Communication Activities for Severe Aphasia

Aphasia often results in word-finding difficulties. Common therapy approaches for naming include talking around words (semantic feature analysis), listening and repeating (errorless learning), the cueing hierarchy and naming from description.

Many people with aphasia can improve their naming skills with practice. However, some individuals with more severe aphasia and/or apraxia of speech continue to have considerable difficulty producing words and as a result have very limited speech output.

Communication is more than words. We can effectively communicate by using other means of communication such as writing, drawing and gesturing. We call this multi-modal communication. This does not always come naturally. We therefore need to train and encourage people with aphasia (especially those with more severe expressive language difficulties) to use others ways of communicating.

Below, you will find some activities which can be used to train the use of multi-modal communication.

Activity 1: Barrier Game

Speech therapy apps for word-finding such as Naming Toolbox have in-built naming therapy activities. However, you don’t have to only use the in-built activities. Think outside of the app, choose from its 500 photos and use them to train the use of multi-modal communication.

1) The person with aphasia chooses a photo from the Naming Toolbox app.

2) The therapist cannot see the photo they have chosen

3) The therapist prompts the person with aphasia to try to communicate what the photo is by writing, drawing, or gesturing.

The person may be able to write all or part of the word. They may make some spelling errors. Their drawings may be confusing or unclear. The therapist may therefore need to ask some yes/no questions e.g. "Is it something you wear?".

Make sure the person with aphasia has a pen and paper. Using the Notes app on their iPad for drawing and/or writing is another option.

Activity 2: The Famous People Protocol

The Famous People Protocol is a motivating activity for people with severe aphasia

The Famous People Protocol is a motivating activity in which the person with aphasia is given a photo of a famous person and they have to convey who it is. They may be able to say part of the word but if not they could try writing the person’s name, make a gesture, indicate their profession by drawing etc.

If the famous person is a singer, they might even try singing or humming one of their songs.

A Famous People Protocol powerpoint presentation and scoring sheets are available on the Aphasia Bank website.

Activity 3: Copy & Recall Therapy with Naming Toolbox

Naming Toolbox can be used in writing therapy

Individuals with more severe writing impairments can benefit from a treatment approach called Copy and Recall Therapy. This simply involves copying a written word 3 times, covering it and writing it again.

1) Ask the person with aphasia to go through the photos in Naming Toolbox and to choose 10-20 words they wish to practise writing.

2) Also consider other more personal vocabulary that may be of benefit e.g. names of family members, places the person goes to often.

Activity 4: Google Maps

Google Maps can support communication when talking about holidays, weekend breaks, restaurants etc

You'd be surprised how helpful Google Maps can be in a supported conversation. Prompt the person with aphasia to use Google Maps to show you where they have been, what their favourite restaurants are etc.

I once had a client with severe apraxia of speech who used Google Maps and Google Street View to show me the exact car garage where he went to get his tyre fixed during his trip to France.

If you have any other tips and tricks that you use in therapy to train and encourage multi-modal communication, please log in and make a comment.