Difficulty With Spoken Language

Difficulty with spoken language is the defining characteristic of aphasia.

No matter what type of aphasia you have, spoken language will be involved. In mild aphasia, spoken language might be mostly intact with only minor difficulties. A minor impairment might be difficulty with repeating or word-finding (thinking of the right word).

In severe aphasia, a person might not be able to communicate using spoken language at all. Some people say the same word over and over again (perseverate), but can use different intonations to convey different meanings. Still others will speak in long sentences, but the words do not make sense together, or might not even be real words.

Common Speech Impairments Following a Stroke or Brain Injury

Here is a list of some of the most common areas of impairment.

• Repetition: inability to repeat words/phrases
• Word-finding: difficulty with thinking of the right word, or having the word “on the tip of your tongue”
• Agrammatism: difficulty with sentence structure, word order and grammar
• Slow, halting, and/or laborious speech
• Word errors, including substituting sounds in a word, or using the wrong word
• Use of non-words: invented words that have no meaning
• Perseveration: using the same word, or few words, repeatedly. Some people use the same word with different intonation to convey different moods and meanings.

Some people with aphasia are aware that they have trouble speaking. Others are not aware of their errors. Difficulty with spoken language can be very frustrating for the person with aphasia. However, it can be just as difficult for family, friends, and other communication partners.

Strategies for Communicating with Someone With Aphasia

A few strategies that are helpful when communicating with someone who has difficulty with spoken language include:

• Using multi-modal communication. This means incorporating gestures, writing/drawing, pictures, or technology to help with communication
• Asking questions to confirm that you understood the intended message
• Allowing plenty of time for the person to get their message out
• Being patient and persistent when you or someone you know is having trouble speaking
• Letting them know that you care about what they have to say