Using Supported Conversation

Communicating with someone who has aphasia may feel challenging at times, but with the right approach, it can be meaningful, positive, and enjoyable. Below, Speech & Language Therapist Karen Stromberg shares her top tips for carers and loved ones interested in using supported conversation techniques.

So, what is supported conversation? It's a way of communicating that helps people with aphasia express themselves and understand others more easily. It involves using a range of strategies to reduce barriers. The aim is not to “fix” communication, but to support it, so that the person with aphasia can take part in conversations as fully and confidently as possible.

💬 Understanding Aphasia

Aphasia affects how a person understands or uses language, but it doesn’t affect their intelligence.

A helpful mindset to keep in mind is:

“I know you know.”

The person you’re talking to likely knows exactly what they want to say, they may just need more time or a different way to express it.

🌿 Creating the Right Environment

Small changes to your surroundings can make a big difference:

• Choose a quiet space with minimal distractions
• Turn off background noise (TV, radio)
• Sit face-to-face where you can maintain eye contact
• Make protected time and don’t rush conversations
• Take regular breaks

🤝 Building Better Conversations

Give Time and Space

• Allow the person extra time to process information
• Give them time to respond at their own pace
• Don’t finish sentences or anticipate their answers too quickly - you might be wrong! Speaking for someone can lead to feelings of frustration, isolation and loneliness. 

Be Open and Honest

• It’s okay to say: “I didn’t understand, can we try again?”
  
• Make informed guesses or clarify: "Are you talking about...?"
• Reword or rephrase to check understanding: "Are you saying you would like to go shopping tomorrow?"
• Misunderstandings are normal and expected
  

Make it Meaningful

• Talk about topics they enjoy
• Use humour where appropriate
  
• Take breaks - conversation can be tiring!

🧠 Adapting Your Communication Style

Keep It Clear

• Use short, simple sentences
• Share one or two ideas at a time
• Speak at a natural pace (not rushed, not exaggerated)
• Signal a change in topic
• Encourage self monitoring: "You said tea. Do you mean tea?"

Use More Than Words

Support understanding with:

• Facial expressions
• Gestures and pointing
• Tone of voice
• Writing or drawing key words

Stay Observant

• Watch for non-verbal cues
• Encourage any form of communication - speech, gesture, writing, drawing

❓ Helpful Questioning Techniques

Some types of questions are easier to answer than others:

• ✔ Ask one question at a time"Do you want a tea?", "Do you want a coffee?"
• ✔ Offer forced choices:
  “Apple or banana?”
• ✔ Use yes/no questions
• ✔ Ask focused open questions:
  “Is it about your family?”

You can also:

• Rephrase: “Do you mean…?”
• Clarify: “Are you talking about when we…?”
• Summarise: “So we talked about…”

🧩 Helping Find the Right Word

If someone is struggling to find a word, try:

• Sound cues:
  “It starts with ‘b’…”
• Description cues:
  “It’s something you eat… it’s round…”
• Sentence completion:
  “You write with a… pen”
• Choices:
  “Is it an apple or a banana?”

Encourage:

• Gestures
• Writing
• Spelling

🛠️ Tools That Can Help

Simple tools can make communication easier:

• Pen and paper
• Phones and tablets
• Alphabet charts or word cards
• Photos (printed, or digital)
• Communication books or personalised charts
• Diaries or calendars
• Maps
• Conversation logs
• Magazines or familiar items

📝 A Final Thought

There’s no single “right way” to communicate - what matters most is patience, flexibility, and connection.

Every person with aphasia is different, so take time to learn:

• What helps
• What doesn’t
• What works best for them

Try to imagine what it might feel like to live with aphasia, and put yourself in their shoes. Communication is a shared responsibility, and the way we adapt can either create barriers or open doors.

With patience and understanding, we can help ensure every person feels heard, valued and included.