Talking to People with Aphasia (in plain English)
What is Aphasia?
Aphasia is a communication disorder caused by damage to parts of the brain that control language. A person’s intellect may not be affected but they may have difficulty with:
- understanding what others are saying
- expressing themselves
- doing math calculations
Aphasia is most commonly caused by a stroke but it can also be caused by head injuries, infections and brain tumors. There are three main types of aphasia:
This is when a person has difficulty understanding what is said to them or has difficulty understanding writing, such as reading a newspaper or emails.
This is when the person knows what they want to say but has difficulty saying words and phrases. They may also have difficulty writing down what they mean.
This is when the person has difficulty choosing and using the right words to name people, objects, places or events.
A person may have just one of the above types of aphasia or a mixture of these. The severity of any difficulties varies depending on the amount of damage to the brain. If a person has all three types of aphasia this is called global aphasia. The person will have trouble speaking, understanding speech, reading, writing and doing math.
Some Do’s and Don’ts
There are lots of things you can do to help a person with aphasia to communicate better. The following are some ideas of things to do when you’re listening and some things to do when you’re speaking.
You as a listener
- face the person and look at them
- reduce any background noise, e.g. turn off the television or radio
- ask the person what helps them to
- listen carefully
- encourage all efforts at communication whether the person is using speech, gesture or another means – respond positively
- be patient, as it may take the person longer to speak and understand – give them plenty of time to speak and don’t look agitated
- don’t answer for the person – let them get the message across in whatever way they can, with suggestions from you if necessary
- encourage the person to use pen and paper to write things down if they can – or use props such as diaries, photo albums, pictures in magazines, and so on, to help get their message across
- don’t finish off words or utterances for them
- try hard to understand but don’t pretend to understand if you haven’t – be truthful and say if you don’t understand
- piece the message together by asking helpful questions based on what you’ve already understood – try making suggestions and ask the person to give you other clues by gesturing, using pictures, writing, pointing to objects, and so on
- ask one thing at a time
- go back over and run through the message to check that you’ve understood correctly
- at the end of a discussion, summarize what you think the person’s been trying to say, e.g. ‘let’s be sure I understand…’, ‘have I got that right?’
- be considerate when the person is frustrated at not being able to express themselves
You as a speaker
- face the person and get their full attention before you start to speak
- ask the person what helps them to communicate
- check that they have their glasses or hearing aid (if they usually wear these)
- if the person has a hearing impairment, sit on the ‘good’ side
- don’t shout
- check that they understand you, e.g. ‘does that make sense?, ‘are you with me?’
- speak clearly, as you would to someone else of the same age
- speak in short sentences
- speak slowly – but not so slowly that it distorts your natural speech rhythm, as this can be confusing and come across as patronizing
- use everyday language, not unfamiliar words
- talk about just one idea at a time
- stress key words and be specific, e.g. ‘I went to town’ not ‘I went there’
- say things in a different way if the person doesn’t understand you the first time and give extra clues through helpful gestures, facial expressions and the tone of your voice
- you can also support what you’re saying by writing down key words, drawing, using pictures and photos, and so on
- if you’re talking in a group, talk one at a time only – people talking all at the same time is confusing and distracting
No two people with aphasia will present with exactly the same communication difficulties. Sometimes you may find it difficult, or impossible, to understand what the person with aphasia is trying to communicate to you. Don’t be afraid to acknowledge any difficulties. Stay relaxed and try to find out if the issue is really important or if you can come back to it later. Sometimes a break from the pressure of trying to communicate a particular idea can be helpful to the person with aphasia. It can be helpful to agree a signal that you can both use to stop and move on to another topic. Keep in mind that you shouldn’t pretend you’ve understood if you haven’t. If the issue is urgent, you can also try and get someone else to help you. Remember…be patient and honest. This demonstrates your respect for the person with aphasia.