Aphasia is a communication disorder that follows a brain injury, stroke, or a progressive condition. Aphasia affects several aspects of language, such as expressing thoughts/ideas, understanding others, reading, and writing.

Those with aphasia understand what they want to say but struggle to produce speech or find the desired words. Individuals who have aphasia may also have apraxia, which affects the motor planning and execution of speech production. For this reason, AAC can be an impactful tool to support communication and participation.

Types of Aphasia🔗

Depending on the location and extent of the injury to the brain, aphasia presents in a few different ways. We divide aphasia types into two major categories: fluent and non-fluent.

In fluent aphasia, the individual produces long strings of speech with natural intonation. However, the sentences may be hard to follow, and the individual may not be aware of errors. Difficulty understanding language often accompanies this.

In non-fluent aphasia, the individual understands language, but has difficulty producing speech resulting in halted speech or mixing up terms. This causes the individual frustration because they know they aren’t saying what they want.

These major categories can then be broken down depending on how other language skills present. A person with aphasia’s language profile is very individualized, so it is important to assess language and tailor support as needed. Language support and AAC enhances both language production and language comprehension.

Tips to Support Aphasia🔗

To support people with aphasia, here are some strategies to use!

Gain Attention and Provide Wait Time🔗

To support comprehension, it’s beneficial to gain the person’s attention before speaking with them. First, say the information, wait, and then say it again.

Provide Physical Cues🔗

Gesturing to items in the environment can also support understanding. For example, pointing to your watch while telling them the time of an appointment.

Use Simple Language🔗

Complex sentence structure can make it more difficult for an individual with aphasia to understand and connect language concepts. Try to use short, simple sentences and pause often to allow for processing time.

Present Choices🔗

Other strategies, such as asking yes/no questions or providing choices, supports successful communication. Be sure to check in to see what benefits the individual and what does not.

Use Visuals🔗

Visuals such as writing or drawing, lists, communication books, or speech apps supports both comprehension and expression. Visuals aren’t a one-size-fits-all solution, so use a mix of supports across settings!

Supports for AAC and Aphasia🔗

AAC can include both lite-tech and high-tech options. Visual supports such as writing or drawing, gestures, communication books, and pictures encompass lite-tech support. High-tech support includes AAC apps or text to speech apps on a tablet. Some apps have specific vocabulary for an individual with aphasia. Check out our Enhancing Communication for Adults With AAC article for a list of different apps designed for adults.

AAC App Features to Support Aphasia🔗

There are a variety of features and ways to program AAC apps to support communication.

Visual Scenes🔗

Familiar pictures can be a great tool to support communication with an individual with aphasia. Many AAC apps offer the ability to program visual scenes pages. The page can have a familiar picture with applicable phrases programmed around it.

Examples of this could be a family group shot with phrases about family members or a picture of a favorite restaurant with phrases for food orders or questions. Some apps allow you to create hotspots with phrases directly on the photograph.

Scripts🔗

Scripts can be very helpful in planning communication across different activities. A script can help someone feel confident to jump back into a favorite activity or prepare for an appointment.

For example, a page can be programmed in advance with questions to ask and information to be shared at a doctor’s appointment. Many apps come with pre-programmed scripts to use right away, or you can customize.  

Communication Repair Strategies 🔗

Many apps come with tools to facilitate communication repairs. There may be a page to help the individual indicate if they know the first letter or the category that then leads to the keyboard page or a page with category options.

Many apps also give access to a whiteboard for drawing or writing. Pages can also be customized with phrases to advocate for support such as ‘ask me yes/no questions’ or ‘please write it down for me’.  

Whiteboard 🔗

The whiteboard feature can be beneficial for both language production and understanding. The individual with aphasia can use it to support explaining meaning or word finding, while communication partners can use it to write keywords or draw an item.  

Keyboard and Word Prediction  🔗

The keyboards in most AAC apps offer word prediction. As an individual begins to type, options for words they may be typing populate. This can be a helpful tool to make communication more efficient.  

Rating Scales 🔗

Rating scales can be used for many purposes beyond just indicating pain. It can be used to describe preferences, ask to add vocabulary to the device, or confirm if their message was understood. Some apps come with preprogrammed rating scales that can be customized to meet the individual’s needs.  

Communication is Possible!🔗

Aphasia can make communication challenging, but it does not take away a person’s ability to think, make choices, share ideas, or participate in meaningful activities. AAC can provide valuable support by giving adults with aphasia additional ways to express themselves and understand others. From lite-tech visual supports and communication books to high-tech AAC apps, there are many options to explore. With the right supports, AAC can help adults with aphasia communicate more confidently, participate in daily activities, and stay connected with the people and communities that matter to them.

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References🔗

Lasker, J. P., & Garrett, K. L. (2008). Aphasia and AAC: Enhancing communication across health care settings. The ASHA Leader, 13(8), 10. https://doi.org/10.1044/leader.FTR1.13082008.10

National Aphasia Association. (n.d.). Communication tips for aphasia. https://aphasia.org/communication-supports/

National Aphasia Association. (n.d.). AAC for aphasia: It’s more than a device. https://aphasia.org/aac-for-aphasia-its-more-than-a-device/