There is no magic...

On occasion, I have walked into a room in which an inidividual with aphasia has been trying, unsuccessfully, to tell a family member or a caregiver something but the family member is not able to 'get' the message. And so in desperation, they utter the words, "Maybe the speech therapist can tell us what you are trying to say". They all turn to look expectantly at me as I enter the room and hope that I will be able to work out what the individual with aphasia is trying to say. There is an air of frustration and helplessness in the room as the family member tries to guess and the individual with aphasia tries emphatically to make his or her thoughts known.

But, there is no magic training that I have received that helps me to understand the jumbled messages and utterances that a person with aphasia tries effortfully to produce. Sadly, I do not possess a 'special' ability to comprehend gestures, sounds, jumbled words or utterances that are produced with so much effort. If there is any secret to deciphering the message presented by an individual with aphasia, it is as follows:

I take my time. I set aside everything that was planned and I listen. I let the person with aphasia realise that I want to know what he or she wants to tell me. I give them the space and the time to try and construct the message and together we try and work it out. I remove any time pressure and I provide as much support as possible to assist the person to get the message across.

And sometimes this works. Using a combination of guessing, keywords, gestures, pictures, and drawing on family structures, local and international events and everyday situations, we are able to piece together the message. And often it is so simple. We tend to complicate it.

Sometimes, however, it is a good idea to leave it until later. You can find yourselves going round in circles and the levels of frustration for all parties involved seem to get worse. In this instance, the likelihood of identifying the subject and reaching an understanding for all involved is less likely. This is a good time to recognise that everyone is a little frustrated by the break- down in communication and to suggest that the conversation should be put on hold for a few minutes or set aside for a time later in the day.

Often, having a slight diversion for a few minutes can just help everyone catch their breaths and settle down. Make a cup of tea, move from the wheelchair to the couch or change rooms and move to sit in the garden. Then the topic can be tackled again with a fresh perspective and, in many instances, you might find that it had already been suggested but in the heat of the interaction the message was overlooked.

We can get so caught up in the moment and trying to solve the issue when in actual fact the person just wanted to express his or her opinion on a topic or wanted to ask a question about something that has been bothering him. We can  make it more complicated than it is and so we lose track of the actual interaction the person is desperate to experience.

Let it be said that living with an individual with aphasia is not an easy task as you do not always have the time or opportunity to wait and set other activities or responsibilities aside. As a communication partner for an individual with aphasia it is essential to recognise that some conversations are more important than others and that these are the ones that need to be given time. Everyday events or issues can be dealt with quickly but there are some discussions or topics that, by their very nature, require more attention. In this instance, setting aside a good time for both the communication partner and the inidividual with aphasia, is necessary and might take some negotiation.

And when you do work out what the individual with aphasia was trying to tell you, it is magic! It is like helping someone to solve a puzzle that they cannot complete on their own. The essential piece of the puzzle when interacting with a person with aphasia is the approach taken by the communication partner. In isolation, the aphasic can express very little but in combination with a good communication partner, an aphasic person can speak volumes! 
10/9/2011 12:01:48 am

This is good advice. It was sometimes very hard for me to assess patients with aphasia for a suitable candidate for rehab. I think most people -even the nursing staff- rather avoid speaking to them than to be in a situation where it takes you so long to try and understand what the patient says and even then you might not get it.

11/6/2011 05:53:01 pm

An understanding of people’s personalities is essential. Compassion of understanding the individual’s challenges and their individual way of dealing with those issues is even more important. This is not a trait every therapists holds. This is a special talent held by the very best speech therapists, for they can use this to leverage the best results from their patients. Keep up the outstanding work


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    Claire Ashford

    Claire has assisted in the rehabilitation of many individuals who have experienced a stroke or head injury and over the years, these are some of the topics that individuals and families have raised.


    April 2012
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We have a special interest in treating individuals who experience communication and swallowing difficulties as a result of a stroke, traumatic brain injury or degenerative disorder.