Hearing, Tinnitus and Balance Clinic

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His answers are inappropriate – Understanding how Aphasia affects comprehension.

When a person gets a stroke that affected the language centre in the brain, they have what we call “Aphasia” – a communication disorder due to language impairment.  The person does not necessarily struggle to use his/her mouth to speak, but rather to remember the words or to form sentences in the brain.  This is a most frustrating condition, as these patients know what they want to say, but cannot find the words to express themselves.

Typically, these patients still understand the social rules of communication and desperately want to take part in conversation.  They often develop behaviours that try to compensate for their loss of words.  One such behaviour is by answering “Yes” or “No” to other people’s questions.  The aphasic person can often understand that you are asking a question by listening to the tone of your voice (We use different tones of voices for questions than for statement sentences). Unfortunately, the Aphasia often cause the person to misunderstand as the language impairment may also affect language comprehension and not just expression.  Therefore, chances are that the person may have misunderstood you but knows you are asking a question, and then simply answers “Yes”.  You may think that the matter is settled since you asked and got an answer, but there is a strong possibility that you have misunderstood one another due to the Aphasia. 

How to facilitate optimal understanding:

Add visual cues to your question – For instance, instead of just asking “Would you like some tea?” you can also point to the tea, or use a gesture that indicates drinking tea.  This way, the person with Aphasia has a much better chance of understanding you correctly.

Ask short and simple questions – Use simple language when speaking to a person with Aphasia, avoid uncommon or complex words.

Stick to one concept at a time – Each sentence or question should represent one idea.  So instead of saying “The weather is not good for outdoors today so I think we should cancel the picnic and go the movies instead, or would you rather like to stay home and bake pancakes?”, rather simplify it like this: “It is cold outside. Do you want to stay home? (Wait for an answer.) Do you want to see a movie?”

Check for true understanding – Double check that you understood the person correctly by rephrasing his/her answer, for instance “So we are going out? We are going to the cinema?”

Finally, remember to have lots of patience and to be kind as this will create a safe and pleasant communication setup for the person. 

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