Aphasia: how to help someone who has lost their speech after a stroke

Aphasia, a challenge for communication and everyday life

Aphasia is one of the most complex and distressing language disorders, both for the sufferer and those around him or her. Often caused by a stroke, but also by head trauma, brain tumors or certain neurological diseases, it affects the ability to speak, understand, read and write.

For family and friends, this disorder can be confusing: the person remains perfectly conscious, their intelligence intact, but they can no longer find words or understand certain messages. This dissociation between thought and language creates an invisible barrier that isolates, frustrates and disrupts social, family and professional life.

In France, an estimated 300,000 people live with aphasia, the majority after a stroke. Yet this disorder remains little-known and often misunderstood. Too many people still mistakenly think that a person with aphasia “doesn’t understand anything”, when in fact it’s language that’s affected, not thought.

In this article, we will :

• explain the different types of aphasia,

• explore their symptoms and consequences,

• propose communication strategies,

• present the role of professionals and family members,

• highlight CLINT, an innovative brain coaching program for post-stroke patients.

The aim is to provide concrete keys to better understanding and support for people affected by this language disorder.

Understanding aphasia: the essentials

Before talking about rehabilitation or communication strategies, we first need to understand what aphasia is and why it doesn’t manifest itself in the same way in everyone.

A neurological origin

Aphasia occurs when certain areas of the brain, usually located in the left hemisphere, are damaged. These areas are involved in :

• oral language production,

• word comprehension,

• reading and writing,

• sentence construction.

A stroke affecting these areas can therefore brutally interrupt the ability to speak or understand.

The different types of aphasia

Not all aphasias are alike. Neurologists distinguish several forms:

1. Broca’s aphasia (non-fluent)

   • Slow speech, short sentences, choppy speech.

   • Relatively good comprehension.

   • Example: instead of saying “I’d like to eat an apple,” the person will say “Apple… eat… me.”

2. Wernicke’s aphasia (fluent)

   • Fluid speech, but sometimes incoherent.

   • The words used may be incorrect or invented.

   • Language comprehension often impaired.

3. Global aphasia

   • The most severe: affects both expression and comprehension.

   • Very limited oral communication.

4. Anomic aphasia

   • Difficulty finding the right word, especially names of objects.

   • The sentences are grammatically correct, but lack precision.

Highly variable manifestations

Two people with aphasia can have completely different profiles.

• One will be able to speak little but understand almost everything.

• The other will talk a lot, but incoherently.

• Some will retain the ability to read but lose the ability to write, or vice versa.

Understanding aphasia means accepting that it is not a single disorder, but a constellation of difficulties that vary according to the area of the brain affected. This understanding is essential for adapting communication, choosing the right strategies and avoiding misunderstandings.

Symptoms and impact on daily life

Aphasia is more than just a language problem. It affects communication in all its dimensions, and can radically transform daily life. Symptoms vary enormously from person to person, but certain signs recur frequently.

The most common difficulties include :

• word search: the person knows what they want to say but can’t find the right word

• oral language comprehension, especially in fast-moving conversations or when there is background noise

• reading and writing: some people can speak but can no longer read a simple sentence

• sentence construction: sentences may be incomplete, disorganized or lack coherence

These symptoms often lead to enormous frustration for the aphasic person. Imagine wanting to tell a simple story and not being able to find the words. This can lead to feelings of confinement and loss of self-confidence.

For example, Sophie, 58, had a stroke two years ago. She understands everything that is said to her, but since her accident, she has had difficulty speaking. She sometimes uses gestures or drawings to make herself understood. She says that the most difficult thing is not that she can’t speak, but that “people think I don’t understand anything”. Unfortunately, this situation is very common: language impairment is often mistaken for an intellectual disorder, adding to the person’s malaise.

Beyond the communication difficulties, aphasia also has a considerable social and emotional impact. Many people with aphasia end up cutting themselves off from social activities because conversations become too complicated. Phone calls, family meals, outings with friends… everything becomes a source of anxiety. Little by little, the person risks isolation, whereas maintaining social ties is essential for quality of life and even recovery.

Family and friends are also affected. Spouses, children and friends sometimes feel helpless in the face of communication difficulties. They want to do the right thing, but don’t always know how. This lack of understanding can lead to tension, frustration and even emotional exhaustion when rehabilitation takes a long time.

