How to communicate with a person with aphasia

Aphasia is an acquired language disorder that can occur after brain damage, often following a stroke. It can affect, to varying degrees, the ability to speak, understand language, read and write.

Difficulty finding words or understanding a sentence should not automatically be interpreted as reduced intellectual ability. It is therefore important to address the person as an adult, with respect, without using a childish or excessively simplified tone.

The most effective strategies can vary greatly from person to person. A speech-language therapist can identify communication methods suited to the specific characteristics of the aphasia and suggest how families and caregivers can apply them in everyday life.

• Speak in a natural tone.
• Use short, clear sentences.
• Allow time to respond.
• Reduce noise and distractions.
• Use gestures, images and writing as well.
• Check that you have understood correctly.
• Involve the person directly in the conversation.

It is helpful to use relatively short sentences and deal with one piece of information at a time. This does not mean speaking in a childish way, but reducing linguistic complexity when necessary.

The most important words can be emphasized with tone of voice or accompanied by a gesture, a written word or an image.

If a message is not understood, it may be more useful to rephrase it using different words rather than repeating it many times in exactly the same way.

Aphasia mainly affects the processing and use of language. Speaking louder does not necessarily make comprehension easier, unless a hearing problem is also present.

It is preferable to speak slowly but naturally, maintain eye contact and make sure you have the person's attention before starting a new topic.

A person with aphasia may know exactly what they want to say but need more time to retrieve a word or build the sentence.

Continuously finishing sentences for the person can increase frustration and reduce their ability to participate actively in the conversation. It is generally better to wait a few extra seconds and see whether the person wants help.

If the difficulty persists, you can ask: "Would you like me to help you find the word?" or offer a few alternatives.

Communication does not necessarily mean speaking. When a word does not come, the person may still be able to convey the message through:

• gestures and pointing;
• facial expressions;
• drawings;
• written words or letters;
• photographs and images;
• objects in the environment;
• smartphones, tablets or digital tools.

The main goal is to understand one another, not necessarily to produce a grammatically perfect sentence.

When giving a complete answer is difficult, it can help to start with questions that can be answered with yes or no.

For example, instead of asking:

"What would you like to drink?"

you can start with:

"Would you like something to drink?"

and then narrow down the options.

Another strategy is to offer two concrete options, possibly showing the objects or writing down the words:

"Would you prefer water or juice?"

When the answer is important, especially for personal or healthcare decisions, it is advisable to check that the choice has truly been understood and not automatically interpret a single response as final if there is any doubt.

If possible, switch off or turn down the television and radio, avoid multiple conversations at the same time and choose a quiet environment.

Seeing the other person's face, gestures and expressions provides additional information that may help with understanding the message.

Important conversations should, whenever possible, take place at times when there is no need to respond quickly.

When the topic is important, it can be useful to briefly repeat what you think you have understood:

"You are telling me that you want to go out after lunch, right?"

This allows the person to confirm or correct the interpretation.

If the message is unclear, it is better to say so naturally and try another strategy: ask the person to point, draw, write a keyword or show the object being discussed.

Continuously correcting grammatical or pronunciation errors may be of little benefit when the overall meaning is already clear.

• Speaking to the person as if they were a child.
• Raising your voice without a real need.
• Asking many questions rapidly one after another.
• Interrupting or constantly finishing sentences.
• Correcting every single error when the message is already understandable.
• Talking about the person as if they were not present.
• Excluding them from decisions because communication is difficult.

Some conversations can become very tiring. If the person is tired or frustrated, it may help to pause and return to the topic later.

This does not mean abandoning the subject, but choosing a time when communication may be easier.

Family members, friends and caregivers can play an important role in creating real communication opportunities: talking about what happened during the day, commenting on photographs, choosing an activity together, reading short texts or using images and objects to support conversation.

It is useful to continue addressing the person with aphasia directly and involving them in decisions that concern them, adapting language and communication tools when necessary.

A speech-language therapist can suggest personalized strategies and indicate which activities are most appropriate in relation to remaining abilities and treatment goals.

Facilitate, do not replace.

Help should make it easier for the person to express what they want to communicate, without automatically taking their place in the conversation.

Photographs, images, written words and simple association exercises can also be used as a starting point for conversation. In some rehabilitation programs, apps and computer programs are also used to practice specific language skills.

PowerAFA includes naming, comprehension, association, verbal and written production exercises and other activities that can be used within aphasia rehabilitation. The software is a support tool and does not replace assessment or treatment provided by a healthcare professional.

👉 Discover PowerAFA and download the free demo

👉 What is aphasia

👉 Types of aphasia

👉 Aphasia rehabilitation

👉 Aphasia exercises and activities at home

👉 Clinical studies and experiences with PowerAFA

Use a natural tone, with short and clear sentences when needed, one concept at a time, and allow enough time to understand and respond.

No, unless there is also a hearing impairment. Aphasia is a language disorder, not a problem related to voice volume.

They can be helpful when formulating complex answers is difficult. Offering two alternatives can also make a choice easier.

In general, it is preferable to wait and give the person the opportunity to finish. A suggestion can be offered when requested or when it is clearly wanted.

Yes. Gestures, drawings, photographs, written words and objects can complement spoken language and facilitate both comprehension and expression.

No. Aphasia can present in very different forms. Strategies should be adapted to the characteristics of the individual, preferably with guidance from a speech-language therapist.

• American Speech-Language-Hearing Association (ASHA) - Aphasia
• NHS - Aphasia
• Stroke Association - Tips for aiding communication
• Kent Community Health NHS Foundation Trust - How to help a person with aphasia

The information provided is for educational purposes and does not replace assessment, diagnosis or treatment provided by healthcare professionals.