Aphasia Communication Techniques

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Communication Access Checklist

Distributed by AphasiaAccess, www.AphasiaAccess.org

Talk face-to-face with the person with a communication difficulty
Communicating with someone with aphasia or other language barrier can be intimidating. But it is important to remember that, like all of us, people with communication difficulties want to be treated with respect, and even people with acute aphasia understand body language and attitudes of others. Create a friendly, positive atmosphere and it will lay the foundation for communication. Greet the person with a smile, shake hands and approach the person as you would any customer or consumer of your services. Use eye contact and talk to the person directly instead of to others present.

Make sure the environment is suitable for communicating.
It can be very difficult for people with communication challenges to communicate in a noisy or distracting environment. Try to talk to the person in a quiet place such as an office, close doors, or turn off televisions or electronic devices to eliminate background noise or visual distractions. Give the person your full attention.

Give the person plenty of time to respond.
It may take longer for a person with aphasia or other language barrier to understand your message or form his/her own messages. Give time; avoid jumping in to ask the next question or moving on to the next topic until you are sure the person has finished. Be attentive, patient and polite.

Speak slowly and use simple wording and short sentences.
People with language barriers are more likely to understand when simple, declarative sentences are used (“Please, sign here” [pointing to signature line] versus “Please insert your signature on the line indicated at the bottom”)

Keep it simple. Stick to the key points. Avoid technical jargon.
Speak slowly and naturally; do not make your speech sound sing song or childlike.

Use ‘Plain language’ guidelines (www.plainlanguage.gov):

  • Organize information so that the most important points come first
  • Break complex information into understandable chunks
  • Use simple wording and define technical terms
  • Use the active voice
  • Emphasize key words that carry your message

To get information from a person with significant speaking problems there are several methods of asking questions:

  • Ask one question at a time
  • Use yes/no questions (“Do you want coffee?” vs. “what do you want to drink?”)
  • Ask either/or questions (“Do you want tea or coffee?”)
  • Use a ‘narrowing in’ yes/no technique moving from general to specific (Are you talking about a person? Is it a relative? Is it your wife?)

Include multiple ways to get information across to the person.
Oral communication should be supplemented with other channels that add to the spoken information such as:

  • Pictures, photos or pictographs relevant to the topic
  • Written key words
  • Gestures that add information (pointing, demonstration)
  • Paper and pencil so you both can draw or write

Listen carefully and pay attention to the multiple channels that the other person uses to communicate.
Listen and watch as the person tries to tell you or ask you something. Body language, gestures and voice intonation can give you important clues to meaning. You can help them get their message across by providing access to multiple ways to communicate – Both you and the person with the communication disability will benefit from using gestures, drawing, written words and pictures.

If an accurate understanding of the person’s message is important, use verification strategies.
Verification helps you make sure you understood the person’s intended message and also helps the person feel like you are paying attention.
Repeat the person’s message in simple language (So you are saying …… Monday is the best day). Add gestures, props and/or written key words when repeating the message (while saying Monday- write MONDAY, Point to a calendar). Expand or paraphrase to verify again (MONDAY is good for you [thumbs up gesture]; NOT Tuesday or Wednesday [thumbs down gesture]).

Pay attention to the ‘social relationship’ by demonstrating respect & interest
Part of a successful communication interaction is feeling good about yourself and about the conversation. This is equally important to people with language disabilities. Therefore, make sure your method of interacting helps the other person feel confident and important.

Openly acknowledge and take responsibility for communication breakdowns (“I think I missed something, let me try again”). Acknowledge that the person with a language disability is an intelligent adult (“I know you know what you want to say, it’s just hard to get it out”).

Although you want to use techniques and strategies to facilitate conversation, be careful that you don’t overuse techniques or come across as patronizing.
Feel free to use a sense of humor and warmth to put the person at ease. When all else fails, admit that it is frustrating to both of you not to be able to get a message across.

Written information should follow ‘aphasia-friendly’ guidelines.
Written information (e.g. pamphlets, instructions, forms, menus) should include:

  • Ample ‘white space’ so that information is not crowded on the page
  • Pictures, photos or pictographs that support the written text
  • Simple wording or ‘plain language’ (www.plainlanguage.gov)
  • Short messages
  • Key word headings
  • Simple, large font size (e.g. 14 to 18 font in Calibri is easy to read)
  • Bolding of important information

A skilled communication partner should talk through written material with the person with aphasia or other language disability. The partner can make sure the person with aphasia is understanding, can emphasize key points, point to supporting information, and generally use ‘supports’ suggested above (e.g. gesture, key words). This will help the person with language disability understand the material.

Signage should include easily recognizable symbols or pictures along with key words. Signage should be available at eye level for people who walk and for those in wheelchairs.

See our Resource Page for links to additional information regarding communication access, health literacy and aphasia-friendly materials.