Difficulty Communicating...Understanding Aphasia

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Let’s Communicate!

Language is a highly developed skill that we use throughout the day. It allows us to make our needs or wants known, develop relationships, give instructions to others, and respond to questions. From calling a friend, to ordering a pizza, from writing a postcard, to reading a book, we rely heavily on language.


So what happens when someone who used to be able to use their language without a second thought, suddenly experiences aphasia?

‘Aphasia’ is the term used to describe an acquired language disorder associated with brain injury. It frequently occurs after stroke, but can also occur after head injury, as a result of a brain tumour or infection, or alongside a progressive neurological condition such as dementia.

Aphasia can be devastating. It leads to frustration for the person experiencing it and it’s equally difficult for family members to see their loved one struggle to find the right words, follow simple commands, read simple sentences, or write their own name. It can make everyday tasks seem impossible – things like reading the newspaper, going to the shop, or making appointments. Over time, it can lead to social isolation.

Aphasia can affect some or all of a person’s language modalities, which means that listening, speaking, reading and writing can be affected and to varying degrees of severity. This is due to the location and extent of the damage to the brain (our language centre is normally located on the left of the brain), the cause of the brain injury, and age. Recovery is difficult to predict, the initial severity of aphasia, age, comorbidities and other factors can guide our expectations.


    Speech and Language Therapy



    This is why it’s necessary to have a comprehensive assessment from an experienced Speech and Language Therapist so that your language abilities and impairments can be identified and an appropriate management plan can be devised. If there are cognitive impairments as well, like poor memory or attention deficits, these will need to be assessed by an Occupational Therapist as these difficulties can affect communication and the ability to recover language skills.

    Therapy for aphasia strives to improve the ability to communicate by one or more methods, for example, promoting use of current language skills, therapy sessions aiming to restore language abilities as much as possible, compensatory strategies for language problems, and/or learning other methods of communicating.


    The kinds of difficulties people with aphasia may present with:

    •  Fluent speech but makes little sense; sometimes the person with aphasia can make up words but have little awareness of this
    •  Difficulty naming items or finding the right words in conversation
    •  Agrammatical speech, leaving out words like ‘is’, ‘and’, ‘the' 
    •  Good grammar but very little meaningful content
    •  Mixing up words, e.g. ‘spoon’ for ‘fork’
    •  Mixing up sounds in words, e.g. ‘tup’ for ‘cup’
    •  Difficulty understanding spoken words, phrases, or sentences


      How to Help

      These are some tips to communicate well with a person with aphasia:

      1. Make sure you have the person’s attention before you start speaking, make eye contact and maintain it.
      2. Watch their body language and gestures. Can they point to show you what they need? Can you tell from their body language that they are uncomfortable?
      3. Minimise or eliminate background noise (TV, radio, other people). Talk in a quiet place.
      4. Keep your own voice at a normal level, unless the person has indicated to speak louder.
      5. Keep communication simple, but adult. Simplify your own sentence structure and reduce your rate of speech. Emphasise key words. Don’t talk down to the person with aphasia.
      6. Give them time to speak. Resist the urge to finish sentences or offer words.
      7. In addition to speech, communicate with drawings, gestures, writing and facial expression. Praise attempts to speak and downplay errors. Avoid insisting that each word be repeated to perfection.
      8. Engage in normal activities whenever possible. Do not shield people with aphasia from family or ignore them in a group conversation. Involve them in family decision-making as much as possible. Keep them informed of events.
      9. Encourage independence and avoid being overprotective.

      Some people with aphasia also carry an information card explaining that they have aphasia and what aphasia is. In addition, it is useful to carry identification and information on how to contact significant others.


      Famous People and Aphasia:

      Did you know that Roald Dahl’s, the BFG, was inspired by his wife’s aphasia? He recorded the many odd words that his wife produced after she suffered a series of strokes. She had severe aphasia and after an intensive rehab programme, regained her ability to communicate well enough to return to acting!

      Sinéad Francis is our Speech & Language Therapist at Strive Clinic Galway. Call 091 393 180 to make an appointment.