Tips for Communicating: Different Types of Aphasia After Stroke

For families living with aphasia due to stroke

Companion piece to "Caring for a Survivor with Aphasia" in our Stroke Connection Fall 2016 issue.

Beth Crawford, MS, CCC-SLP

With a survivor with receptive aphasia

“Never assume that the person with receptive aphasia is comprehending your message,” Crawford said. Always verify they understand what you said by presenting your messages in a variety of ways -- writing, drawing, gesturing, looking at pictures, etc. For the person with aphasia it can be exhausting trying to keep up in a world full of words. Caregivers need to be sensitive to this fatigue, and recognize if they are not in an ideal state for comprehending language. Set the stage for successful communication by maintaining good eye contact, positioning yourself on the same level and offering a listening attitude.  Dedicate some time to the interaction rather than adding to the pressure by rushing.  “For someone with receptive aphasia, the actual words may not sink in, but these nonverbal cues (setting the stage, eye contact, a listening attitude) will send a clear message that you believe them to be a competent, intelligent communication partner,” she said.

With a survivor with expressive aphasia

When communicating with someone with expressive aphasia, never assume that you received the message that was intended. You have to go back and verify that you understood accurately. “You can do that in several ways, but most commonly you would try to restate their message using simple language or ask yes/no questions to verify that you understood with accuracy,” Crawford said. Accept communication in any form, and don’t fake understanding because you don’t want the survivor feel bad. Be honest when you hit a road block and ask for permission to take a break and come back to it later if you can’t think of any other way to facilitate that interaction. “But when you ask permission to take a break and come back later, make sure that you follow up on that.”

With a survivor with global aphasia

“With global aphasia, you have to continually remind yourself that verbal loss is not the same as cognitive loss,” Crawford said. “Even though they can’t always reveal it, they still can reason and use their judgment.” When communicating with a survivor with global aphasia, decrease distractions and pay attention to body language and facial expression; engage all of the senses when you’re trying to interact and communicate. “Don’t avoid interacting because it’s hard. Even if you can’t communicate specific messages all of the time, you can still achieve a social connection. Find ways to enjoy each other that don’t rely heavily on words. So you may listen to music or take walks, appreciate art, those kinds of nonlanguage activities.”


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