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A. Create an Atmosphere Conductive to Successful Communication
- Treat the aphasic patient as an adult.
- Create an atmosphere in which the individual is encouraged to make decisions, offer comments, and communicate thoughts and desires.
- Remember that successful communication is the goal, regardless of the modality or quality of the response.
- Ignore the grammatical errors and poor articulation if you understand the message.
- Do not turn "conversation" into "therapy" by correcting or requesting repetition unnecessarily.
- Really listen, give undivided attention.
- Keep distractions and background noise to a minimum.
- Try to keep the communication situation relaxed, thus facilitating reactive utterances.
- Seek and appreciate humor to lighten the communication interaction.
B. Maximize the Aphasic Patient's Ability to Understand
- Look at the person when you speak.
- Speak slowly and clearly, but speak with natural intonation and loudness. Make the most of facial expression and tone of voice, without overdoing it.
- Supplement your speech with natural gestures and pointing.
- Have paper and pencil available. Write down key words from your message, or even sketch a picture, if it will help to your point across.
- Repeat and rephrase as needed.
- Take your time.
- Confirm that you are being understood. Ask simple questions to make sure. Determine if yes/no responses are reliable, then structure your questions accordingly.
- Keep your messages focused, i.e., one message at a time. Simplify long, complex directions. Break into steps, if possible.
- In a group, one speaker should talk at a time, and switch speakers slowly.
- Change topics slowly, and with warning.
- Ask for guidance or feedback from the aphasic individual. What helps the most? Does it help if I write some words?
C. Understanding Speakers with Aphasia
- Be an attentive, active listener.
- Be patient, and allow the individual to complete his or her own statements.
- Do not routinely anticipate and fill in the end of statements. However, such assistance is appreciated in some instances. Be sensitive to the abilities and desires of the person. Find out if they want your help, or would rather have more time to finish the statements themselves.
- Focus on what the patient is able to communicate, regardless of the modality (spoken, gesture, written, facial expression, vocal intonation, body language).
- Confirm your understanding by a natural conversation style.
- When you don't understand, encourage the use of gesture, pantomime, writing and drawing. Always have a pencil and paper available.
- Give the aphasic individual enough time to respond. Before you speak again, watch closely for cues that the individual may be thinking or preparing a response.
- Observe and discern the communication strengths and liabilities of the talker. Rely on the strengths, and try not to let the liabilities get in the way.
- If the individual produces few words, but lacking in meaning, listen and watch for the bits of information that emerge from the words, facial expression, and gesture. Ignore the non-words.
- Ignore the content of preservations (repetitive utterances) because they are likely to have little meaning. But attend to the way in which they are spoken, because that may convey meaning (e.g., agreement, disagreement).
- Again, be patient and enjoy the exchange. Focus on what you so understand, rather than the communication failures.
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