Laura Thorburn, M.S., CCC-SLP
If you’re communicating with someone with aphasia, conversations may feel harder than expected. This isn’t because the person lacks understanding or intelligence. Aphasia affects language, not thinking or personality. With the right strategies, communication can become clearer, more respectful, and far less frustrating for everyone involved.
What is aphasia?
Aphasia is a language disorder caused by damage to the brain’s language centers, most often due to stroke. It can affect:
Speaking
Understanding spoken language
Reading
Writing
Many people with aphasia:
Know what they want to say but struggle to express it
Understand more than they can produce
Feel frustrated or misunderstood in conversation
According to the American Speech-Language-Hearing Association (ASHA), more than two million people in the United States live with aphasia, and about 180,000 people acquire it each year. Speech therapists provide essential treatment for people with aphasia. Based on years of experience treating aphasia, this expert guide explains what people with aphasia want others to understand. Read on for aphasia communication tips that caregivers, family members, and friends can start using right away.
Expressive aphasia, aphasia symptoms, and more. Learn what causes aphasia, what aphasia sounds like, and how aphasia is treated.
What people with aphasia want you to know
1 “I know what I want to say—my words just won’t come out”
Aphasia disrupts the pathway between thoughts and spoken language. This does not reflect confusion or lack of intelligence.
Try this helpful approach:
Give the person extra time to respond.
Maintain eye contact and patience during pauses.
2 “Please don’t finish my sentences unless I ask”
“While well-intended, completing someone’s thoughts can feel disempowering and discouraging for them,” says Alexis Irazoque, M.S., L/SLP, a licensed speech therapist with Expressable.
Try this helpful approach:
Pause and wait.
Offer support only when the person asks for it.
3 “Speaking louder doesn’t make language clearer”
Aphasia is not a hearing disorder.
Try this helpful approach:
Speak at a natural volume.
Slow your speech rate and simplify the structure of your sentences.
4 “Yes/no questions help me participate”
Open-ended questions can feel overwhelming when language access is limited.
Try this helpful approach:
Ask yes/no or choice-based questions. For example, instead of “What do you want to do for lunch today?,” ask “Do you want to go out for lunch?” (yes/no) or “Do you want to eat at home or go out?” (choice-based).
Use visual supports when possible. For example, if you’re asking the person if they’d like tomato or black bean soup, show them both options.
5 “I’m still myself; I just communicate differently”
“Aphasia does not affect a person’s intelligence, personality, or emotional awareness,” Irazoque says.
Try this helpful approach:
Speak directly to the person.
Use age-appropriate language and tone.
Learn the physical and emotional effects of stroke and what caregivers can do to help a partner, spouse, or loved one cope post-stroke.
How to talk with someone with aphasia
Research and clinical experience support the following aphasia conversation strategies:
Use short, clear sentences
Break complex information into smaller units. Here’s an example:
Instead of: “After lunch we’re going to the store because we need milk and then we’ll stop by your sister’s house.” Try: “After lunch, we’re going to the store. We need milk. Then we’ll visit your sister.”
Allow extra processing time
Word retrieval and language comprehension often take longer.
Wait quietly after asking a question.
Avoid interrupting or rushing the person to respond.
Caregivers report that once they slow down, wait, and simplify language, conversations improve. People with aphasia participate more, and frustration decreases.
Use visual supports
“Gestures, written words, pictures, or pointing can significantly improve the person’s understanding,” Irazoque explains.
The National Aphasia Association recommends combining speech with visual cues to improve communication success and reduce frustration.
Confirm the person’s understanding
Instead of asking, “Do you understand?” try:
“We’re leaving at 2:00—yes?”
“Doctor tomorrow—correct?”
This reduces ambiguity and supports accuracy.
Reduce background noise
Limit competing noises or distractions such as televisions, radios, or group conversations. A quiet environment improves the person’s ability to understand language. Smaller conversation groups increase success.
What to avoid when talking with someone with aphasia
Caregivers, family, and friends may mean well, but certain behaviors can unintentionally interfere with communication. Try to avoid:
Finishing the person’s sentences
Speaking for the person
Pretending to understand them when you do not
Talking primarily to caregivers instead of the person with aphasia
Ending the person’s communication attempts too soon
Remember, small communication shifts can create meaningful change. Caregivers often report that once they slow down, wait, and simplify language, conversations improve. People with aphasia participate more. Their confidence increases, and frustration decreases. Most importantly, connection returns.
Does aphasia improve over time?
In many cases, aphasia does get better, especially with consistent speech therapy. Aphasia recovery depends on:
Severity and location of brain injury
Time since onset
Frequency and quality of speech therapy
Support for communicating from family and friends
Research summarized by the Stroke Association shows that people can continue improving their communication months and even years after a stroke with the right intervention.
How speech therapy helps with aphasia
Speech-language pathologists work with individuals with aphasia to support communication in practical, meaningful ways. Aphasia speech therapy can help clients:
Improve word-finding and sentence formulation, making it easier to express thoughts clearly
Strengthen comprehension, so they can better understand spoken or written language
Learn compensatory communication strategies, such as using gestures, drawing, or writing key words
Build confidence in conversation, enabling more participation in daily interactions
Modern aphasia therapy doesn’t rely on repetitive drills. It emphasizes functional, real-life communication in situations that matter most, such as family conversations, medical appointments, and social interactions.
“Aphasia therapy isn’t just about rebuilding language skills. It’s about restoring confidence, autonomy, and participation in everyday life,” Irazoque says. “When communication improves, quality of life improves.”
Through virtual telepractice, speech therapy can be personalized to each individual’s goals and needs. Online speech therapy provides the flexibility to practice communication skills at home, where they’re actually used. This approach makes therapy both effective and directly relevant to everyday life.
As one Expressable client explains it, “I love going to speech therapy. With online therapy, I can continue my sessions even when I’m traveling with my wife. I appreciate the homework from the Expressable portal and I always do it—that’s been a big factor in my progress.”
After a stroke left her with aphasia and acquired apraxia of speech, online speech therapy is helping this therapist regain her ability to speak.
Getting started with aphasia speech therapy
Improving communication after aphasia is a journey, and the right support can make a meaningful difference. Speech-language pathologists at Expressable provide evidence-based, individualized therapy to help clients regain practical communication skills for everyday life.
Through online sessions at Expressable, therapy is tailored to the specific needs of each person. The focus is on real-world outcomes such as participating in family conversations, managing medical appointments, and engaging socially with confidence. With guidance from experienced clinicians, clients can build strategies that strengthen word-finding, comprehension, and overall conversational confidence—all from the convenience of home.
Speech therapy offers a structured, supportive path to improving communication and reconnecting with the people and activities that matter most. Click here to get matched with a speech therapist.
Frequently asked questions (FAQs)
There are several aphasia conversation strategies that are helpful. Use simple language, speak slowly, and give the person extra time to process what they hear. You can try using visual supports, like gestures or pictures. It’s also helpful to confirm that the person understands you.
Avoid finishing the person’s sentences or speaking over them. Don’t pretend to understand them, or talk only to caregivers instead of directly to the person.
Aphasia symptoms can vary from person to person. Some people may struggle to understand what’s being said, especially in fast-paced conversations or large groups. However, many people with aphasia comprehend more than they can express verbally.
In many cases, aphasia does get better, especially with consistent speech therapy. Aphasia recovery depends on the type of brain injury, time since onset, and the frequency and quality of speech therapy. Working with a speech therapist helps improve communication skills and confidence, even months or years after a stroke.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
