Ways To Support Comprehension in Aphasia

Updated: Feb 21, 2019


Comprehension difficulties in aphasia are difficult for the person, their family and close friends

Problems understanding spoken language can be very difficult for the person with aphasia. They can feel lost, frustrated and isolated. There may be a communication breakdown with close friends and family members.


Speech therapy can certainly help improve comprehension skills. It can also help family members learn how to adapt their own communication to support their loved one's ability to understand.


There are strategies that can help support the comprehension of a person with aphasia. Below is a list of 10 tips that we have compiled.


Reduce Background Noise


When there is background noise, it can be much harder to hear and understand what is being said. While you may be able to filter out the background noise, this is often much harder for the people with aphasia to do.



Ensure You Have The Person’s Attention


Level of attention is an important factor. If someone is not paying attention or is distracted, it is very unlikely that they will understand what you have said to them. Can you recall a time when someone was talking and your mind was elsewhere? Did you follow what they had been saying? You can get the person’s attention by saying their name. Try to be face to face with them when you are talking to help focus their attention.



Use Simple Language & Speak Slowly


When speaking to the person with aphasia, try to speak slowly and keep sentences short and to single thoughts. Add a short 1-2 second pause between sentences to allow the person additional time to process what you are saying. Always give the person time to respond.



Emphasise Key Words 


We do not need to understand every single word in a sentence to get the gist/follow the message. Therefore, it can be really helpful to emphasise key words to further facilitate understanding. Here are some examples:


"Yesterday I went to the cinema. The movie was really good" 

You can emphasise key words by placing stress on them when you are talking. Always ensure that your tone of voice is not patronising  when doing so.



Break Instructions Down Into Smaller Chunks


Remember that longer instructions may be more difficult for the person to follow so break any instructions down into small steps.



Use Gesture


Hand gestures can also facilitate understanding and may be particularly helpful when supporting a person with more severe comprehension deficits. However, it should be noted that gestures may not always be fully representative of the intended meaning/may be unclear to the other person. Here are some examples of gestures:

  • Acting out an action such as drinking, eating

  • Making a glasses shape with fingers and thumbs over eyes to indicate a pair of glasses

  • Moving a hand backwards 3 consecutive times over one shoulder to indicate a past event

  • Moving a hand forwards 3 consecutive times over one shoulder to indicate a future event

  • Pointing at objects can also be helpful as the person with aphasia will likely then understand that you are talking about a particular object.



Write Down Key Words/Sentences 


If the person with aphasia can read/understand single written words or sentences, writing will likely be a very effective way of supporting their communication. Try writing down the key words or full sentence and point to each word as you say it or simply allow the person to take the time to read what you have written. You can also find out how you could use Written Choice Communication by clicking/pressing here.



Use Photos To Set The Context


We live in the era of Instagram, Facebook and Google Photos. Many of us are partial to sharing our travels, days and nights out with others by posting photos on social media. Why not also share some photos with your loved one with aphasia? By showing them a photo of a place, event or people, you are setting the context for the conversation. The person with aphasia will know that any comment you make or any question you ask will in some way be related to that photo, thereby facilitating their understanding and perhaps also their expressive language skills.



Avoid Sudden Changes of Topic


Try to stay on one topic at a time as otherwise the person with aphasia may not follow and may assume you are still talking about the first topic. If you do need to change the topic, explicitly state that you are going to talk about something else and consider using a photo or writing a key word to indicate that the topic has shifted/ introduce the new topic.



Conversation Partner Training 


Different communication strategies may work better than others when supporting the comprehension of a person with aphasia. Should you wish to have training on how to be a more effective conversation partner, call the Aptus Clinic to arrange a free consultation.

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