How to Communicate with People with Aphasia 

A man with aphasia discusses speech therapy.

Imagine living your life knowing what you want to say or write but being unable to do so. People who have survived stroke, traumatic brain injury, or other neurological injuries and have aphasia deal with these types of communication difficulties every day. You can imagine the difficulty and frustration experienced by both the person with aphasia and the person they are trying to speak with during situations like these. It is not easy and can lead a person to experience anxiety or depression. 

While there is no cure for aphasia, many people improve over time, especially with intensive speech therapy. The key word here is “time.” It is crucial for loved ones and caregivers to be patient, persevere through plateau periods in treatment, and learn how to optimize communication with their loved ones with aphasia on the road to recovery. Below, we will provide tips and strategies on how to best support friends, family, or others who struggle with aphasia. 

Aphasia After Suffering a Stroke 

Aphasia is a fairly common acquired neurological language disorder that affects more than 2 million Americans. An aphasia diagnosis can come from many injuries or disorders, although strokes are the leading cause. In fact, more than a third of stroke patients will be diagnosed with  aphasia.  

But despite its widespread effects, many people are still unaware what aphasia is or how it impacts individuals and their families. A 2016 study on aphasia awareness found 84.5% of people had never heard of aphasia. 

The frustration of aphasia comes from why and how it occurs. In this case, having trouble speaking or communicating is not indicative of intelligence level. People with aphasia have a clear idea of what they want to articulate, but damage to the brain does not allow for effective communication.  

Symptoms vary depending on where in the brain the injury occurs, but aphasia can affect spoken language, comprehension of language, written expression, or reading comprehension. For example, someone could look at a food menu and know what they want to order, but they may have trouble verbalizing what they want. Common tasks such as gesturing or using numbers may also be impacted.  

Aphasia Communication Tips 

Aphasia can have a profound impact on a person’s sense of identity, mood, social relationships, and professional roles. Thus, the need to communicate as successfully as possible and reduce barriers to effective communication is crucial at every step of every person with aphasia’s journey. This allows them to maximize life participation, connections to important people, confidence, support the aphasia recovery process, and ultimately enable living successfully with this neurological disorder. 

When approaching a person with aphasia, make every effort to acknowledge their competence. Many people with aphasia report that due to their communication impairments, they are perceived as incompetent and are consequently denied opportunities to participate in important life events and decisions. This has a direct impact on psycho-social well-being and their sense of dignity and worth. 

As you begin to communicate with a person with aphasia, use the appropriate tone of voice and maintain a conversation at an adult level. You can simplify your own sentence structure, reduce your rate of speech, and emphasize key words to increase understanding, while still treating them with respect and dignity. Asking yes and no questions can also keep communication simple. Try to incorporate humor to keep the mood light. 

When they begin to talk, give them time to complete their thoughts. Try to resist the urge to finish sentences or offer words, and instead, allow them time to use their own strategies for word retrieval. 

Inevitably, frustration may occur during your loved ones’ attempt at communicating. Support them by acknowledging the frustrations they experience and verbally reinforce the notion they know what they want to say. Praise their attempts to speak but also downplay their errors. Each word does not have to be produced perfectly! 

Additional Tips and Strategies  

If you find yourself struggling to communicate with a person with aphasia, check your surroundings and environment, and be cognizant of how you choose certain words. 

For example, ensure you have their attention before you start a conversation. Minimize or eliminate background noise (television, radio, or other people). Again, people with aphasia have a medical problem with expressing what they want to say, not with what they hear or what they think. Thus, keep your voice at a normal level. There is no need to raise your decibel level. Do not “talk down” to a person with aphasia. 

Remember spoken words are not the only way to communicate. Consider using drawings, gestures, writing, or facial expression to convey your message or understand your loved one. These varying means of communication offer your loved one alternative ways to give you clues by describing, showing, or pointing. If asking questions, pose one thing at a time. 

Above all else, try to keep an open mind and have empathy — this is a difficult time for your loved one and they need all the support and understanding they can get. Engage in normal activities whenever possible and try to involve them in family decision-making. 

Verify Responses and Take Notes 

As with anything, practice and repetition play a key factor in how you communicate with a person with aphasia.  

With each conversation, verify their responses by ensuring you have correctly understood their message. To do so, summarize, reflect, or expand on what has been communicated by using writing, gestures, or images as needed. 

You can then keep a written log of conversations to notate what worked and what did not work. Use this as a learning tool to further expand the communication. 

Post-stroke Aphasia Treatment 

Speech therapy is a proven method to treat individuals with aphasia. In fact, research shows the brain can make new networks and heal over time, according to the National Aphasia Foundation.  

Led by a skilled speech language pathologist (SLP), speech therapy involves assessing and determining which areas of speech, language, reading, and writing have been impacted by a stroke, followed by a plan to help improve how your loved one communicates. 

Your SLP will first conduct an evaluation, which involves a thorough assessment of all aspects of language, speech, and communication along with stimulability testing to determine individual strengths, weaknesses, and responsiveness to trialed therapeutic techniques.  

It is important to listen and understand your loved one’s needs to customize a personal plan of care that offers innovative solutions using the latest, evidence-based therapeutic interventions. 

Your SLP will then work with you, your family, and your caregiver, as requested, to set goals and develop a plan of care. Throughout the process, they will provide education, counseling, training, and modeling to maximize carryover of skills into daily experiences. You SLP will also monitor progress over time and help ensure treatment goals are relevant and enabling successful communication across all facets of your life.   

Part of this process includes specific training using tailored communication strategies that will increase communicative participation. These may include guidance on how to deliver a verbal message (for example, slower rate, accompanied by visuals, or written support) to support comprehension, or strategies for increasing expressive skills including offering access to written aids, visuals, or yes/no answer choices. 

Aphasia Treatment at Open Lines  

At Open Lines, we are proud to offer our custom intensive aphasia treatment program to help your loved one rebuild their life and improve their communication. 

Contact Open Lines today by phone at (212) 430-6800, by email at info@OpenLinesNY.com, or through our contact form. If you are ready to take the next steps in treating aphasia, request an appointment to discuss your goals and review our service options.