How to Speak with Someone Who Cannot Speak
Tips to Improve Communication When a Person has Expressive Aphasia
Jun 20, 2009
Communication is supposed to be a two-way street, but whenever one person experiences aphasia, that road suddenly experiences many unexpected twists and turns.
Causes of Expressive Aphasia
According to the MayoClinic, expressive aphasia most commonly results from a brain injury, such as a stroke (CVA) or trauma, such as a motor vehicular accident (MVA). Aphasia may also result from certain types of dementia or as the result of other conditions, illnesses, or treatments.
Symptoms of Expressive Aphasia
The American Speech-Language-Hearing Association lists several different characteristics of expressive aphasia. Someone suffering from expressive aphasia may:
- Experience nomia (You know the word but cannot remember it)
- Speak only in single words or short phrases (Sometimes these words may be expletives or other words that may be completely out of character for the person before the brain injury.)
- Not speak at all
- Leave out connecting words such as “the,” “an,” “or,” etc.
- Place words out of logical order
- Reverse sounds in words (“slopped dripper” instead of “dropped slipper”)
- Create new words or phrases that make little or no sense to others
When trying to communicate with someone who has expressive aphasia, you may wish to use the following techniques:
Focus on Ability
- Although language may be hampered, many of the person’s abilities may be intact.
- Recognizing and incorporating his abilities in daily life can give a boost to his feelings of self-worth and feelings of autonomy.
- Always speak with the adult experiencing aphasia as an adult and not as if she is a child.
Allow Extra Time
- While normal adult conversations tend to flow naturally from one word and thought to the next, speaking with someone who suffers from aphasia may seem anything but natural.
- After speaking, allow extra time for the person to process the thought and then attempt to articulate or gesture a response before moving to the next thought.
- Avoid the temptation to speak for the one who has aphasia.
Observe Non-verbal Communication
- The actual words we use may only account for about 10% of our communication, while up to 90% involves non-verbal cues, according to a 2003 international study by Tandberg.
- If the person can gesture or use other non-verbal forms of communication, recognize those efforts and encourage continued interaction with others. People who have aphasia may be tempted to withdraw from others and may be at high risk for depression.
- People who use sign language as their main form of communication may also experience aphasia in that they cannot sign just as someone else experiencing aphasia may not be able to speak or write.
Ask Yes/No Questions
If the person can comprehend questions but cannot verbalize answers, ask yes/no questions and simplify your sentences so that they focus on only one thought at a time.
- Determine one gesture for yes (nod of the head, two blinks, etc.)
- Decide on one gesture for no (shake of the head, one squeeze of the hand, etc.).
- Ask questions that are progressively detailed if necessary. (Are you in pain? Does you head hurt? Does it hurt here? Or here? Continue in this manner until you manage to pinpoint the pain, etc.)
Use Communication Boards
A communication board can range from simple and inexpensive to complex and costly. Some examples include:
- A dry erase board or paper and pen for writing messages
- A sheet with the alphabet, numbers, etc. on it to which the person can point
- Pictures and/or words on a piece of paper that indicate common phrases, objects, and/or needs. These can be homemade with a pencil and paper, pre-printed versions for downloading, or customized printables. Click here for an example of a printable communication board.
- Electronic devices that enable the person to “talk”
Incorporate Music
According to a November 2006 New Scientist article entitled “After a singalong words come easier,” people suffering from aphasia may enjoy quicker speech improvements by singing in a group.
Consider Animal-Assisted Therapy
Some animals seem to have a healing power all their own. A 2003 case study report entitled “The effect of a therapy dog on the communication skills of an adult with aphasia” indicates that the presence of a therapy dog may result in an increase in both verbal and non-verbal skills in a person with aphasia. One hypothesis of this study suggested that people may be more likely to stop and speak with someone who has a pet, and their study indicated that the man with aphasia tended to be more outgoing socially when the therapy dog was present.
Verify the Message
If the person is trying to say something and you think you understand what she is trying to say, repeat the words back to give her the opportunity to verify that what you understood is correct.
Life Despite Aphasia
Recovery after a brain injury is a long, hard, lonely, and often silent road. Some people enjoy a complete recovery while others face lifelong deficits. By incorporating some of these tips, communication may improve, which can potentially increase the quality of life for your loved one and you.
Your healthcare provider can provide you with specific communication techniques related to your loved one’s particular needs. Information provided in this article is not meant to be medical advice.
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