Supported Conversation for Adults with Aphasia

Supported Conversation for Adults with Aphasia

Kelli Pierce


Aphasia is a disturbance to speech and communication caused by damage to the brain.  Typically, this damage is due to a stroke, but can also be caused by traumatic brain injury, brain tumors, or dementia.  Aphasia affects a person’s production and/or comprehension of language, and can also have an impact on reading and writing abilities.  It is important to know that an individual with aphasia has NOT lost intelligence or knowledge of speech and language – they have lost their ability to access language due to the brain damage.  This inability to access language prevents many individuals with aphasia from engaging in conversation and participating in social and recreational activities that they enjoyed prior to the event that caused brain damage.  If you know someone who has difficulties with language, there are many ways you can help.  Below are some tips and tools you can use to communicate with an individual with aphasia.




STEP ONE - Acknowledging Competence
• Use a natural tone and volume of voice (unless it is clear that the individual has a hearing loss)
• Strive for a natural, adult conversation
• Encourage the person with aphasia to keep trying when appropriate
     o      Acknowledge competence when individual becomes frustrated or upset by communication breakdowns (“I know you know what you want to say.”)
     o     Take some of the blame for communication breakdowns (“You know, sometimes I’m not very good at explaining things clearly.”)
The individual with aphasia will be more comfortable and open to communication when he or she feels as though the experience of being frustrated is shared


STEP TWO - Revealing Competence
Getting the message IN
• Try to use as many language modalities as you can if you feel like a person with aphasia is not understanding you

VERBAL
• Use short, simple sentences
• Use an expressive tone of voice
• Repeat when necessary
• If you feel like they are not understanding after a few repetitions, try to modify the way you are producing your message
      o “Before you do the dishes, take out the garbage”  “First, take out the garbage.  Then, do the dishes.”


NONVERBAL
• Use gestures when speaking
• Write key words down 
      o e.g., “Do you have any pain in your legs or arms?”
      o Write down: PAIN   LEGS    ARMS
      o Point to each word as you say it
• Eliminate any distractions (if possible)
      o Noise
      o Other people
• Respond to facial expressions, eye gaze, body posture, or gestures to help determine if your message is getting in

Getting the message OUT
• May be more difficult, but it ensures that the person with aphasia has a means of responding

• VERBAL
      o Ask yes/no questions; provide a visual or written YES/NO sheet for individual to point to if necessary
      o Ask either/or questions
      o Phrase yes/no and either/or questions from general to specific
• NONVERBAL
      o Ask him or her to gesture, draw, write, or point to objects to help relay their message
              “Can you show me…”
      o Provide enough time for the individual to respond



STEP THREE - Verification
• Accuracy of the individual’s response should not automatically be assumed
• “So let me see if I’ve got this right…”

      o Repeat the individual’s message
      o Add written cues and/or gestures
      o Expand on what you think the individual is trying to say


RESOURCES
• aphasia.ca(Aphasia Institute)
• www.aphasia.org (The National Aphasia Association)
• www.aphasiahope.org (The Aphasia Hope Foundation)
• www.stroke.org (The National Stroke Association)
• www.strokeassociation.org (The American Stroke Association/The American Heart Association)

Kelli earned her Bachelor of Arts in Psychology and Anthropology from Michigan State University, and returned to MSU for a post-bachelor degree in Communicative Sciences and Disorders.  She received her Master's Degree in Speech-Language Pathology from Eastern Michigan University .  She has worked in a variety of settings including community mental health facilities, inpatient hospital settings, school settings, and outpatient therapy centers.  Her special interest areas are aphasia, apraxia, early childhood development, and social language skills.

leif.borreson@gmail.com
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Copyright 2012