURPOSE: Interactions with unfamiliar communication partners-such as buying groceries or ordering in a restaurant-can be challenging for people living with aphasia. These situations remain poorly understood, particularly for individuals with severe expressive aphasia. This study aimed to explore how a man living with severe expressive aphasia managed service interactions with unfamiliar providers. MATERIALS AND METHODS: A case study was conducted using an ethnographic approach combining Go-Along observations, semi-structured interviews, and participant-generated discussions. Over ten weeks, the participant was accompanied during six community outings. Data included video and audio recordings of service interactions and interviews, field notes, and informal conversations. Thematic analysis was carried out through iterative coding and team-based discussion. RESULTS: Despite severe expressive limitations, the participant engaged autonomously in varied service-based interactions. He expressed confidence in completing tasks and being perceived as a "good client," relying on non-verbal communication, selective disclosure of aphasia, and markers of social competence. Confidence was context-dependent and actively maintained. CONCLUSIONS: Findings suggest that some people with severe aphasia can participate meaningfully in service-based interactions without assistance. Results underscore the importance of confidence and interactional positioning.