Many people develop aphasia after experiencing a stroke or brain injury. Aphasia is the loss of language and is an acquired language disorder. This means that people who have aphasia typically had proficient language skills prior to the event and lost their communication abilities after their stroke or injury. Click here to learn more about aphasia, how it affects social interactions and how speech-language pathologists can help.
Here are six different tips and methods to you can try today to talk with someone with aphasia! These tips can be helpful for any adults with communication difficulties. These supportive communication partner strategies can be used for adults with cognitive based communication difficulties or motor speech difficulties (e.g., apraxia of speech, dysarthria).
Explore different strategies for communication, whether they be verbal or visual methods. You should aim to trial different techniques to convey your message and employ different strategies when communicating with an individual who has aphasia.
1) Show Patience and Provide Time for the Person with Aphasia to Respond
Providing wait time is extremely important when having a conversation with a person with aphasia. Allowing ample time for them to respond gives them the space to try to communicate what they need. According to McLellan Communication Services (2024), this extra time is beneficial for the PWA because it gives them the chance to carefully compose their message and make sure it's clear and effective. Additionally, it helps them choose the right words to convey their thoughts accurately. Rushing a person with aphasia will only hinder their ability to communicate even more and may discourage them from wanting to share what they have to say.
2) Use "yes" and "no" Questions When Talking to Someone with Aphasia
Yes and no questions are very helpful to both the communication partner and the individual with aphasia.
Simplify the conversation and narrow the topic with "yes" and "no" questions. If you are having difficulties communicating with a person with aphasia, asking yes and no questions can help you gain a basic understanding of the category or area that the person with aphasia is trying to communicate.
Verify your understanding of their message. A person with aphasia may have difficulties finding the right words to communicate their thoughts and/or can use the wrong words. For example, they may say "yes" when they mean "no". As the listener, yes and no questions can be a strategy to see if you have understood what the person with aphasia is trying to communicate.
Verify their understanding of your message. After explaining a concept or giving an instruction to a person with aphasia you can provide repetition and also ask some simple comprehension questions to see if they have understood your message.
3) Using short, simple sentences and Provide Repetition When Talking to Someone with Aphasia
Simplifying language is another important strategy when communicating with a person with aphasia (PWA). The English language contains many ambiguous meanings, such as metaphors, idioms, similes, sarcasm, and other figurative language, which can be visually represented as one thing but understood as another. Aphasia limits one's ability to differentiate between the intended meaning and what it may appear to mean. That's why keeping sentences short and straightforward as possible will help people with aphasia to better understand deliberate meanings.
Here are some suggestions on how to simplify the language you're using:
Communicate key words and main ideas.
Use simple and common words.
Repeat your message. Repetition is also crucial for understanding.
Do not use phrases that may have alternate meanings like metaphors, idioms, etc
4) Prioritize Face-to-face Interactions When Talking to Someone with Aphasia
If possible, limit the use of virtual or audio means of communication. When we cannot see the other person directly, we lack a sense of the enhanced communication levels that facial expression brings (Garcia & Connor, 2011). This can make it more difficult for a person with aphasia to both receive and express the message.
People with aphasia may have difficulty understanding language in verbal communication. Face to face interactions and facial expressions provide helpful non-verbal cues that enhance the communication exchange and help with additional understanding.
Facial expressions and non-verbal cues are also very helpful for you as the communication partner. When you have this additional information, you may be more sensitive to communication breakdowns. This will allow you to repair the message and intervene sooner by repeating, explaining, or trying different ways to communicate.
When we can’t think of a word, a common strategy is to act it out. For example, if you forgot the word “dumbbell” you might mime lifting weights or doing a bicep curl. People with aphasia often rely on this strategy to supplement their verbal communication. When you have a face to face conversation with a person with aphasia, you have the additional information from their gestures which can be very helpful to understand their message.
5) Drawing or Writing Key Words when Talking to Someone with Aphasia
Encourage people with expressive aphasia to write or draw what they need if they are unable to communicate verbally (Garcia & Connor, 2011). They may not be able to say the words but they may be able to write or draw the message. You can also use this strategy to confirm your understanding. People with aphasia may mix up words within a category or use the wrong word for what they mean. For example, if they are saying “buy an apple” but draw a banana, you may have to ask more clarifying questions to see if they wanted to buy an apple, a banana, or another type of fruit.