In conclusion, the symptoms of aphasia go far beyond language: they affect self-esteem, social relationships, family and professional life. That’s why it’s vital to provide comprehensive treatment that goes beyond language rehabilitation.

Non-verbal communication, a precious ally

When words no longer come easily, body language becomes an essential bridge between the aphasic person and those around him or her. Communication isn’t just about words: gestures, facial expressions, voice intonation, gaze… all these elements take on vital importance.

For people with aphasia, non-verbal communication can be a lifeline. When it’s impossible to formulate a complete sentence, a simple gesture or facial expression can be enough to convey an emotion or a need. For example, pointing to a glass of water to say “I’m thirsty”, or waving to indicate “Come” or “Stop”.

Those around you must learn to interpret these signals. This requires observation, patience and sometimes a little creativity. Certain gestures are universal, but each person with aphasia can develop his or her own codes. In some families, we end up creating a hybrid language made up of words, signs and images, understandable only by the immediate circle.

Visual aids also reinforce communication. Pictograms, photos or even communication boards with simple images can help overcome word blockage. For example, a board can contain images for basic needs: eating, drinking, sleeping, going out, seeing the doctor… All the person has to do is point to the image to make himself understood.

There are even digital applications that offer libraries of images and pictograms to build visual sentences. Used on a tablet, they offer extra autonomy and reduce the stress associated with communication situations.

In addition to facilitating the exchange of information, non-verbal communication helps preserve the emotional bond. A smile, a caress on the hand, an attentive look can say “I’m listening, I’m here for you” without any words. For a person who has lost part of their ability to speak, this non-verbal support is essential if they are not to feel isolated or misunderstood.

In conclusion, non-verbal communication does not replace speech, but complements it and sometimes becomes the main means of expression. Encouraging its use right from the start of the rehabilitation process helps maintain dialogue and reduce the frustration associated with aphasia.

Strategies for better communication with a person with aphasia

Communicating with someone who has aphasia may seem difficult at first, but there are many techniques available to make exchanges smoother and less stressful. These strategies are used by speech therapists, relatives and sometimes even taught in communication workshops for families and caregivers.

Here are the main tips to put into practice:

1. Speak slowly and clearly

• Use a slower-than-usual rate of speech, without exaggerating or infantilizing the person.

• Pause between sentences to allow time for understanding and responding.

• Articulate correctly, but speak with a natural tone to avoid the conversation sounding artificial.

Example: instead of saying “Do you want to go for a walk in the park this afternoon?”, say “Do you want to go to the park?”, articulating and pausing after the question.

2. Simplify vocabulary and sentences

• Use short sentences with a simple structure.

• Avoid jargon, complex expressions or sentences with double meanings.

• Repeat keywords several times if necessary.

Example: say “Doctor. Tomorrow. 3 p.m.” rather than “Don’t forget that tomorrow at 3 p.m. we have a doctor’s appointment for your annual check-up.”

3. Ask closed rather than open-ended questions

• Questions that require a “yes” or “no” answer are easier to manage.

• Open-ended questions can be too demanding for a person who is searching for the right words.

Example: “Would you like some coffee?” (simple answer) rather than “What would you like to drink?” (complex answer).

4. Using gestures to support oral language

• Accompany words with a clear gesture or pictogram.

• Show the object in question to facilitate understanding.

• Encourage the aphasic person to express his or her needs in the same way.

For example, pointing to the cup as you say “coffee” helps the person immediately understand what the conversation is about.

5. Avoid noisy environments

• Background noise complicates understanding and increases stress.

• Choose a quiet place to talk, especially for important exchanges.

For example, turn off the TV or radio when you’re talking to avoid auditory overload.

6. Allow time to respond

• People with aphasia sometimes need several seconds to formulate their response.

• Interrupting them or talking over them can discourage and frustrate them.

Example: wait calmly after a question instead of rephrasing too quickly or guessing the answer.

7. Reformulate if necessary

• If the person doesn’t understand, repeat in a different way rather than repeating the exact same sentence.

• Changing the word or simplifying the structure can help unlock understanding.

Example: if the phrase “Would you like to go for a walk?” doesn’t work, try “Shall we go for a walk outside?”.

8. Value every attempt at communication

• Don’t correct every mistake: this may discourage the person.

• Praise efforts, even if the sentence isn’t perfect.

Example: if the person says “Me… park… tomorrow”, answer “Yes, you mean you want to go to the park tomorrow? Very good!” to validate and encourage.

