Aphasia is characterized by a reduced ability to understand and/or generate speech and language. Speech-language therapy helps individuals with aphasia regain language and cope with changes in their communication abilities. The therapy process is largely paper-based, making multimodal digital pen technology a promising tool for supporting therapy activities. We report on ten months of field research where we examine the practice of speech-language therapy, implement Write-N-Speak, a digital-paper toolkit for end-user creation of custom therapy materials, and deploy this system for 12 weeks with one therapist-client dyad in a clinical setting. The therapist used Write-N-Speak to create a range of materials including custom interactive worksheets, photographs programmed with the client’s voice, and interactive stickers on household items to aid object recognition and naming. We conclude with a discussion of multimodal digital pen technology for this and other therapy activities.