General guidelines for communicating with people with aphasia:

  • Communication in a quiet, calm, relaxed environment is usually most successful. For example, avoid conversations when the TV is on or situations in which multiple people are talking at once.
  • Be patient when communicating. Give your partner time to communicate.
  • It is not necessary to avoid social situations. Instead, such activities should be encouraged. Whenever possible, continue normal activities.
  • Communication is usually most successful when individuals are not fatigued.
  • Communication, not perfection is the goal; therefore, avoid correcting grammar or pronunciation if the message is understood.
  • Be aware that communication abilities are often inconsistent in individuals with aphasia. For example, a particular word that is easy to produce one day may be difficult the next. Avoid comments such as, “You said it yesterday, so why can’t you say it today?”
  • Treat persons with aphasia as adults; allow independence in activities of daily living unless otherwise advised. Don’t talk down to people with aphasia. Intelligence is NOT impaired in aphasia; rather, communication is the problem.
  • The main goal is to communicate—not speech or perfection. Use whatever methods you can to get your message across—speech, writing, drawing, gesture and/or communication notebook.
  • Avoid talking too fast as sometimes aphasia affects the ability to understand speech.

Suggestions for communicating with individuals who have difficulty expressing themselves:

  • Do not speak for the individual with aphasia unless it is absolutely necessary.
  • Allow adequate time for responding to questions or requests.
  • Try not to interrupt or supply words unless help is requested.
  • When you don’t understand what the individual is trying to say, ask simple questions that require yes/no answers or gestural (pointing) responses for clarification.
  • Avoid “pretending” that you understand, when you don’t. Admit your problem, saying, “I’m sorry, but I’m not sure I understand.”
  • Ask your partner to repeat if you don’t understand what was said. Use facial expressions to indicate when you misunderstand.
  • Some responses will be incomplete or may be unrelated or opposite to what the person actually wants to say. For incomplete responses such as “glass…..water,” you can complete the utterance by saying, “You want a glass of water.” If a wrong word is produced, it is not necessary to correct the word, but you can repeat what you think the person meant to say, such as when the individual says “fork,” but meant to say “spoon,” respond to him/her by saying “here’s the spoon.”
  • Avoid using open-ended questions when seeking clarification. For example, ask “Do you want pasta for dinner?” rather than “What would like for dinner?”
  • Encourage all modes of communication (speech, gesture, drawing and use of a communication notebook).

Suggestions for communicating with individuals who have difficulty understanding language:

  • Do not assume that a person with aphasia understands everything that you are saying, even if he/she looks alert and nods appropriately while you are talking.
  • Conversely, do not presume that the individual with aphasia does not understand what you are saying. Don’t talk about him/her in his/her presence without inclusion in the conversation.
  • Establish the individual’s attention by saying the person’s name or tapping his/her shoulder prior to the initiation of conversation.
  • Repeat or rephrase what you have said, as necessary.
  • Supplement directions with use of facial expression and/or use of gestures.
  • Keep your own communication simple, but adult-like. Use short, concrete statements rather than lengthy, complex questions and directions in daily conversation. Focus on expressing the “main points.”
  • Ask questions one at a time, pausing between each. Ask yes/no questions, or multiple choice questions.
  • Avoid giving long, involved directions.
  • Avoid a rapid speech rate.
  • Talk at a normal volume, unless the aphasic person also has a hearing loss.

Useful Resources