9. Use visual aids

• Notebooks with images, tablet applications, photos: anything that facilitates dialogue is useful.

• Some professionals create personalized “communication booklets” with the words and images most commonly used in everyday life.

10. Maintain eye contact and a positive attitude

• Look the person in the eye when you talk to them to show you’re listening.

• Smile, nod, show patience: this creates a reassuring atmosphere.

Example: even if the person takes a long time to respond, remaining calm and benevolent encourages the exchange to continue.

In conclusion, these strategies do not require any special skills, but they transform communication. They enable people with aphasia to regain confidence, participate in conversations and reduce the frustration associated with language loss.

The use of visual and written aids

For a person with aphasia, words can become inaccessible, but images and simple writing are often easier to understand. Visual and written aids are therefore powerful tools for facilitating communication and making everyday life less frustrating.

Why are visual aids so effective?

• The brain processes images faster than spoken language.

• Pictograms and photos make it easy to understand without the need for a full sentence.

• They provide a concrete point of support when words fail to come.

Many families report a clear reduction in misunderstandings as soon as they start using visual aids at home.

Different types of visual media

• Communication boards: these are made up of images or symbols representing everyday needs (eating, drinking, sleeping, seeing the doctor, etc.). The person simply points to the corresponding image.

• Illustrated cards: they fit in the hand and can be used in any context, including outdoors.

• Tablet applications: some apps offer libraries of images and pictograms, with the option of constructing simple visual sentences.

A concrete example: an application can display pictograms such as “I want”, “drink”, “water”. The user clicks on the images in the right order to form a sentence, which the tablet then reads aloud.

The role of the written word in communication

Even when speech is difficult, some people with aphasia retain the ability to read and write. Writing can then become an alternative means of :

• explain an idea by writing it down in a notebook,

• show key words instead of saying them,

• use lists for shopping, appointments and medication.

A simple notebook or whiteboard can be an invaluable tool. For example, if the person is unable to say “doctor’s appointment tomorrow”, they can write it down or show it on a note prepared in advance.

Combining visual and written communication

In many cases, the image + written word combination gives the best results. The image helps to understand the concept, and the written word supports language memory.

Here’s a concrete example: on an “eat” card, we see both a plate of food and the word “eat” written in large letters.

Creating a visual environment at home

Relatives can put up signs with words and pictures around the house:

• “kitchen” with a photo of utensils,

• “bathroom” with an image of a washbasin,

• “bedroom” with a photo of a bed.

This enables the aphasic person to find their bearings and express themselves more easily, even outside direct conversation.

Visual and written aids do not replace speech, but they do open up new avenues of communication. They enable people with aphasia to express their needs, take part in exchanges and regain a degree of autonomy in their daily lives.

Patience and active listening: two indispensable qualities

Living with aphasia takes time, lots of time. Progress is often slow, sometimes uneven, and this can be frustrating for both the person and those around them. That’s why patience is a fundamental quality in all support.

For loved ones, it’s important to accept that the person may need more time to understand a sentence, find the right words or answer a question. Silences may seem long, but they are necessary to allow the brain to do its work. Interrupting too quickly, or finishing sentences for the person, can create a feeling of helplessness and loss of control.

Active listening completes this patience. It’s not just about hearing the words spoken, but also observing facial expressions, gestures, gaze – anything that might give a clue as to what the person is trying to say. Often, an approximate word or gesture accompanied by a certain tone of voice can be used to guess the intention and validate the message.

Here are a few simple tips for practicing patience and active listening:

• Turn towards the person and look at them as they speak, to show that you’re giving them your full attention.

• Nod, smile, show visual signs that you’re really listening.

• Repeat or rephrase what you have understood to confirm the message: “You mean you went to the park?”

• Give the person time to approve or correct, even if the process is slow.

• Avoid showing signs of impatience such as sighing, looking at your watch or talking to someone else while she’s speaking.

For example, if 65-year-old Paul finds it difficult to say “I have an appointment tomorrow”, he can simply say “rendez-vous… demain… moi”. Rather than guessing too quickly, his wife can reply: “You mean you have an appointment tomorrow?” to validate and encourage communication.

In the final analysis, patience and active listening are not just techniques: they are proof of respect. They show the person with aphasia that his or her words, however incomplete, have value, and that he or she remains an interlocutor in his or her own right.