When you are speaking to a person with aphasia, it is helpful to write down the key words in your message. Writing key words provides a visual that can enhance their understanding of what you are saying. A person with aphasia might not be able to understand your verbal words, but may be able to fill in the gaps of their understanding by reading your keyword. As well, writing the key words of your message can be helpful when you are repeating the message to them.
6) Use Visual Aids and Communication Boards when Talking to Someone with Aphasia
Pictures or communication boards are also a great way to enhance understanding and to support an individual with aphasia’s ability to communicate their wants and needs.
You can find many different types online or even personally create customized boards that incorporate the individual’s main needs. A communication board can be helpful for a person with aphasia who is unable to verbally express their choice. Having access to a board allows them to point to the picture of what they need and still have their needs met (Garcia & Connor, 2011).
Here is a free printable of a communication board that can be used at a grocery store. Click here to download this helpful visual for your loved one with aphasia. This communication board can help them communicate if they need help getting a cart, reaching for something on a shelf, finding an item on their list, confirming prices or asking for help to bring the groceries to their car.
Where to go from here?
These are 6 simple strategies you can try to support your conversation with someone who has aphasia. Talking to a speech-language pathologist is valuable to get personalized recommendations for how you can support your loved one with aphasia. As well, speech therapists may be able to show you how you can help them practice language skills they may have lost or how you can help them participate in important life activities. If you live in Edmonton, Alberta check out our other post for additional resources you can explore!
References
Aphasia Institute. (n.d.). Home page. Retrieved from https://www.aphasia.ca/
American Speech-Language-Hearing Association. (n.d.). Speech-language pathologists [Webpage]. Retrieved from https://www.asha.org/students/speech-language-pathologists/#:~:text=Speech%20and%20Language%20pathologists%20(SLPs),disorders%20in%20children%20and%20adults.
Brain Injury Association of America. (n.d.). What is aphasia? Retrieved from https://www.biausa.org/public-affairs/media/what-is-aphasia#:~:text=It%20can%20also%20impact%20a,it%20does%20not%20affect%20intelligence
Garcia, E., & Connor, L. T. (2011). Understanding Barriers and Facilitators to Participation in People with Aphasia: A Qualitative Approach. CSD Working Papers, No. 11-38. Washington University in St. Louis, Center for Social Development.
Huyen Le, & Lui, M. Y. (2023). Aphasia. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK559315/
Lanyon, L. E., Rose, M. L., & Worrall, L. (2013). The efficacy of outpatient and community-based aphasia group interventions: A systematic review. International Journal of Speech-Language Pathology, 15(4), 359–374. https://doi.org/10.3109/17549507.2012.752865
Marshall, R. S., Lazar, R. M., Mohr, J. P. (1998). Aphasia. Medical Update for Psychiatrists, 3(5), 132-138. https://doi.org/10.1016/S1082-7579(98)00026-0
Mayo Clinic. (n.d.). Aphasia - Symptoms and causes. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518
Mayfield Clinic. (n.d.). Anatomy of the Brain. Retrieved from https://mayfieldclinic.com/pe-anatbrain.htm
McLellan Communication Services. (2024, March 7). The 10-Second Rule: Waiting as a Communication Tool. Retrieved from https://www.mclellancommservices.ca/blog/the-10-second-rule-waiting-as-a-communication-tool
Therrien, M. C. S., Madden, E. B., Bislick, L., & Wallace, S. E. (2021). Aphasia and Friendship: The Role and Perspectives of Speech-Language Pathologists. American journal of speech-language pathology, 30(5), 2228–2240. https://doi.org/10.1044/2021_AJSLP-20-00370
Whitaker, H. A. (2007). Language Disorders: Aphasia. In Encyclopedia of Gerontology (Second Edition). Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/expressive-aphasia
Chatty Therapy is based in Edmonton, AB. We have wonderful speech-language pathologists who can help you support your loved-one with communication difficulties. Speech-language pathologists specialize in helping adults understand others and express themselves better. Click here to learn more about our services or book a free 15-minute consultation.