This chapter describes current clinical practice in assessment and intervention in adults with pragmatic deficit associated with acquired brain damage. The chapter focuses on the management of communication disorders in people with left or right hemisphere damage following a stroke, traumatic brain injury or dementia. Other progressive conditions such as Parkinson's disease and multiple sclerosis are also mentioned. Various techniques and instruments that are used in clinical settings are discussed in relation to current views on the nature of cognitive-communication disorders, pragmatics and functional communication. Finally, the chapter offers a brief description of research-based intervention methods used to address pragmatic aspects of communication and examines treatment outcomes in specific populations.