Therapies and professionals involved

Aphasia rehabilitation does not rely on a single person, but on a multidisciplinary team. Each person brings a complementary expertise to help the person regain as much autonomy as possible and improve his or her quality of life.

The professional most often involved is the speech therapist. He or she assesses the type of aphasia, suggests appropriate exercises and works on comprehension, oral expression, reading and writing. Sessions can be individual or group, depending on the patient’s needs. The speech therapist uses a variety of methods: word repetition, role-playing, simulated dialogues, visual aids, computerized exercises, etc. The aim is not only to “relearn to speak”, but also to restore confidence in communication.

Alongside speech therapy, neuropsychologists play an important role. They assess memory, attention, concentration, logic and other cognitive functions that may also be affected after a stroke. Their tests enable them to adapt exercises to the patient’s actual abilities, and they often work hand in hand with speech therapists to propose coherent rehabilitation.

Occupational therapists help people to adapt their daily lives: they help them to use communication tools, organize their living space and regain their independence in everyday activities. For example, they can propose personalized communication notebooks, with images and words adapted to the person’s needs, or specific tablet applications.

Physiotherapists are essential when the stroke has also caused motor disorders. They work on coordination, mobility and breathing. The latter is very useful for improving speech, as a clear, well-projected voice relies on efficient breathing.

Finally, psychologists provide emotional support for the person and his or her family. Aphasia can lead to loss of confidence, anxiety and even depression. Talking about these difficulties, expressing emotions and learning how to manage them is an important step in overall rehabilitation.

In short, each professional has a specific role:

• The speech therapist for language.

• The neuropsychologist for cognitive functions.

• Occupational therapists for autonomy and tools.

• The physiotherapist for the body and breathing.

• The psychologist for emotional support.

Working as part of a team enables us to provide comprehensive and coherent care, where the aphasic person progresses in several aspects at the same time, rather than in isolation.

CLINT: the brain coaching program for post-stroke patients

Among the modern tools available to complement traditional rehabilitation, CLINT occupies a prime position. Developed by DYNSEO, CLINT is a cognitive stimulation program designed for people with language, memory or concentration problems following a stroke or brain injury. Its objective is clear: to offer a fun, progressive and personalized re-education program, accessible to all, including the elderly.

CLINT is presented as a tablet application. This choice is not insignificant: the tablet is intuitive, easy to use and requires no particular technical knowledge. For someone who is not at ease with computers, it remains much more accessible than a PC.

CLINT’s main functions

• Memory games: adapted to the individual’s level, they help memorize words, images and logical sequences.

• Language exercises: to help with vocabulary, comprehension and sentence construction.

• Concentration and attention activities: to improve the ability to stay focused on a task, a point often weakened after a stroke.

• Personalized feedback: CLINT records progress, suggests appropriate levels and encourages the user with positive messages.

One of CLINT’s greatest assets is its progressiveness. The first exercises are quick and simple, so the user doesn’t get discouraged. Then, as successes are achieved, the difficulty increases, stimulating the brain without creating too much pressure.

How CLINT fits into rehabilitation

Speech therapists and neuropsychologists often recommend daily exercises to achieve lasting progress. But between rehabilitation sessions, it can be difficult to find suitable activities. That’s where CLINT comes in:

• You can play for 5 to 15 minutes a day, at your own pace.

• Family and friends can accompany him, turning the exercise into a moment of sharing.

• The results are visible: more fluent speech, better memory, new-found confidence.

For example, 62-year-old Luc started using CLINT three months after his stroke. At first, he couldn’t name simple objects. After a few weeks of daily play, he found the word “chair” when he saw a picture, even though he’d been stuck on it for months. This small success has given the whole family renewed confidence.

Emotionality: a key factor

An important point is that CLINT is not limited to technical exercises. Encouraging messages, progress monitoring and a playful approach make rehabilitation less intimidating and more motivating. For many users, rediscovering the pleasure of learning is an essential step towards recovery.

In short, CLINT is not a substitute for professional sessions, but an effective complement to them. Accessible, motivating and customizable, it offers a modern solution for continuing to make progress every day, even at home.

The central role of family and social support

Aphasia affects not only the person concerned, but also their whole family and sometimes even their circle of friends. Losing one’s words, having difficulty making oneself understood or understanding others can lead to a breakdown in communication and gradually isolate the person. This is why the support of loved ones and the maintenance of social ties are essential at every stage of the rehabilitation process.

