Individuals with aphasia who have trouble understanding spoken language can have different kinds of problems.
Some individuals have more trouble at the beginning of listening to a message. This has been called slow rise time. If you are missing the beginning, you may have trouble following the rest of the message. One way to help this is to get the person’s attention first by calling their name and introducing the task. For example, you could say, “Let’s talk about our dinner plans tonight.” Then go on to say, “Tonight we are going to have dinner with our friends Mary and Joe.” This gives a “warm-up” to the topic.
Sometimes people with aphasia just don’t retrieve the meanings of the words being used fast enough or with enough certainty to understand the whole message. In this case, using a slower speech rate or repeating the message may help.
Sometimes people with aphasia hear the word, but the brain connects what is heard to a related word that is not really the one being said. For example, if you said: “I got a new cat”, it would be possible for the person with aphasia to think of a dog instead of a cat. This could lead the person with aphasia to say something like “Walking?” to ask if you are walking your new pet. This might seem strange to you, but is more easily understood when you realize that the person with aphasia linked the word “cat” that you said to the meaning “dog”. Paraphrasing with additional and alternative words can help. For example, you could say, “I got a new cat. She meows a lot but she also purrs a lot.” This extra information that helps to describe the cat will help the person with aphasia link to the meaning “cat”.
Sometimes people with aphasia hear the word, but it doesn’t sound to them like a real word. For example, if you say “Please put the book on the table”, the person with aphasia might hear “batle”. In that case, the person may not know where to put the book. Using gestures or additional information can help here. If you pointed to the table, or added some additional information like “the table by the chair”, this could help the person with aphasia understand.
Some people with aphasia understand most of the nouns that are being used in sentences, but have difficulties understanding the “little words”, verbs, and verb endings that form the grammar of what is said. For example, if you say “The girl with the red purse is being kissed by the boy”, this might be understood as “Girl – red purse – kiss – boy”. So, the person with this kind of auditory comprehension problem might understand that the girl with the red purse is kissing the boy – not being kissed by the boy. Articles, prepositions and other functor words – in this example, like the word “by” – are not processed. Something that can help here is to simplify the types of sentences that are being used. Break them into shorter sentences and avoid the use of lengthy, complex sentences.
Finally, some people with aphasia who have difficulty understanding what is said can read some words. So, it is helpful to write out key words on some scratch paper while you talk. For example, you could write the words “new cat” or “book – table” for the messages above.