Comprehension Difficulties in Aphasia

Updated: Feb 21, 2019




How would it feel to lose your own language?



Imagine not being able to fully understand your own language. You are in your own country, not a foreign one and people are speaking a language you have spoken all your life yet you have difficulties understanding what you hear. Imagine how isolating that must feel. That is a harsh reality for some people with aphasia.


The breakdown of comprehension varies widely among individuals with aphasia. It may be at word level, phrase level, short sentence level, longer sentence level or above. Some people with aphasia may have severe difficulties understanding single words and one-stage commands e.g. “Pass me the salt”. Others may understand well in a one-to-one conversation yet have difficulty understanding when people speak fast, when a lot of spoken information is given e.g. (radio or television) or in the presence of background noise or group situations.



How can you tell if a person's comprehension is impaired?


A Speech and Language Therapist will carry out a full language assessment and will be able to ascertain the level of comprehension of the individual. Finding out that a loved one has difficulty understanding spoken language is difficult and initially it can be hard to know how you can help.

You may find that you do not fully believe that the person’s comprehension is impaired and give examples of how they have demonstrated understanding in different situations. It is important to remember that in context a person with aphasia will likely understand much better as there are often lots of situational cues. One example of communication in context is when you are at a checkout desk in a supermarket and the cashier after scanning all the items asks “Would you like a bag?” Even if you did not understand the word ‘bag’ you could probably deduct what they were asking. Understanding language out of context and beyond the here and now is much harder and may be a challenge.

If the person with aphasia is able to verbally answer questions and their answers are not related to the question asked, then it will become apparent to you that they have not understood. However, if they have more limited expressive communication, they may simply smile and nod and you may assume that they have understood when they have not.


Some individuals with aphasia are very good at masking that they have not fully understood while others may look puzzled, openly tell you that they have not understood or ask you to repeat. Furthermore, some individuals may not understand that they in fact have misunderstood. 


If you wish to have guidance on how to support a person with aphasia and comprehension difficulties, please register your interest in the Aptus Clinic's conversation partner training workshop.


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