The primary role of the family is to remain present. Spending time together, continuing with the usual activities, even with adaptations, helps the aphasic person not to feel left out. Family meals, board games and walks are all opportunities for communication that complement speech therapy sessions or exercises using tools such as CLINT.

The second role of family members is toadapt the way they communicate. Many families report that they have learned to speak more slowly, to ask simple questions, to use gestures, drawings or even communication books to make themselves understood. These efforts may seem small, but they create a calmer, more reassuring environment for the person with aphasia.

It’s also important toencourage the person to take an active part in exchanges, even if they don’t speak much. For example, they can be asked to choose between two options with a gesture or a picture card, or to point out what they need. Even the slightest participation boosts self-esteem and prevents the person from turning in on him or herself.

Emotional support is just as crucial. After a stroke, some people experience a real emotional shock: they feel diminished, are afraid of no longer being understood, dread losing their friends. Those close to them need to be attentive to these signs of distress, encouraging small victories and reminding them that progress takes time.

Finally, maintaining an active social life is essential. Leisure clubs, patient associations and conversation groups for people with aphasia offer spaces where communication is facilitated and everyone feels understood. These activities prevent isolation and boost morale, which in turn promotes cognitive recovery.

In short, family and friends are not just spectators: they are an integral part of rehabilitation. Their attitude, patience and emotional support can make a huge difference to the aphasic person’s progress and well-being.

Adapting the environment for better communication

The environment in which a person with aphasia lives plays a huge role in his or her ability to communicate and regain independence. A home or living environment that is too noisy, poorly organized or full of distractions can make communication much more difficult, even if those close to the person are already using good strategies.

The first step is to reduce noise distractions. Television or radio in the background complicates understanding, especially when several people are speaking at the same time. It’s best to turn off noisy devices during important conversations, or move to a quieter room to facilitate the exchange.

Secondly, it helps to make the visual space more legible. For example, putting labels with words and pictures on doors or cupboards makes it easier for people with aphasia to find their bearings and name objects. You can write “kitchen” on the corresponding door, “cupboard” on the cabinet, or put pictures of food items on the boxes to make them easier to recognize.

There are also wall-mounted communication boards, placed in the kitchen or living room, where the person can show pictures to express their needs: eating, drinking, going out, seeing the doctor… This avoids long explanations when words fail to come.

For some people, organizing a space dedicated to communication is very useful. This space can contain :

• a whiteboard with a marker for writing or drawing

• a notebook with photos of family, friends and places frequently visited

• a tablet with an application such as CLINT or a pictogram board

The person knows he or she can use this space to prepare ideas, write a note or show a picture when he or she can’t speak.

Finally, it’s important toadapt conversation times. Talking in a quiet room, with sufficient light to see gestures and facial expressions, and avoiding times when the person is tired make communication more effective.

In short, environmental design is not complicated: a little organization, labels, visual aids and quiet time are all it takes to make daily life a lot easier for a person with aphasia.

Available resources and associations

Living with aphasia doesn’t mean facing difficulties alone. Numerous resources exist to support those affected and their loved ones, from information and workshops to financial aid and discussion groups. Knowing about them gives you access to practical advice, specialized services and a valuable support network.

In France, several associations play a major role:

• France AVC: this national association provides information on stroke, its consequences and the different stages of rehabilitation. It also organizes discussion groups for patients and families, and awareness-raising campaigns for the general public.

• Fédération Nationale des Aphasiques de France (FNAF ): defends the rights of people with aphasia, offers conversation workshops and training for caregivers, and puts families in touch with professionals.

• Discussion groups for family carers: these enable relatives to exchange experiences, find moral support and share tips on how to better support their aphasic parent or spouse.

• Specialized hospital services: in many rehabilitation centers, there are specific programs for people with aphasia, with multidisciplinary teams and adapted workshops.

Online resources are also available:

• sites offering practical information on communicating with an aphasic person

• explanatory videos to learn how to use tools such as pictogram charts

• forums where families can ask questions and talk to other caregivers

Some associations even organize cultural or sporting events open to people with aphasia, with activities adapted to encourage participation and break down isolation.

Last but not least, local social action centers (CCAS ) and departmental disability centers (MDPH ) can provide information on financial aid, home support and job placement schemes for people whose aphasia limits their professional activity.

In short, there’s a real network to support people with aphasia and their families. Knowing where to turn means you can find support more quickly, share experiences and avoid being left alone to face the difficulties of everyday life.