A pictorial computerized communication aid for aphasic patients, PicBox, (12) has been developed by a group in Sweden. During the technical and clinical work with the PicBox program we have had the reason and possibility to reflect on the relation between aphasia, language and thinking. From linguistic and neuropsychological research it has been claimed that in aphasia there is often a general cognitive impairment. Preliminary results from three patients' use of PicBox show that aphasic disturbances can, to some extent, be compensated for by pictorial communication, thus indicating an underlying cognitive competence. There are, however, also data indicating a deeper disturbance leading to an inability to fully use alternatives for spoken or written language.